California bill for universal health care creates higher taxes, single-payer system

CAL/AAEM News Service at
Fri Apr 7 18:01:21 PDT 2017



March 30, 2017


California bill for universal health care creates higher taxes, single-payer



sal-health-care-creates-higher-taxes-single-payer-system> Santa Cruz
Sentinel Health



By Tracy Seipel and Katy Murphy, Bay Area News Group


An ambitious proposal to create a single statewide insurance plan for every
Californian - including undocumented residents, seniors on Medicare and
people who now get their health coverage through work - began to take shape
on Thursday when two legislators released details about what services would
be covered and who would run the giant program.


Still missing, however, are the details that have bedeviled universal health
care advocates for decades: how much it would cost taxpayers. And the plan
will be difficult, if not impossible, to execute without permission from
Washington to steer billions of federal Medicare and Medicaid dollars into a
trust fund that covers everyone.


But advocates say it's time for California to prove that a universal
approach to health care isn't just possible for the U.S., but also cheaper
and less anxiety-inducing than the employer-based system now in place.


"I hope that people will have the vision and the guts to do it," said Sheila
Kuehl, a Los Angeles County supervisor and former state lawmaker who made
numerous attempts to make universal health care the law of the land a decade
ago, only to have the bills vetoed by then-Gov. Arnold Schwarzenegger.


A single-payer system generally works like this: Instead of buying health
insurance and paying for premiums, residents pay higher taxes. And those
taxes are then used to fund the insurance plan - much like Medicare provides
insurance for Americans 65 and over.


With its simplicity, low overhead and cost controls, single-payer insurance
"has the potential to create a lower cost health care system, so in total it
could very well be that people in this state would pay less for health care
than they do now," said Larry Levitt, a senior vice president at the Menlo
Park-based Kaiser Family Foundation.


One author of Senate Bill 562, Sen. Ricardo Lara, D-Bell Gardens, argues
that the approach "covers more and costs less."


"We have the chance to make universal health care a reality now," Lara said
in a statement about his bill, the Healthy California Act, which is
sponsored by the California Nurses Association and a coalition of
Californians and health care providers. "It's time to talk about how we get
to health care for all that covers more and costs less."


The law would be administered by a nine-member, unpaid board appointed by
the governor and Legislature and a public advisory committee of doctors,
nurses, health care providers and consumers. The board also would develop
proposals related to long-term care, retiree health care and health care
services covered under worker's compensation.


But there are significant political hurdles. Experts say that unless the
federal government allows California to funnel Medicare and Medicaid dollars
into the system, it will be all but impossible to carry out.


And the health insurance industry, which would be upended by such a plan,
has come out strongly against the bill.


"California led the pack in expanding quality health care to millions of
residents over the past four years; we cannot jeopardize our progress by
hastily instituting a failed model during this time of uncertainty," Charles
Bacchi, president and CEO of the California Association of Health Plans,
said in a statement Thursday.


Advocates are also eyeing another challenge: the governor himself.


Jerry Brown rarely comments on current legislation, but he recently
expressed deep skepticism.


"Where do you get the extra money?" Brown asked during a conversation with
reporters last week during his visit to Washington, D.C., just before the
GOP health care plan fell apart. "This is the whole question. I don't even
get. . How do you do that?"


The ambitious California proposal is similar in its goal to a single-payer
health care system that Democrats like Vermont Sen. Bernie Sanders have


Proponents say that with its 39 million people, California is large enough
to make the system work - unlike Vermont (population 620,000), where in 2014
a similar effort fell apart after the governor decided it would cost too


"I think that Bernie Sanders' campaign last year indicated there was broader
support for single-payer than a lot of people understood," said Gerald
Kominski, a professor of health policy at the UCLA Fielding School of Public
Health. "This is an issue that's not just going to go away."


But one longtime critic of single-payer plans on Thursday called the Senate
proposal "a budget buster."


"This is a utopian socialist plan that will be very costly for the state
budget and result in major tax increases for Californians, if passed and
signed into law," said Sally Pipes, president and CEO of the San
Francisco-based Pacific Research Institute, a nonprofit that promotes
limited government.


Pipes is originally from Canada, whose publicly funded health care system is
viewed by some Americans as a model for the United States. But Pipes said
the system has resulted in "rationed care" and growing wait lists to see a


One advocate for the single-payer approach, however, said he has one
question for those who question its viability: "Why is it that every other
country does it and it's cheaper?" asked Andrew McGuire, founder and
executive director of California OneCare, which is raising money to launch a
campaign for the proposal.


The full California bill is available at




The bill's authors say their proposed single-payer system would include
these features:


. Coverage for all medical care, including inpatient, outpatient, emergency
care, dental, vision, mental health and nursing home care.


. No co-pays or insurance deductibles.


. Ability to choose your own doctor from a full list of health care
providers rather than an insurer's network.




Jeff Wells
Deputy Editor, CAL/AAEM News Service


Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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