Good move, Mr. Speaker. The single payer health care measure incorporated in Senate Bill 562 was “woefully incomplete” as Assembly Speaker Anthony Rendon declared. Rendon’s move to bury the bill in the Assembly Rules Committee was driven by both policy and political concerns. The health care improvements cannot be fixed by one state alone, even one as rich and as powerful as California.
SB 562 has numerous policy problems—“fatal flaws” the Speaker pointed to in his release announcing the bill was dead for now. Among those policy hurdles listed in the release: “financing, delivery of care, cost controls, or the realities of needed action by the Trump administration and voters to make SB 562 a genuine piece of legislation.”
Politics was also a problem for Rendon and his majority Democrats. Activists in the Democratic Party have threatened to support or oppose elected officials based on the one vote they make on SB 562. However, many politicians were concerned about voting for a bill that would come with a massive tax increase. Assembly Democrats avoided the damned-if-you-do, damned-if-you-don’t vote by Rendon’s decision.
Any long-term health care solution is going to have to incorporate both federal and state action. It will also have to be careful not to remove the profit motive that spurs medical innovation.
The key problem in all the health care solutions is cost. Funding the California single payer proposal was clearly a major issue, with even the best scenario requiring a $100-billion-plus tax increase. The Affordable Care Act is breaking down over rising costs. The difficulties the Republicans in Congress are having with formulating a health care bill founders on the cost problems.
Conservatives in Congress intend for the GOP bill to cut costs by billions of dollars, banking that cutting the taxes required under the Affordable Care Act will stimulate economic growth and allow people to purchase the insurance they need. As Wisconsin Senator Ron Johnson wrote in a New York Times op-ed: “The primary goals of any health care reform should be to restrain (if not lower) costs while improving quality, access and innovation.” However, those cost reductions are partly accomplished in the Senate bill with cuts in funding for Medicaid (Medi-Cal in California) and other services. That has proved a stumbling block for more moderate Republicans.
In a Washington Post column, Henry Olsen, senior fellow at the Ethics and Public Policy Center, and one-time Republican political activist in California, wrote that conservatives might be surprised at Ronald Reagan’s focus on the human dimensions of health care concerns before dealing with matters of cost. It becomes a delicate balancing act. Olsen quoted Reagan, “we can be compassionate about human needs without being complacent about budget extravagance.”
Some supporters of SB 562 have labeled their proposal “Medicare for all” based on the Medicare program in place for seniors. However, the Medicare program is not as all encompassing as the California single payer proposal that consists of no payments, no deductibles, and all-inclusive benefits.
Seniors make Medicare payments and are allowed to buy secondary policies to increase their health care coverage, for which they pay. As one doctor suggested to me, the country has succeeded as a capitalistic society so a universal system that covers basic health services with an additional insurance purchased on the open market could satisfy health advocates and the public. That is the way Medicare works now.
But that solution won’t satisfy those who want all health care costs to be covered by the government.
As I wrote previously, creating a single payer health care system for anyone who declares residency in California is a formula encouraging a population increase. Think of the Argonauts who rushed to California for gold or the Sooners who drove their wagons into Oklahoma for free land. “Free” health care would create similar energy.
California taxpayers cannot afford to fund a borderless society. The health care solution is going have to be a combined effort of state and federal governments.