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How Californians View Current Health Care Reform Proposals

Armen Hareyan's picture

Health Care Reform Proposals

A new report summarizes how Californians across the state view the major health care reform proposals being debated by state lawmakers in the final weeks of the legislative session.

From employer mandates to single payer coverage, the report outlines what conditions must be met in order for the public to support specific proposed reforms. The report is based on the findings of CaliforniaSpeaks -- a 3,500 person statewide conversation that took place simultaneously across eight California cities on August 11.

The final report, issued today, showed that Californians want major health care reform passed this year. Among the findings, 82% of the participants believe the system requires major change, 86% said they believe that it is essential or important for reform to pass this year, and 84% said they were at least somewhat willing to share responsibility to help pay for reform.

The report's findings give lawmakers a detailed picture of how Californians see the critical elements within the reform packages, and offer lawmakers insight into the public's perspective on health reform as they work to pass legislation this year. The data represents the collective judgment of thousands of Californians who took part in a day-long deliberation in which they learned about the issues, shared their ideas, and voted on the options using electronic keypads.

Forums were held simultaneously in Sacramento, San Diego, Humboldt County, Fresno, Los Angeles, San Luis Obispo, Oakland and Riverside.

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Fifty-three percent of participants said that part-time, seasonal and other non-traditional workers must be included in order for them to support a mandate on employers to provide health coverage to their employees, also known as "pay or play." Other conditions for supporting an employer mandate included provisions to prevent employers from reducing coverage or benefits (49%), caps on rising costs (48%), and protections for small businesses (45%). Five percent of participants said they would support an employer mandate under any conditions.

Conditions for supporting a single-payer health care system included controlling costs and bureaucracy (55%), maintaining choice for providers (53%), and ensuring quality of care regardless of geography or income (51%). Sixteen percent of participants said they would support a single-payer system under any circumstances.

Other reform options that were discussed include an individual mandate that would require all Californians to have health insurance, an expansion of public programs to cover vulnerable populations, a guarantee for health care coverage by insurance companies, and a variety of cost control measures.

The real-time, nonpartisan health care discussion blended small-group dialogue with cutting-edge technology. The event was organized by AmericaSpeaks, a nonpartisan, nonprofit organization with the mission of providing Americans with a greater voice in policy making.

"While political and media pundits continue to ponder the future of health reform in this state, 3,500 Californians ignored the rhetoric and sent a simple, powerful message to California's lawmakers," said Dr. Carolyn J. Lukensmeyer, founder and president of AmericaSpeaks. "Now that the state budget has been resolved, it is time for leaders to turn their attention to health care reform and respond to the public's sense of urgency."

The eight sites were linked by satellite, so that participants could see and hear what other attendees said across the state. Skilled facilitators led face-to-face discussions at each location while ideas were recorded, considered and voted upon throughout the day with personal voting keypads. To ensure that attendees spanned all different ages, ethnicities, and socio-economic backgrounds, CaliforniaSpeaks used a random selection process to invite most of the participants to take part in the conversation.

CaliforniaSpeaks was a nonpartisan discussion without ties to special interest groups, and did not support or oppose any specific proposal. The program was made possible by grants from three independent foundations: The California Endowment, Blue Shield of California Foundation and The California Wellness Foundation. Additional funding was provided by Alliance Healthcare Foundation, The Sierra Health Foundation, and The San Francisco Foundation.

Most recently, AmericaSpeaks convened thousands of New Orleanians to create their city's recovery plan. AmericaSpeaks has engaged more than 130,000 people across the country on such topics as shaping municipal budget priorities in Washington, D.C., creating regional plans for the greater Chicago and Cleveland regions, and developing rebuilding plans for the World Trade Center site in New York City.