The Wall Street Journal had this tragic story last week about a Merced man -- who was insured -- but still socked with a $1.2 million hospital bill (not counting thousands in doctor's office bills also).

What happened to Jim Dawson, of Merced, that landed with debt that could bankrupt him is a textbook example of what health consumer advocates have been fighting to reform for years.

Dawson had a good job with Valero Energy Corp., a big oil refinery. He had Valero-sponsored comprehensive health insurance policy, and a regular primary care physician who knew his medical history, *should* not have been vulnerable to medical-financial angst. That's at least what many think. But Dawson's story shows how anyone can be vulnerable.

Shane Goldmacher at Capitol Alert has the scoop on the most recent developments:

The Assembly sessions for December 5th and 6th are now postponed. There was an issue that they conflicted with retreats with the Assembly and Senate Republican caucuses, and it seems they need more time in negotiating on health reform.

We've heard from various Assembly offices that the Speaker has asked members to be available within 24 hours notice.

By Anthony Wright
Executive Director
Health Access California

As health reform negotiations go on, I continue to be puzzled why the Governor has yet to publicly budge on having some--any--affordability standard for individuals in the context of a mandate. Any other politician, concerned about voter reaction, would not just include affordability in their plan, but lead with it. The presidential Democratic candidates, like Clinton, Obama, and Edwards, both provide assurances to voters than coverage will be affordable, both in terms of costs (tied to a percentage of their income), or in terms of benefits (for example, saying that people should have access to coverage as good as what Congress gets).

Some, like healthcare blogger Alan Katz, have criticized the notion of an affordability exemption--saying it undermines the point of a mandate. The Governor's team asks, "don't you want universal coverage?" Of course, but I think they misunderstand the point.

The America's Health Insurance Plans is patting itself on the back for discovering that the majority of high-deductible health plans, which are connected to Health Savings Accounts, cover recommended preventive benefits -- meaning that patients can go in and get pap smears, well-baby visits, colonoscopies without having to pay full price for the office visit.

Okay... that's a good start. But what happens when your preventive screening shows you have Diabetes? Asthma? Breast Cancer? Then what?

Herein lies the problem. Actually, there are a couple problems.

The era for public reporting of medical safety and cost data is now! That’s why transparency is a key piece of healthcare reform.

In a new survey from the esteemed Commonwealth Fund, three-fourths of health opinion leaders said that increased transparency about quality and price is important to improving the U.S. health system performance. More than 4 in 5 opinion leaders think that stimulating provider performance improvement activities is the key benefit of quality and price transparency.

By Anthony Wright
Executive Director
Health Access California

For another time this year, the Assembly Health Committee Wednesday passed comprehensive health reform legislation aimed at expanding coverage to a significant swath of California’s 6.5 million uninsured. The newly reconstituted Assembly Health Committee voted on the first health reform bill of the special session, ABX1 1 (Nunez/Perata) and vowed to send the bill to its Senate counterpart by the end of the month. The bill passed on a 10-5 party-line vote.

Earlier this week, Speaker of the Assembly Fabian Nunez (D-Los Angeles) and Senate President Pro Tem Don Perata (D-Oakland) announced the framework of a new healthcare universal healthcare proposal.

Health Access California Executive Director Anthony Wright stayed up late to take an in-depth look at the framework, compared it to the vetoed AB 8 and offers his analysis. For anybody that wants to see the details before the legislative language is made available, check it out.

By Anthony Wright
Executive Director
Health Access California

In preparation for the Wednesday hearing on the Governor's health reform, here's the Health Access California 15-page letter to the Governor with our issues.

The proposal isn't a bill, but most of the consumer, community, and constituency groups that I work with say they oppose the measure if there was no change... but we hope that by being clear about our concerns, it creates the conversation to get to a compromise that we can be actively in support.

By Anthony Wright
Executive Director
Health Access California

Aurelio Rojas in the Sacramento Bee has a terrific story about the young and uninsured, which Robert in Monterey at Calitics comments on extensively.

As we stated on this blog previously and in the article, twenty-somethings are the biggest slice of the uninsured, but it's not because they don't want coverage: it's that they are more likely to be low-income, to work at jobs that don't provide coverage, to not be eligible for public programs. When offered coverage, they take it up at similar rates as other age groups.

The question is whether we can offer coverage that is affordable, available, and administratively simple.

Last week's 48-hour, candle light vigils were a great success. Held in six cities around the state -- Sacramento, San Francisco, Fresno, Riverside, Los Angeles and San Diego -- the vigils drew lots of interest from health advocates, and the local press.

Check out some of the local news reports below the fold.

By Anthony Wright
Executive Director
Health Access California

Yesterday, the Department of Managed Health Care released a draft of proposed regulations to stop insurers from retroactively denying people for health coverage.

Because this is an informal comment process on "post-claims underwriting," the draft proposed regulation text is not posted to the Department’s web site. However, it was the subject of some press, by Lisa Girion in the Los Angeles Times, and Victoria Colliver in the San Francisco Chronicle, as well as California Healthline.

Wednesday at noon, the coalition kicked off 48-hour vigils for healthcare from Sacramento down to San Diego. Vigils are being held outside six district offices of Governor Arnold Schwarzenegger to continue to apply pressure him on healthcare.

Here in San Francisco, several members of the local clergy of various faiths spoke to the amassed crowd. Mayor Gavin Newsom spoke at the opening ceremony and lit a candle along with others in support of meaningful healthcare reform. Attendees also signed a large "reality check" for the Governor.

For more of the story, check below the fold.

Below is a statement issued by the It's OUR Healthcare! coalition, correcting Tuesday's story in the Los Angeles Times.

Health Access Executive Director Anthony Wright digested the 200-page proposal from Governor Arnold Schwarzenegger announced at a press conference this week and produced a thorough critique of the plan.

By Anthony Wright
Executive Director
Health Access California

We'll post our analysis shortly on the Governor's language... but one thing...

The Governor suggested yesterday that it is just the numbers left to negotiate. Actually, it's not just the numbers. There's still issues about the fundamental framework. It starts with an individual mandate, without condition, exception, or limit.