As Congress hammers out its final version of health-care reform, the bipartisan compromise legislation is moving away from radical changes to the current system. As Congress pushes incremental approaches, the focus is on meaningful reform and phase-in strategies to meet President Clinton's goal of universal coverage. The moderate view in Congress may reflect the general shift noted in the recent Times Mirror poll that shows public support for employer mandates waning even though the desire for universal coverage remains strong. Oddly, as the pendulum swings to the right in Congress, Californians are swinging left as they open their debate on the single-payer model for health care.

As ideal as these benefits sound, they come with costs. The costs do not exceed the present costs that we pay for our private and public system, but do require everyone to contribute their fair share toward universal and comprehensive coverage. The cost of providing universal coverage for all Californians will be about $100 billion. More than half of the revenue would come directly from government programs such as Medicare and Medi-Cal. The rest would be generated by eliminating employer-based premiums and using a payroll tax on employers, a flat 2.5% income tax, a 2.5% surtax on those who make incomes above $250,000 for individual returns and $500,000 for joint returns and a $1-per-pack tobacco tax.