Now What?
Rules, Regs and Political Snips
By Melinda Eppler
Healthcare Reality
California’s newly re-elected governor came to power two years ago saying he was a new broom ready to sweep out all the old government-as-usual vested interests and take on the bureaucratic culture of Sacramento. Now, on the heels of his landslide election victory, Arnold Schwarzenegger is vowing to tackle healthcare in our state.
But the governor has tapped the usual suspects and a boatload of folks with deep connections to the Sacramento status quo. Is this pragmatism? Foolhardiness? Showing his true colors?
Evidence of the governor’s focus on improving, if not reforming, California’s healthcare system began last summer when he organized a highly successful Health Care Summit at UCLA, focused on healthcare affordability. The event brought together state and national representatives of business, consumers, labor, providers, health plans, insurance companies, private foundations and academic organizations, as well as members of the California Legislature. It was there Schwarzenegger announced his administration, in collaboration with all healthcare stakeholders, would develop a proposal to address healthcare affordability by the end of 2006.
Further evidence came when the governor swiftly approved SB 162 by Sen. Debra Ortiz (D-Sacramento) at the final hour before last fall’s election, thereby paving the way for the overburdened Department of Health Services to be split into two departments, institutionalizing a new, stand-alone Department of Public Health (see Prosper’s Now What? November 2006).
And, since his overwhelming victory this past November, the governor has proceeded to build a strong and strategically necessary political infrastructure within his administration. The goal: to bring a health proposal forward and move it, in a bipartisan manner, toward implementation.
Herb Shultz, a Democrat, is serving as Schwarzenegger’s senior adviser for health policy. Shultz was most recently vice president of government programs for McKesson Health Solutions, where he had oversight of disease management and nurse advice in the government Medicaid and Medicare programs.
A consultant in partnership with Shultz, Republican John Ramey is a widely known veteran from the George Deukmejian and Pete Wilson administrations. Since his 1996 exit from government, Ramey has worked in the private sector and since 2000 has served as principal and partner with Ramey, Macomber & Associates, specializing in healthcare and health insurance contracts.
The olive branches the Schwarzenegger administration has extended to the Legislature, and the relationships built with a large group of healthcare stakeholders, will be critical to the success of any new statewide plan or initiative to improve healthcare.
Minority Revolt
California’s Republican legislators held onto their seats better than their Congressional colleagues in November elections, but Assembly Republicans have engaged in a bit of “intrarevolt.” The 32-member Assembly minority caucus ousted its leader, George Plescia (R-San Diego), who had served in that role only half a year.
The new leader is Mike Villines (R-Clovis), owner of a public relations company from the city immediately east of Fresno. Villines is a former advance man and legislative aide to Pete Wilson and chief of staff to state Sen. Chuck Poochigian (R-Fresno).
The shakeup comes after a year in which Schwarzenegger largely worked around the Legislature’s Republicans. He struck deals with the majority Democrats to raise the minimum wage, push for greenhouse-gas reductions from industry and cut costs for prescription drugs.
Assembly Speaker Fabian Nunez (D-Los Angeles), who was re-elected by his colleagues to a third term as Speaker, says he hopes Villines will work with Democrats to “continue the bipartisan progress” they achieved with the governor.
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