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IN THE STATES: Governors Who Have Walked the Walk

Governors Arnold Schwarzenegger of California and Christine Gregoire of Washington co-hosted the fifth of President Obama's health care forums in Los Angeles earlier this week.

As the Los Angeles Times wrote, "A wide array of forum participants, including hospital and insurance company executives and the mother of a teenager who died from a preventable hospital-acquired infection, gave voice to the growing desire for change." The director of New America's Health Policy Program, Len Nichols, participated in the discussion, as did representatives from Health CEOs for Health Reform.

The White House live-blogged the event, as did the California Endowment, which helped host the discussion. Video of the event will be available here soon and a partial transcript of the forum is posted here.

The issues raised during the forum should be all too familiar to the followers of health reform. One mother told the story of her son who died from a preventable staph infection. Another participant recounted how the cost of insurance broke his family financially saying: "I grew up in this country that I knew I had the right to an education, and if I got in trouble with the law I had a right to a defense. Why don't I have a right to have health care?"

Their stories are the reason, as Governor Schwarzenegger asserted, that "We've got to act and we've got to create the action, and this is the year where we can do it." Because as  Governor Gregiore said "Every governor—Republican or Democrat—would tell you it's not only a moral imperative, it is an economic imperative."

And while these Governors can talk the talk of health reform, there is no question that they have also walked the walk of health reform. Actions taken during California's year of reform have served as the blueprint for many of the proposals currently under consideration in the nation's capital.  And programs already in place in a majority of states, including Washington and California, may act as a model of policy innovation that will allow us to find a solution to one of the thorniest questions of this round of reform. 

The issue, quite familiar to readers of this blog and followers of this round of reform in the nation's capital, is whether Americans should be offered the choice of a public health insurance plan.  As Len Nichols and John Bertko pointed out in their "Modest Proposal for a Competing Public Plan," more than 30 states offer state employees the option to choose between traditional private insurance plans and a plan or plans self-insured by the state. For more information about why such plans can serve as models for future reforms, read my piece in the Sacramento Bee last Sunday

California has plenty of experience with navigating this polarizing debate.  We will reflect in days to come on lessons from California's year of reform, but there is no question that executive leadership from Governor Schwarzenegger was instrumental in getting the state as far down the road as it did, despite all the mitigating and complicating factors of state-level reform. And the paths blazed by States such as California, Washington, and Massachusetts are currently being traveled by members of Congress.  As such, Governors Schwarzenegger and Gregoire were ideal conveners for this event. Their experiences and their voices should continue to inform the national debate.