States, heal thyselves

Chris Reed at "America's Finest Blog" has been digging into Gov. Schwarzenegger's health care proposal and finds an insurmountable wall that can't be torn down without Congress and the president, or the federal courts.

The elephant in the punchbowl is called ERISA, a federal law that prohibits states from dictating health-plan coverage - to avoid a hodgepodge of laws in all 50 states. Reed writes:

"Last week, (former) state Attorney General Bill Lockyer told me that in Sacramento, there was an awareness that the governor's health initiative might not survive the ERISA challenge, but that 'some are of the view that Congress would change the law' if California actually did pass something grand and ambitious. Wow - realism about how Arnold's initiative might be made lawful instead of boundless, groundless optimism."

Reed's analysis is here. It's long, and he takes a meandering tour through Central Europe at one point, but it's worth a look. In any event, whatever Schwarzenegger and the Legislature produce on health care reform, it's likely to be challenged with a referendum like in 2004 with Proposition 72, which overturned a pay-or-play system of health coverage for employers. After that, we can talk about the federal courts.

Today, Schwarzenegger heads to Eureka for a demonstration of telemedicine - linking a 6-year-old patient, her mother, a pediatrician in Eureka and neurologists in Phoenix.

On Tuesday, Dr. Schwarzenegger spoke with patient Ivy Harris of San Diego during a tour of the emergency room at Scripps Mercy Hospital (pictured.) According to a pool report of the visit, Harris has been in the hospital since Friday due to complications from a March 20 surgery to remove intestinal blockage.

"The hospital is taking good care of me," Harris told the governor. She questioned Schwarzenegger about how his health care insurance reform plan might affect unmarried women such as herself, and she noted that her out-of-pocket costs for health care have increased substantially in recent years. "We should have free health insurance," she said.

"Someone always has to pay for it," the governor replied. "What we want to do is make sure that health insurance covers everyone."

(Photos: Laura Embry/San Diego Union-Tribune, via AP; Duncan McIntosh/Office of Gov. Schwarzenegger.)