Single payer stunt makes a comeback

It’s back. On Friday, Assemblyman Ash Kalra, D-san Jose, introduced Assembly Bill 1690. The minimal text of the bill announces, “the intent of the Legislature to guarantee accessible, affordable, equitable, and high-quality health care for all Californians through a comprehensive universal single-payer health care program that benefits every resident of the state.”

We have been here before. Kalra introduced a single-payer proposal last year by way of Assembly Bill 1400, which didn’t go anywhere.

The California Nurses Association has vowed “to spend the next year growing support for Calcare,” the proposed single-payer system, “outside and inside the state’s capitol.”

No one should expect much from the effort. While the notion of a single-payer system excites many progressive lawmakers and interest groups, it doesn’t take much looking around to realize California simply does not have the governing chops to be trusted with such a responsibility.

As shown by the scandal around the Employment Development Department, California’s state government can’t even mail out checks correctly.

In 2021, state officials admitted to paying out as much as $31 billion in unemployment checks to scammers. The previous year, the state auditor reported the EDD “has sent at least 38 million pieces of mail containing claimants’ full Social Security numbers.”

Can Californians really trust a state government with that sort of administrative and privacy-protecting competence to handle health care?

Then there’s the cost.

Last year, Calmatters cited legislative analyses estimating

such a system would cost somewhere between $314 billion and $391 billion per year. For reference, the governor’s entire proposed state budget for 2023-24, including special funds, calls for under $300 billion in spending.

A recent survey by the Public Policy Institute of California found that 70% of Californians believe they pay “much more” or “somewhat more” state and local taxes than they should. A single-payer health care system will cost far too much for most Californians to stomach.

Again, it might be one thing if state government demonstrated competence in, well, anything. The same state that has struggled to build a high-speed rail line between Bakersfield and Merced can’t be taken seriously on any great new responsibilities.

And this is before getting into discussions of health care policy itself. Of the trade-offs of a single-payer system versus the current mixed system. What will happen to the quality and availability of care? Will private sector health providers be allowed to operate? Will health care be rationed? What will the true costs be? And, importantly, should government be doing this?

For all these reasons, and more, it’s best to regard Kalra’s effort as just another political stunt, a joke maybe, because he can’t be serious.