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Single-Payer Plan Is Politics, Not Policy

John Wildermuth
Journalist and Political Commentator

If you ever wonder why the Legislature’s popularity with California voters is at 16 percent and falling, you only have to know that state Sen. Mark Leno has reintroduced a plan to bring single-payer health care to the state.

Here’s all anyone needs to know about the chances of passing single-payer health insurance in California this year:

1. A Senate analysis of the bill, SB 810, found that it would cost the state $200 billion the first year.

2. Gov. Arnold Schwarzenegger has vetoed nearly identical measures twice before and promises to do it again.

3. California already is looking at slashing basic services for children, the poor, the elderly and the disabled in a desperate effort to close a $20 billion budget deficit.

But that’s not going to stop the usual suspects from revving up the troops for another round of political Kabuki, a highly stylized theater piece where everyone knows from the start how it’s going to end.

The fun started earlier this month with a march through downtown Sacramento and a rally on the steps of the Capitol, with marchers chanting, “Single-payer for our state, right now, we can’t wait.”

“Don’t let anyone say we can’t afford single-payer,” Leno told the crowd. “We can’t afford not to have single-payer.”

The bill moved out of the Senate Appropriations Committee last Thursday on a straight party line vote and now goes to the Senate floor. If past-year’s form holds true, it will pass with support only from Democrats and then move to the Assembly, where it will be approved without a Republican vote.

After a few days of cheering from supporters, Schwarzenegger will veto the bill and single-payer will disappear for another year.

They’ll be plenty of noise in the meantime. The Orange County Register already has run an editorial headlined “Go West, Obamacare,” while Republicans and other conservatives are complaining that the bill shows just how out-of-touch California Democrats are with the new tea-party reality sweeping the nation.

“California Democrats are either tone-deaf or delusional,” said Ron Nehring, chairman of the California Republican Party.

Progressive Democrats, for their part, argue that it’s time someone stood up to the insurance companies and that tough economic times make it even more important to guarantee that every Californian has access to high-quality, affordable health care.

“Health care is a right, not a privilege,” the Consumer Federation of California said in a position paper.

What’s frustrating about the entire single-payer legislative dance is that health care and health insurance are incredibly important issues for Californians. Various types of single-payer plans are used in countries around the world system and the state needs to have a detailed discussion about why it would or would not work here.

That’s not going to happen this year. Leno’s bill doesn’t even include the answer to the obvious question “How much is this going to cost me?” It does, however, call for establishment of a commission that will “develop an equitable and affordable premium structure that will generate adequate revenue.”

A serious bill would talk about where, exactly, the $200 billion a year is going to come from and just how California will be able to afford a single-payer system at a time when the budget is awash in red ink.

But that’s what a serious bill would do and this isn’t a serious bill. For Democrats, it’s a feel-good vote that lets them show their supporters that they feel their pain, without having to face the possibility of actually having to make a single-payer system work in California.

It’s no better on the GOP side of the aisle. Republicans will win political points with their conservative backers by attacking a single-payer plan and ignoring the millions of Californians who would like to see them come up with a health-care alternative.

When single-payer disappears from the political radar for another year, both Republicans and Democrats will be able to say that they fought the good fight.

And Californians will be reminded again of why they hate the Legislature.


John Wildermuth is a longtime writer on California politics.

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