California Needs To Lead Way On Single Payer

As national Republicans still mull over how many people they are going to deny medical access to in order to give tax cuts to wealthy people, some California Democrats and their allies have taken the first steps toward establishing a health care system based on a single payer.

While it’s disappointing the single-payer proposal recently stalled in the legislative process that doesn’t mean the values and the cost effectiveness of the idea itself has been rendered dormant. In fact, the Republican’s fumbling efforts to put together a plan to replace or reset the Affordable Care Act have only made the single-payer argument more cogent and viable in the last couple of weeks.

Last month, Anthony Rendon, the speaker of the California State Assembly, removed the legislative proposal, titled Healthy California, from consideration after the state senate had passed it. Rendon called the proposal “woefully incomplete.” At issue, as with every major health care proposal, was the financing of such a large undertaking. Under the bill, the state of California would essentially finance health care for its residents.

Rendon was met with derision by National Nurses United and others for his decision to stall the proposal, and one of the conventional wisdoms that emerged immediately, as represented by this article in the New Republic, was that if California, with its Democratic governor and legislative super majorities, couldn’t pass a single payer system then it was a non-starter elsewhere and especially on a national level.

But that was before Republicans in the U.S. Senate failed to come up with a majority of votes for a new national health plan, casting much needed light on how difficult it is to provide medical coverage in a system designed to make profits for insurance companies. As U.S. Senator and former presidential candidate Bernie Sanders said, “If the great state of California has the courage to take on the greed of the insurance companies and the drug companies, the rest of the country will follow. The eyes of the country are on California today.”

It’s easy to understand if not accept Sander’s rhetoric here. One might even argue that if California established a well-functioning and humane universal health system then all the “cares” as in Hillarycare, Obamacare and Trumpcare, would become quaint memories of a more barbaric age when Americans placed the importance of business profits above the medical needs of the populace.

It’s obvious that a single payer system in California would be expensive. The New Republic article parses the numbers. It would mean increased taxes, but that would be offset by the lack of insurance premiums, deductibles and co-pays. That doesn’t even bring into consideration that people would no longer have to hassle with health insurance companies working diligently to pay out less money and bring in more money. Here’s more on the proposal from the Healthy California site.

What the Republican debacle over health care has revealed, along with its inept, crass and lying president, is that there is a fundamental disagreement over how we should approach health care in this country. Do we first consider the needs of sick people and design a system that provides them health care in efficient and effective ways or do we myopically focus on a business model that ensures profits to companies? Now that this disagreement is finally making some headway into Trumpland—the people who voted for Trump and other Republicans in the last election would suffer the most because of proposed Medicaid cuts—California’s proposal doesn’t seem so farfetched.

The fight to create a single payer health care system in California will go on. At this point, it’s probably the most effective national mainstream protest against what most Senate and House Republicans aim to do, which is to deny more people medical care and make it more expensive for others. If the Senate Republicans do pass a repeal of the ACA this week with no alternative plan or some callous, immoral plan it will make the fight for single payer to become even more urgent in California.

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