From the Editor

By Martin Lasden
     
At least as far back as Harry Truman's presidency, prominent politicians have pushed for a comprehensive national health care bill that would give all Americans access to good, affordable care. Yet, after nearly 60 years, all the country has to show for these efforts is an uneven patchwork that leaves 47 million people uncovered. And so the question has now landed before the U.S. Court of Appeals for the Ninth Circuit: Can the city and county of San Francisco-and, by extension, any state, city, or county government-devise an employer-funded, universal health care plan of its own that doesn't run afoul of the preemption clause in ERISA?
      Enacted by Congress in 1974, the Employment Retirement Income Security Act has been to health care reform what black holes are to matter, sucking the energy and light out of just about every local health care initiative that ever crossed its path. And even though Congress never intended for the act to have this effect, the fact remains that absent clarifying legislation, existing case law presents a mind-numbing array of nuances that would have mystified even Saint Thomas Aquinas, whose angels dancing on a pinhead were the talk of his day.
      To write this month's cover story ("ERISA Reflux," page 18), Senior Editor Jeanette Borzo had to wade into the arcana. "I took solace from the many agonized attorneys I interviewed," she confides. "One attorney I spoke with who is representing San Francisco told me he was thinking about the law so much that he was having ERISA dreams." Even the attorney's pregnant wife suffered. In fact, Borzo notes, "She got so sick of hearing about the case that she threatened to name her first-born child Erisa if it was a girl."
      If San Francisco does become the nation's first city with a universal health care plan that survives an ERISA challenge, a whole new wave of local experimentation may follow. And that in turn may force Washington to finally take decisive action to provide comprehensive reform.
      Also in the issue, contributing writer Bill Blum takes a hard look at a very different crisis-this one involving the courts in Riverside County, which for some time now have been wrestling with a huge backlog of felony cases ("No Deal," page 30). Who's responsible? Many accuse the county's tough-talking DA, Rod Pacheco, of dramatically slowing down the wheels of justice by refusing to cut deals on cases that involve serious crimes. But, Blum says, "It's difficult to say how much Pacheco is to blame for the backlog." After all, Blum notes, Riverside also has a rapidly expanding population and a shortage of judges. The real question, of course, is whether, with the help of a special strike team of retired and out-of-county judges, Riverside can dig itself out of the hole. The initial signs are encouraging. But as Blum's piece makes clear, the jury is still out.
     
     

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