Saturday, February 10, 2018

California discovers the complexity of creating a single payer health care system

California Assembly Speaker Anthony Rendon may have expected to torpedo the idea of a statewide single-payer healthcare system for the long term last June, when he blocked a Senate bill on the issue from even receiving a hearing in his house.

He was wrong, of course. His shelving of the Senate bill created a political uproar (including the threat of a recall effort), forcing him to create a special committee to examine the possibility of achieving universal health coverage in the state. On Monday and Wednesday, the Select Committee on Health Care Delivery Systems and Universal Coverage held its final hearings.
The panel ended up where it started, with the recognition that the project is hellishly complex and politically daunting but still worthwhile — yet can't happen overnight. "I'm anxious to see what it is that we can actually be working on this year," committee Co-Chair Jim Wood (D-Healdsburg) said toward the end of Wednesday's seven-hour session. "Some of the logistics and the challenges we have to deal with are multiyear challenges."

Little has changed since last year, when a measure sponsored by the California Nurses Assn., SB 562, passed the Senate in June and was killed by Rendon (D-Paramount) in the Assembly. The same bill, aimed at universal coverage for all residents of the state, including undocumented immigrants, is the subject of the select committee's hearings and the template for statewide reform.

Backers of the Healthy California program envisioned by the bill feel as if they're in a race with federal officials intent on dismantling healthcare reforms attained with the Affordable Care Act, and even those dating from the 1960s with enactment of Medicare and Medicaid.

In just the last few weeks, the U.S. Department of Health and Human Services has approved adding a work requirement to Medicaid in Kentucky and begun considering a plan to place lifetime limits on Medicaid benefits — profound changes in a program traditionally aimed at bringing healthcare to needy families.

The Republican-controlled Congress effectively repealed the individual mandate in the Affordable Care Act. That is likely to drive up premiums for unsubsidized middle-income insurance buyers and has prompted California and other states to consider implementing such a mandate on their own. (Idaho is moving distinctly in the opposite direction from California, proposing to allow "state-based health plans" that allow insurers to discriminate against applicants with pre-existing conditions.

Read the rest here.


lannes said...

We'll see how the Hollywood types like waiting in line behind masses of indocumentados to receive medical care under this scheme. Free halthcare, a guaranteed income (free money), free marijuana, you name it. What a foolish place.

The Anti-Gnostic said...

Where will they get the money?

unreconstructed rebel said...

From all those Hollywood types. Where else? How about Mark Zuckerberg? That is if we can get him to repatriate any of it.

Michael Martin said...

There is another factor to add to this discussion.

Quite a number of First World countries (e.g., Australia, New Zealand, Scandinavia and Western Europe) have single payer medical care systems that work quite well, thank you very much.

However, ALL of these countries have VERY restrictive immigration policies, which (a) are merit based (i.e., no "visa lotteries") and (b) rigorously exclude migrants with significant health problems.

What California is about to discover, is that you cannot have a functioning single-payer system and also have a "sanctuary city, invite the world" immigration policy at the same time. If Californians actually want a functioning single-payer system, they are going to have to make some tough, rock-hard choices.

Unknown said...


Work quite well? Waiting times for months for simple X-rays or doctor visits and waiting even for years for non-invasive procedures? If that's your bar for working well, I'd hate to see what your definition of working poorly is.

evagrius said...

The definition of working poorly is quite evident in the U.s. with its high rate of infant mortality, maternal death, obesity, diabetes, opiod addiction etc;etc;.

Michael Martin said...

"Waiting times for months for simple X-rays or doctor visits and waiting even for years for non-invasive procedures?"

Not where I live! I can visit my GP whenever I need to, and I have never had to wait more than a few weeks for X-rays or other routine hospital procedures.

Please stop listening to MSM propaganda, and do your own research and think for yourself! Oh, and BTW, please have the courage to actually post under your own name! Otherwise, you advertise yourself as a troll.


Chris said...

I've lived in Europe, Michael. You know what you call hospitals on the weekends over there? Morgues. I've seen the disasters of socialized medicine. It nearly took one of my relatives if it were not for the efforts of another relative who was chief of neurosurgery at a hospital in Munich. By her own authority, she had him airlifted from a hospital in the country to Munich. Had that not happened, he would have died. Rationing and denial of care is typical of such a system. He was saved because of whom he knew. If my relative didn't have her, the result would have been surely different. Even the British NHS has come under fire recently. it doesn't work.

evagrius said...

"Rationing and denial of care is typical of such a system" True for the U.S. You have to have money to pay for, rationing using income as the key is the way to go....

No health care system is perfect. However, if the system provides care to the whole population, even in a limited way, it is functioning as best as it can. The U.S. fails in all measures of health care except in expenditure where it is practically double that of other countries.