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California's Initiative Process Could Lead the Way on Real Health Insurance Reform

Given a chance to do something simple, clear, and fair to limit insurance company death panels and to punish bad faith insurance decisions, many people might stand up for beginning health insurance reform the way they stood up for car insurance reform.

A century ago, California voters decided that we should be able to use popular initiatives to pass legislation that our elected representatives were not enacting. And for a while it worked. But as corporate money has taken over so much of our government, it has also pretty much taken over the field of ballot initiatives as well.


Click here for the March 8, 2011 ballot recommendations.

The first big, modern corporate success in ballot measures was Proposition 13. Although it was sold as a measure to protect homeowners from rising tax rates, the funding for the measure was mainly from big real estate investors. And the result of their campaign is that some downtown office buildings can now pay real estate taxes similar to what some single family homes pay.

Proposition 13 essentially destroyed the tax base for public schools. More recently, we have had corporate-funded campaigns to deny schooling and other services to Latin American immigrants. And then the corporate jackpot in the campaign to replace Governor Grey Davis with Gropenator Arnold Schwarzennegger. The Gropenator’s most consistent approach to state budgets has been to demand more and more cuts in school funding and education at all levels.

Do you see a common theme here? It isn’t just short-term financial gains that the corporate initiatives seek, but a long-term undermining and destruction of California’s once proud and world famous education system. Corporations see an educated population as the single greatest threat to their profitability.

Wander into any McDonalds or other fast food franchise and watch the workers as they ring up orders. They don’t need to be able to read the menu or total your bill. Picture symbols on the register buttons take the place of word labels. And the registers calculate both the total and the change from the money you give them. Fast food restaurants profit if neither the workers nor the customers are even able to read the terrifying nutrition information posted beside the counter.

The success of corporate ballot campaigns is revealed in the current noise about health care (let’s not call it a “debate” when one side has formally published its goal of disrupting and silencing the voices on the other side). Most people have either experienced, or know someone who has experienced an insurance company “death panel” denying coverage for care to someone who spent decades paying premiums. But all the noise we hear from bussed-in agitators at town meetings is about government death panels.

The bussed-in agitators, like the McDonald’s workers, may not be able to read the legislative proposals that they rail against. But for a few weeks, people who ignore them for all of their lives are paying attention and even putting them on TV. After trashing reforms which might have helped them, they will sink back into lives of drab obscurity and quiet desperation, but knowing that they had their brief moment in the spotlight.

And what of those who can read and who care about their own well-being and that of their parents, children, and grandchildren? Is it possible that the initiative process might provide solutions that our current crop of elected legislators will not give us? Could a voter initiative provide relief from, at least limit, some of the most egregious misconduct of insurance company death panels?

Consider the possibilities. How about a measure that said something like: “Any insurance company that makes a decision about what treatment a patient receives, overruling the patient’s doctor’s recommendation, will be deemed to be practicing medicine for purposes of any malpractice action brought by or on behalf of the patient.” A second section of the measure could empower a jury to decide whether the insurance company’s denial of coverage was in good faith or not. If not, the jury could impose punitive damages on the insurance company.


Right now, insurance company death panels can deny medical care to a patient and cause the patient to die. Panel members don’t need medical training or licenses and don’t need to follow any rules of acceptable medical practice or ethics. Their only goal in overruling the patient’s doctor’s advice is to achieve higher profits. A ballot measure which said that overruling a doctor’s advice is just as much “practicing medicine” as the doctor’s original advice was, would be simple, clear, and understandable for the average voter.

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It would also be anathema to insurers, who now pay no consequences when they deny coverage to someone who is clearly entitled to it under the terms of their policy. Insurers would pay billions in campaign funds to defeat such an initiative.

But what of those people who want insurance companies to be accountable? Would they campaign for such a measure? Remember Proposition 103 a few years ago? It was a citizens’ initiative to reform the corrupt business of auto insurance. Insurance companies fought tooth and nail to defeat it. They claimed that it would push rates sky high. But it passed, and everyone’s car insurance rates went down.

Look at how campaigns operate now. President Obama is in office because people supported him with the new Internet campaign world. Groups like Move-On got people organized, energized, out into the streets, and then to the polls. Since then, the corporate world has tried to ride the same energy. They have mobilized everyone who hates the idea of a black president to attend meetings trashing anything that “Marxist n****r” in the White House proposes.

This is a good thing. The neo-con rabble are burning their energy on a corporate campaign which doesn’t have any payoff for them. When they have trashed health care reform, they will cry victory and then discover that that damn “Marxist n****r” is still in the White House. They will discover that having defeated public health care, they still have to contend with insurance company death panels.

A large number of them may be discouraged from joining the next corporate campaign. Some may even think about what happened, how they were used, and end up rebelling against corporate control.

On the other hand, a fairness-oriented campaign to hold insurers liable when they practice medicine might help energize voters who are now under-represented. Latinos are rapidly becoming a plurality ethnic block, but they vote at lower than average rates. As they struggle to play by the rules and build better lives for their children, they understand the cost of corporate decisions to deny coverage for which they’ve paid, or to impose business decisions to over rule the recommendations of doctors trying to treat their children.

A campaign for a measure to make insurance death panels medically accountable might resonate with such citizens and motivate them to become voters. Just as Neo-con corporate campaigns strive to craft an emotional message for their divisiveness, a campaign for medical accountability for insurance death panels could resonate broadly with voters if it combined themes of fairness for insurance customers and responsibility for the corporations who collect the premiums with promises of coverage when it’s truly needed.

Tom Hall

Given a chance to do something simple, clear, and fair to limit insurance company death panels and to punish bad faith insurance decisions, many people might stand up for beginning health insurance reform the way they stood up for car insurance reform.

Tom Hall