An informational and advocate meeting to discuss efforts to pass a single-payer health care system in California drew a packed room of people in the Mission District in San Francisco on Saturday afternoon.
Two panelists at the meeting sharply refuted arguments against Senate Bill 562, called Healthy California, the single-payer measure stalled in the California State Assembly in June by Speaker Anthony Rendon. The state senate has already passed the measure, which, as advocates propose, would use a combination of state and federal money and new, relatively small tax increases to pay for all needed medical costs for Californians. California would have to obtain waivers from the federal government to fold Medicare and Medi-Cal and other federal money into the state plan.
Cowan said the editorial, which claimed the plan would cost an estimated $400 billion annually, was misleading. For example, California already spends $368 billion annually on health care, Cowan said, and a single payer system is predicted to save an additional $37 billion through consolidation and bargaining power. The state also receives $225 billion for health care from the federal government, which would be folded into the new program.
So the $400-billion figure is misleading and contains errors of omission once one also considers the monetary offset of people not having to pay insurance premiums, deductibles and co-pays for medical, dental, vision, mental health treatments and prescription drugs covered under the plan.
The editorial also claimed a 15 percent payroll tax would be needed to pay for the new system, but advocates are pushing for a 2.3 percent increase on gross receipts on businesses and a 2.3 percent increase in sales taxes, Cowan said. The first $2 million on gross receipts of businesses would be exempted, creating a boon for small companies with only a few employees. The sales tax hike also would not be applied to necessities, such as groceries.
Cowan also argued the proposal is NOT fee-for-service, as claimed by the editorial. Under the proposal, health care providers would be given leeway to manage their own systems and patients would have freedom as well to choose providers, he said. The editorial argued, “It would prohibit co-payments or deductibles,” as if it were a flaw in the proposal.
”But that’s a good thing,” Cowan remarked as the crowd applauded and cheered.
Another panelist, Laksh Bhasm, chair of the San Francisco Berniecrats Health Committee, called Rendon “disengenuous” on the issue and said he was “covering for Jerry Brown.” He argued Rendon wasn’t interested in the policy underpinning the proposal. Advocates of the proposal believed the legislation was going into conference—or, to put it another way, would be studied and considered—in which all the details of the funding mechanisms would get debated and sorted out. Instead, Rendon just pulled the plug on it after calling it “woefully incomplete.” Advocates, however, were prepared with amendments and funding suggestions and other ideas, but were shut out.
It should be noted that Gov. Brown once supported a single-payer health care system but has since apparently changed his mind on the issue. In 1992, Brown said:
My preference is that we create a single system, put everyone under a universal health care system. We treat health care not as a commodity to be played with for profit but rather the right of every American citizen when they’re born.
But recently, Brown has said he didn’t know how such a system would work in California. In addition, Bhasm said the fact that Rendon didn’t want to work on the policy issues showed he wasn’t dealing seriously with the proposal. California has a Democratic governor and Democratic super majorities in the state’s governing bodies.
Another speaker at the meeting, Dan Geiger, co-director of the Business Alliance For A Healthy California, argued that businesses “stood to gain a lot under single payer.”
Small companies, as mentioned before, would be exempt up to $2 million in gross receipts from the new taxes and their employees would have health insurance through the state plan. If a small business currently provides health insurance to employees, this could translate into significant money savings. Large businesses, Geiger said, could also significantly reduce the money they spend on benefits coordination and expenses. Single payer would also free up entrepreneurs to start new businesses or workers to change jobs without worrying about losing access to medical care, he said. This would drive economic development.
All the panelists talked about the need for outreach to explain the proposal to people. It’s difficult to get people to wade through the numbers. At this point, given Rendon’s move to stall the proposal, it has become grassroots effort across the state. Should it become a ballot initiative or can the state’s Democratic leadership get fully behind the measure? A recent poll commissioned by the California Nurses Association, which supports single payer, showed 70 percent of Californians support a single-payer system.
The Republican debacle over health care recently in the U.S. Senate—the debate sunk down to how many people the GOP should deny medical access with “skinny” repeal—has exposed the greed and callousness in our current system. Every advanced country in the world offers a form of universal care at much lower costs and, in many cases, with far better medical outcomes. California can and should lead the way on single payer.