A wise pause on flawed bill

Advocates of a singlepayer health care system are outraged that Democratic state Assembly Speaker Anthony Rendon decided to shelve the legislation for the year.

Their ire is misdirected. They should be appalled that the state Senate voted 23-14 to advance SB562 with so many unanswered questions — including a plausible plan to cover its estimated $400 billion annual cost.

California’s single-payer legislation could not be more different in substance from the Republican health care plan being jammed through the nation’s capital, but they share some common traits in their overreliance on ideological certainty and underreliance on supporting evidence for their magical claims.

SB562 would essentially replace private health insurance with a government-run system that would be funded through a new 15 percent payroll tax (with no cap on wages) and seizure of all health care money now being spent by Medicare, Medicaid, the Veterans Administration and other programs. Anyone who thinks it would be possible to obtain the waivers and law changes necessary to convert those federal funds has not been paying attention to what is going on in GOP-dominated Washington.

The spending side has its own issues. Its fee-for-service approach, which rewards consumption of health care over outcomes, is exactly the opposite of the direction taken by those trying to contain costs. It would prohibit copayments or deductibles. Patients would have the freedom to choose out-of-network providers.

A transition to a singlepayer system is a debate worth having, but it should be a clear-eyed debate, with a full assessment of its costs and a strategy to contain them. SB562, as passed by the Senate, failed each test.