Building the bridge to a national health service

March 11, 2017

OPINION by STEW JENKINS

In their head-over-heals rush to throw the nation backwards, Republicans are about to provoke the California bear out of hibernation to build its own model for a national health service, like every other industrialized nation has built.

The last time California tried this, 73 percent of voters rejected the proposition. But that was 1994; prosperous times, when health care cost was modest compared to what it is in 2017. Now the cost of staying well siphons off 17 percent of every dollar in the economy – everyone’s economy.

On March 23, 2010, when President Obama was able to sign the Patient Protection and Affordable Care Act (the ACA), there was one thing everyone agreed on.

Whether it was democratic-socialist Bernie Sanders of Vermont, or republican Jim Inhofe of Oklahoma, everyone agreed that it was not good enough. President Obama described the law as a step forward. A step short of the universal coverage he saw as the nation’s ultimate goal. But a step toward achieving the “fifth Freedom” Franklin Roosevelt and Harry Truman sought to assure.

Compromises left the ACA with no “Medicare-for-all” option, no controls over drug company prices, and a system preserving and subsidizing the health insurance industry to bring those behemoths on board. In giving individual states the power to set up their own health care exchanges and expand Medicaid, the lead authors never expected that the majority of republican governors and legislatures would turn down local control or free federal money that would improve the health of their citizens.

But in California, the governor, legislature, and citizenry embraced and built a successful state exchange that has served as a major step toward universal health coverage. By Valentine’s Day this year, Covered California records showed that more than 412,000 new people had enrolled in 2017 than had been covered in 2016.

Even with the Trump administration taking steps to end adverting for new enrollment, the number of folks without health insurance had reached a record low in California.

In fact, it was a woman who spent her formative years in Los Osos and Cal Poly who helped build Covered California’s successful system under the ACA, Ms. Kathleen Keeshen, appointed as deputy director, (in plain English, second in command of the program) to the Board of Directors when Covered California was being stood up. With Mitch McConnell, Paul Ryan, and President Trump’s concerted effort to destroy the Affordable Care Act this month, you will not be surprised that Ms. Keeshen flew out Monday to the District of Columbia for conferences about what the State of California is facing.

No doubt about it, we are facing a collapse in confidence and a breakdown in the federal structures that helped California stand up one of the best working health insurance systems in America. Everywhere it exists a single-payer health care system is less expensive, more efficient, and keeps people healthier longer. This fact cannot seem to penetrate the blind spot of the “free market” zealots, McConnell, Ryan and Trump.

In 1994, the legislature found the funding for a universal California health care plan, an income taxes on corporations and the super wealthy. Then it was rejected by the electorate. But propping up Covered California without federal subsidies and mandates will require revisiting a progressive income tax.

If the public is to consider taxing themselves, the cheaper, more efficient and more effective single-payer should be our state’s goal. Either way, the experience of folks like General Counsel Keeshen will be needed to preserve or build California’s health care system.

Prudent preparation to replace the federal structure and funding takes more than marches. Under the arcane rules of the California Legislature, state representatives have a short time in which to introduce a bill. And, when the Republican Congress and President don’t even know how they are going to gut the Affordable Care Act, setting up a state replacement in the few months allowed for introducing state legislation presents a challenge.

There are two California senators who are doing more than marching. Ricardo Lara, of Long Beach, and Toni Atkins, of San Diego, did not wait. They’ve introduced Senate Bill 526, entitled Californians For a Healthy California.

Short as it is, by proposing that it is “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,” it presents the California Legislature with the legislative spine from which to build out a universal California health service available to every resident during the upcoming two-year legislative session. Senator Lara and Atkins deserve support for seeing that something needed to be done to preserve our state’s options.

But they will need more than that. They will need your support and ideas on how to structure and pay for a California health care system.

You can help by sending letters and calls of support to Senator Ricardo Lara, State Capitol, Room 5050, Sacramento, CA 95814; Phone: (916) 651-4033.  And send letters and calls of support to Senator Toni Atkins, State Capitol, Room 4072, Sacramento, CA 95814; Phone: (916) 651-4039; Fax: (916) 651-4939.

More importantly, send copies of those letters of support to our own state senator and assemblyman. Democrat, Bill Monning, needs to know you support a California single-payer health system at his address: State Capitol, Room 313, Sacramento, CA 95814; Phone: (916) 651-4017; Fax: (916) 651-4917.  So does Republican, Jordan Cunningham, 1150 Osos Street, Suite 207, San Luis Obispo, CA 93401; 805-549-3381.

And, for your neighbor Jordan Cunningham, it might be helpful to remind him what another good Republican, Ohio Governor John Kasich, said to a Republican legislator when he was trying to expand Medicaid under the ACA.

“I respect the fact that you believe in small government. I do, too. I also know that you’re a person of faith,” Kasich said. “Now, when you die and get to the meeting with St. Peter, he’s probably not going to ask you much about what you did about keeping government small. But he is going to ask you what you did for the poor. You better have a good answer.”

A single-payer state plan is not just for the poor, it will provide effective health care for all at less cost for all. Now is the right time for California to lead the way.