For example, a central tenet of Schwarzenegger’s health proposal – and one embraced by the reform backers – is that the cost of universal coverage should be shared by employers, workers, health providers and government. But the real question is how to spread the load ($12 billion, under the governor’s plan). Unions fret that workers will be forced to buy coverage they can’t afford. Health insurers worry that they’ll be forced to cover everyone, without any assurance that people won’t simply wait until they’re sick to buy insurance. The California Medical Association, which is also part of the reform coalition, says a 2 percent fee on doctors’ revenue recommended by Schwarzenegger would be unfair to many doctors. Those are just a few of the possible quarrels. Meanwhile, potential adversaries – which include well-heeled interests such as the California Restaurant Association, Blue Cross and the state Chamber of Commerce – could spend millions to derail reform. Those groups have been relatively quiet so far, but that could change if lawmakers close in on a compromise. Still, veterans of past health reform efforts say the atmosphere feels different this year. Having a popular Republican governor at the helm provides a huge boost. “The biggest difference this year from the past,” Senate President pro tem Don Perata, D-Oakland, said in an interview, “is that the governor has declared this his No. 1 issue.” Perhaps equally important, Perata and others say, is that the issue seems to have reached a tipping point in the public conscience. An estimated 6.5 million people are without insurance for all or part of the year, but that’s just part of the problem. Spiraling health care costs are pinching business profits more and more each year, and chipping away at workers’ paychecks. Health-care premiums this decade have grown at more than double the inflation rate; last year they rose 8.7 percent in the state, to $988 per month for a worker enrolled for family coverage, according to the California Healthcare Foundation. The employee’s share of that total: $235 per month – and growing. Those costs are creating a sense of urgency, and bringing unexpected players to the health reform table. Steven Burd, the chief executive of the Safeway supermarket chain and an outspoken proponent of national health care reform, is expected to announce in the next few weeks that a coalition of large businesses will push for change in California as well. On a separate but parallel track, the Silicon Valley Leadership Group, whose members include dozens of high-tech companies, has embraced the governor’s health care push, without endorsing his specific proposal. Among those joining the business group are the AARP, labor unions representing teachers and service workers, and three of the state’s top health insurance companies – Kaiser Permanente, Blue Shield and Health Net. “We believe we are responsible corporate citizens and should be actively engaged,” said David Olson, senior vice president of corporate communications at Health Net. One sign that the coalition appears serious: It has hired a prominent political consultant, David Doak, to craft an advertising campaign. If reform advocates “can gather the resources and stick together,” said Sragow, the political adviser, it could give legislative leaders “political cover” to broker a compromise on health care legislation. Skeptics warn that even if a deal can be reached, opponents could challenge it in court or launch a ballot initiative to overturn it. In 2004, after the Democratic Legislature passed a mandate on medium-size and large businesses to provide health care, voters narrowly overturned it. But the political landscape has changed since then, and reform advocates vow they wouldn’t let that happen again. “Because we came so close last time, everyone knows we could go back to the ballot and win,” said health care lobbyist Beth Capell. Since Schwarzenegger announced his plan for universal health care in early January, he’s been spending much of his time trying to mobilize support. The governor has made dozens of speeches around the state, bemoaning what he calls the state’s “broken” health care system, and held private meetings with interest groups, including some that are unenthusiastic about his proposal. Last week saw the first flurry of activity on the legislative front, as Democratic health reform plans – which mirror the governor’s proposal in some respects and depart from it in others – cleared health committees in the Assembly and Senate. The votes were not considered significant, though, because key details of the plans, including how much employers would have to pay if they don’t provide coverage to workers, haven’t been spelled out. All the while, Schwarzenegger, who has dubbed 2007 the “year of health care,” continues to raise expectations. “California will be the first state, I guarantee you,” the governor said in a speech Tuesday to the California Medical Association, “where we will have universal health care, where we will insure everybody.” [email protected] (916) 441-4603 160Want local news?Sign up for the Localist and stay informed Something went wrong. Please try again.subscribeCongratulations! You’re all set! As Gov. Arnold Schwarzenegger and Democrats begin negotiating a plan to revamp the state’s health-care system, an unlikely band of interests is forming to demand change, raising the hopes of reform advocates that Schwarzenegger will deliver on his promise of universal health care this year. The agitators span a wide spectrum. They include unions and consumer groups, a Fortune 500 supermarket chain, Silicon Valley tech executives and three of the state’s largest health insurers. “You have a group of people who don’t usually see to eye-to-eye coming together on health care and saying, `We’ve got to do something,”‘ said Democratic strategist Darry Sragow, an adviser to the California AARP, one of the groups pressing for reform. “These are people who normally don’t hang out together.” At this point the groups are not uniting behind any one plan, but instead endorsing a set of broad reform principles. And their camaraderie could collapse under the stress of fashioning an actual compromise. Health-care reform has eluded policy makers for decades for good reason: It affects practically everyone, and any change that pleases one constituency is bound to offend another – and hit them in the pocketbook.