Does California want single-payer healthcare?

February 27, 2017

Ricardo Lara

With Republican lawmakers and President Donald Trump planning to repeal some, if not all, of Obamacare, California’s Democrat-controlled state government is considering the idea of instituting a state-run single-payer system that would operate like Medicare. [LA Times]

A single-payer system currently exists in Canada, but it has not been adopted by any state in the United States. Earlier this month, State Sen. Ricardo Lara (D-Bell Gardens) introduced a bill that would make California the first state in the nation to adopt single-payer healthcare.

“In California we say we want health care for everyone,” Lara said last week at a universal health care rally. “In California, we say that health care is a human right.”

Lara also said in an interview that, now more than ever, universal healthcare is popular in the minds of Californians.

If California were to create a single-payer system, private insurers would be replaced with a state agency that would function as an insurance company, paying doctors and hospitals when people seek treatment. All Californians would receive access to health care via the state funded agency. Residents who currently receive insurance through employers would receive coverage through the state.

Bills calling for a single-payer system in California previously made it through the Legislature in 2006 and 2008. But, then-Gov. Arnold Schwarzenegger vetoed both of the bills.

Previous proposals suggested financing the state insurance agency by pooling California’s current funding for Medicaid, Medicare and other health programs, then taxing employees 4 percent of their income and employers 7 percent of payroll. However, a 2008 report produced by California’s Legislative Analyst’s Office found that, even when coupling a tax with pooled state healthcare funds, California would be short more than $40 billion in the first full year of implementing a single-payer system.

“Where were they going to come up with the $40 billion?” said Micah Weinberg, president of the Economic Institute at the Bay Area Council.

Weinberg said single-payer is not feasible to do as a state. He noted a single-payer initiative was scrapped in Vermont, and a single-payer measure that appeared on Colorado’s November ballot failed.

Government officials and healthcare analysts in California have floated other policy proposals the state could adopt instead of a single-payer system. Those suggestions include mimicking how Massachusetts provided universal healthcare and creating a public option — a state-run health plan that would be sold on California’s insurance exchange.

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Taxing employers another 7% of their payroll sounds like a good way to get more of them to take their business elsewhere.

I’d like to know just one thing. Where did this notion that government provided health care is a “human right” come from?

Something implicit in the foundation documents… TLDR? Promote the general welfare , depends on what we decide general means , what’s possible?

You entirely missed the point of those “foundation documents” then, if you think that a human right is what “we decide general means” – the very reason “the Creator” was named as giving inalienable rights is because if given by “the Creator” then “the gubmint” cannot take them away.

There is a reason welfare was the name chosen for government control programs, that is, assistance.

Government instituted for common good protection safety prosperity and happiness of the people not for the profit honor or private interest of any one man family or class… John Adam’s

general welfare public health care shall we create debt to have it ? If we must have debt to create currency , is it possible?

Something implicit in the foundation documents… TLDR? Promote the general welfare , depends on what we decide general means , what’s possible?

I need a new house to promote my general welfare. Why won’t government buy it for me?

Let me put it this way, if it is not a basic human right, then we should stop providing emergency care for and admitting people to the hospital for treatment they cannot pay for. Because guess what, one way or another, we as a society end up footing the bill when people who have no insurance and no way of paying find their way into our health care system. When people start using the ER as their only form of primary care, it costs us as a society a lot more than if we provided them with basic health care.

Let me put it this way: Do not equate a medical emergency with health care. One is urgent, the other is a series of life choices, prevention and education, as well as medical care.

Why not ask for your Auto Insurance (e.g. Geico) to pay for your car’s gasoline, tires, and oil changes? We can call it Automotive Care, and call it a right. I mean, when you’re insured, someone pays when you get in an accident (like an E.R. visit); so if we think all healthcare is like the ER, then all auto-care should be like the body shop after an accident, right?

Great logic. Try not to follow it to it’s conclusion, it will only be confusing.

You can say what you want about not equating medical emergencies with health care, but that doesn’t change the reality that those without insurance DO use the emergency room as their primary health care provider for basic health care. Your car analogy is flawed because a body shop will not even start to repair your car unless you or your insurance company is footing the bill. An emergency room, on the other hand, is not going to deny someone treatment while they figure out if they can pay or not. They treat everyone, send them the bill later, and when those without insurance don’t pay it, the rates go up for the rest of us who do.

Why do you think the rates for ER visits and hospitalization are so high? Because they have to subsidize those who visit the ER and never pay their bill. Unless you deny all health care including emergency care to those without insurance or who can’t pay, you are going to end up paying for them one way or another.

As JimF says, there are plenty of countries in the world that get better overall medical results for substantially less cost with single-payer systems. Are they perfect? No. Are the worse in some ways than ours? Yes. But overall they are better and cheaper.

When looking at the overall costs of health care for a nation (or state), you need to take into consideration all the costs. That includes such indirect costs as higher hospital bills to paying patients and insurers to cover the free care they are currently providing those who can’t pay.

Yes, we would have to raise taxes or otherwise find new funding for a state-wide single-payer system. What we should get in return as compensation are lower hospital costs and an end to health insurance premiums among other lesser benefits. The question is, would be get enough back to compensate as we should. Given the degree of corruption and fiscal gamesmanship in Sacramento, this is a major concern.

Also, in addition to the usual chaos involved in changing systems that big, there would likely be some sabotage attempts by those with a vested interest in the current system — either from economic motivations (health insurance companies and others) or from those with partisan political motivations.

Finally, there is the issue of illegal/undocumented workers. While many of them do pay Social Security and Medicare taxes using phony SSA numbers, that doesn’t contribute to a state funded health care program. We need to either bring them into the system as state tax payers or deny them benefits to keep government-funded health care solvent. (I vastly prefer the former solution but that may not happen given the current US Govt.)

I know you are not supposed to say it, but the only people that WANT single payer system are 1)those that currently pay little or no taxes and get HUGE subsidies or free healthcare and 2)those that want the vote of people referenced in #1.

Under the California single payer plan, undocumented immigrants would be included. The plan has been submitted as a skeleton project because the program hasn’t actually been devised yet.

Do the people paying less than a full premium want single payer, YES

Do the people paying not only a full premium for themselves, their family and paying for several other family’s want single payer, NO