California Proposition 52: Voter Approval for Hospital Fee Changes
From the editor: With a mere 24 hours before the election, we've arrived at Part 4 - the final installment - of our 2016 election mini-series. Unlike our previous posts on drug prices and plastic bag propositions, here we'll reflect on a far less contentious initiative: Prop 52, which helps ensure future funding of California's Medi-Cal health care program. In this summary, Hannah reflects on why this particular prop is providing us with a much-needed political-kumbaya moment, including a nice analysis that highlights the value of voting. So enjoy Hannah's writing, and then go make your voice heard: vote!
If you missed the rest of the mini-series, check out Part 1, Part 2, Part 3, and an election edition link lot.
Proposition 52: Voter Approval for Hospital Fee Changes
A desire for quality health care is a rare equalizer in populations with diverse incomes, social statuses, and ideologies. Proposition 52 guarantees more stable protection and regulation of government funding reserved for Medi-Cal, California’s current health care program that provides free/low-cost coverage to vulnerable or low-income individuals. Surprisingly, this proposition has received a wide range of supporters and advocates, making it an ideal example of bipartisanship despite a very polarized political climate.
Medi-Cal is partially funded by state money collected from agreed-upon hospital fees, and partially federally funded. Since the establishment of the state hospital fees in 2009, legislature has often attempted to divert some of the funds collected from hospital fees into other areas of government. Prop 52 would require voter approval to divert future Medi-Cal funds, creating a check on how that money is used. It would also indefinitely extend the lifespan of existing hospital fees, in order to ensure continued Medi-Cal funding (which is currently scheduled to end in January 2018).
YES to Prop 52
The varied arguments in support of Prop 52 demonstrate its wide appeal. Supporters argue that the proposition would both provide more government accountability (through more voter-regulation), and make quality healthcare more widely available in California. To sweeten the deal, the proposition boasts either no negative fiscal impacts, or up to one billion dollars in savings through the continuation of existing hospital fees without any tax increases. So basically: more voter power, better health care coverage, and for-all-intents-and-purposes-free money. This proposition seems to sit in a unique place - right in the middle of the aisles - that allows for an extremely large support network.
NO to Prop 52
There is no formal opposition to Prop 52, however there are still some arguments and predicted flaws. The proposition would make it more difficult to change established policies for Medi-Cal funding, and it is technically increasing bureaucracy. However, the main arguments found from the opposition side can be explained in great detail on this single web page. It is unclear how the money would end up going to hospital CEOs, as the site argues, and there appears to be not much explanation or background available.
Funding and Support
Funding for Prop 52 is heavily skewed toward the supporting side, with around 60 million dollars raised, compared to around 14 million on the opposing side.
- Prop 52 is officially endorsed by the Democratic, Republican, and Green parties, a really really long list of representatives, and a really really really long list of hospitals, healthcare organizations, civic organization, business associations, medical associations, and unions.
- The proposition has been opposed mainly by a handful of individuals, including a single U.S. Rep, and a blogger here and there.
- The original organization responsible for the opposition website and a large portion funding against the prop (Californians for Hospital Accountability and Quality Care) has since switched their position from “against” Prop 52 to “neutral,” dissolving the only official opposing party to the proposition.
Why Prop 52 is Almost Universally Appealing (plus some rumination on voting)
With such widespread support, the interest in this proposition lies less in the arguments of the conflicting sides, and more in why this proposition is able to unite groups that are normally diametrically opposed. In the current political climate, healthcare discussions seem to immediately trigger steadfast stubbornness, with democrats refusing to acknowledge the flaws in existing attempts at universalization, and republicans refusing to acknowledge that beneficial improvements to those attempts are possible. Yet, both parties for some reason have found common ground in this ballot proposition.
This could be because Prop 52 really isn’t doing anything other than continuing the status quo (by ensuring the continuation of hospital fees, and thus a steady funding source for Medi-Cal), and letting voters weigh-in on more things. It is very possible that future votes on allocation and transfer of Medi-Cal funds could not have such clear-cut support or bipartisanship, but it is encouraging that both parties agree that they should be allowed to vote on them.
This could be because of a false sense of control, born of our tendency to believe that a large, diverse group of people (as opposed to a handful of legislators) will somehow be able to converge on the “right” decision. This sense of control is of course spurious, once we consider that the concept of a “right decision” is extremely subjective. Regardless, republicans and democrats alike support the idea of deferring certain governmental decisions (on healthcare and other issues) to a popular vote; they just do so using slightly different rhetoric.
While republicans would argue that voting is an important way to check the government and prevent it from gaining excessive power over its citizens, democrats would stress that voting allows for otherwise-unheard voices to be considered equally with those from power and privilege. Either way, there is no question we all value voting as part of a functional system of government. Are you convinced to vote yet?
Overall, Prop 52 serves as a seemingly rare example of effective politics, and it is a peaceful escape from the current mudslinging. This proposition also proves that some form of compromise between parties is a possible, tangible thing to strive for, and offers plenty of room for future case studies and political analysis on why it was able to work so well. Focusing on political measures that have succeeded in appealing to different ideologies could be a valuable way to determine future policy approaches that would have a higher chance of causing real change.