Single-payer bill is back in Sacramento
Does it qualify as news when legislators file a bill aiming to do a lot but saying very little about how? Yes, when the issue is single-payer health care and the state is California. There’s been no such proposal in Sacramento for the past four years, and, under normal circumstances, there probably wouldn’t have been this year either. But then came Bernie Sanders and Donald Trump.
Sanders almost tipped the Democratic Party establishment’s candidate with a campaign that caught them by surprise. One surprise was the boldness of his issues, including the need for an American universal-access health care system — just like every other industrialized country has. Another was his constituency: He won 70 percent of the under-30 primary vote, a group not previously thought to be interested in such matters. Then came Trump’s victory, and a White House that would likely sign a repeal of the Affordable Care Act coming from a GOP Congress.
Recognizing the need for action, state Sens. Toni Atkins, D-San Diego, and Ricardo Lara, D-Long Beach, have filed the Healthy California Act, which states nothing more specific than “the intent of the Legislature to enact legislation that would establish a comprehensive universal single-payer health care coverage program and a health care cost control system for the benefit of all residents of the state.”
California has considerable history with the issue, starting with an unsuccessful 1994 initiative campaign proposing to replace the private health insurance industry with a state-operated single payer. A 2006 bill passed both houses before being vetoed by Republican Gov. Arnold Schwarzenegger; a scenario repeated two years later. Yet with Democratic Gov. Jerry Brown in office, the Democratic legislative leadership has not allowed such a bill to be filed — the rationale being that the Affordable Care Act should be given a chance to work first.
The new bill is a “shell” — a placeholder to be filled in at a later date. In one veto message, Schwarzenegger declared “socialized medicine is not the solution to our state’s health care problems.” National health care systems do exist — in Sweden and the United Kingdom, for instance — and there’s much to be said for them. But the system Schwarzenegger vetoed — and the system likely to be considered this year — was not one of them. Rather it was a form of “socialized” health insurance, similar to Canada’s, where privately operated health care systems send bills to a single publicly operated insurer, just like the U.S. Medicare system that is wildly popular — and efficient, with operating costs running at only about 2 percent, considerably below those of for-profit insurers. Ironically, Republican proposals to convert Medicaid funding to a block grant program might ease the transition to a single-payer system by reducing federal control over those funds.
Some universal health insurance advocates have always held that success would not come from Washington but from the states, as in Canada, where it started in Saskatchewan and then swept through the nation’s other provinces.
Who knows? Maybe someday we’ll thank Trump for getting us on track. In the meantime, if you, too, think it’s high time we joined the modern world, write, call, text, email — even visit — your legislators and tell them Californians deserve a single-payer health care system.