Another half-baked single-payer bill
Not that any of us needed additional reminders, but Californians in the past year have seen the stark limits of government power as state bureaucracies mishandle their most fundamental responsibilities.
We’re all still reeling from the Newsom administration’s contradictory responses to COVID-19. Meanwhile, the state Employment Development Department struggles to pay unemployment benefits to legitimate recipients even as it paid billions of dollars in fraudulent claims.
Then there are the state’s ongoing miscues that percolate under the radar — its struggles to deal with the homeless and housing crises, the continuing cost overruns with its ill-conceived highspeed rail plan, and California’s decades-long inability to reform the Department of Motor Vehicles. We could go on, but you get the point.
Amid these real-world troubles, California Democrats are once again proposing to take control of California’s entire health care system by proposing a single-payer system. It’s bad enough to wait for an unemployment check, but can you imagine what it will be like when your health is on the line?
“This country either gets it right with Medicare for All, or this state leads this conversation in a way that ultimately advances that,” Gavin Newsom said in an interview during his 2018 campaign. A year earlier, the Senate had passed a universal health care bill that the Legislative Analyst’s Office predicted would cost more than the entire budget.
“This bill wasn’t even halfbaked. It wasn’t even a bill. It was an incomplete list of principles,” said Assembly Speaker Anthony Rendon, D-Paramount, as he derailed that clunker. Yet something similar is back. Assemblyman Ash Kalra, D-San Jose, introduced Assembly Bill 1400 to “provide comprehensive single-payer healthcare coverage” for everyone in the state.
AB1400 is more detailed than the 2017 bill, but still is a half-baked vision statement. “(I)t leaves many of the most challenging details — how much hospitals and doctors should be paid for services, how to reroute federal health care dollars into a single program — to a governing board,” CALmatters reported. It also doesn’t identify funding streams.
CALmatters framed the issue in political terms, given that the bill forces Newsom to grapple with his campaign promises. Should the governor, now facing a serious recall effort, try to energize his progressive base or should he focus instead on the basics? We’re less concerned about the short-term politics and more fearful that the Legislature would consider transferring all of our health decisions to a group of state bureaucrats.
Single-payer proponents believe that the current system of private and public health programs is inefficient. In reality, a mish-mash of private insurance plans and government-support programs is more accountable and reliable than a top-down system managed by a single government entity. Throwing out the current method endangers the mostly top-notch healthcare that Californians now receive — and will lead to easily predictable results.
“The waits imposed by government-run health systems often have tragic and irreversible consequences,” wrote the Pacific Research Institute’s Sally Pipes on these pages last year. In addition to lower-quality care and longer waits, single-payer health systems require enormous tax increases that imperil the economy.
Before lawmakers embrace these proposals, they need to remember how the state handles other matters. Do we want our health care handled with the “efficiency” of the Employment Development Department or the Department of Motor Vehicles?