When he was running for governor in 2018, Gavin Newsom enthusiastically called for a “single-payer” healthcare system that would cover all Californians with little or no out-of-pocket.
As Newsom campaigned, the state Senate passed a single-payer bill and Newsom endorsed it, saying there was “no reason to wait.”
“I’m sick of politicians saying they support single-payer but it’s too soon, too expensive, or someone else’s problem,” Newsom said, drawing praise from the California Nurses. Association, the main sponsor of the measure.
The legislation lacked a funding system and stalled in the Assembly. Newsom’s election delighted single-payer advocates, but he didn’t push for it, opting for a commission to study how it could be achieved. When another single-payer bill passed the Senate, it made no effort to gain Assembly approval and also died without a floor vote this year.
This week, Newsom’s Healthy California for All commission delivered its report, endorsing — in theory — “unified funding” that would pay for universal health care coverage, but stopping long before a specific proposal.
“A unified financing system is uniquely positioned to transform the delivery of care and shift the power that resides in health and health care to those who have too often been overlooked,” said the commission chair, Mark Ghaly, Newsom’s senior healthcare executive. cover letter.
The report said that by rolling back the money currently spent on health care by federal, state and local governments in California and imposing certain taxes, such a system could slow the growth of costs, now pegged at $517 billion. dollars a year, while extending coverage to everyone. and save lives.
It is apparent that commission members often disagreed on details, leading to a report containing a list of potential options rather than a clear path to a full system. Thus, he left more questions than answers.
How would California persuade the federal government to agree? What types of taxes would be levied and who would pay them? What services would be included? What about co-payments? How would care be structured?
The two main sticking points are persuading the federal government to give California tens of billions of dollars currently spent on Medicare, Medi-Cal, Obamacare and other federally funded programs, and to raise at least $200 billion in new taxes.
Federal compliance would likely result in congressional action, exposing California to its many critics in Congress. The two recent single-payer bills in California died because lawmakers were unwilling to bear the pressure to raise taxes.
It’s fair to say that Newsom and the legislature are pretty much where they were before the commission was established — having to make many specific and difficult decisions if they want to pursue the cause.
Coincidentally, the commission released its report just as the UCLA Center for Health Policy Research published another version of California health care, concluding that even if a single-payer system were to become a reality, it would not be enough to make California a healthier state. .
Its report calls for defining “health” in a much broader sense than access to medical care, suggesting that “health and well-being include an understanding of the social determinants of health and are relevant to the whole of the state’s population (and) health is strongly integrated with social needs such as housing or education…”
The UCLA report implicitly proposes that policymakers should not only create a universal health care system, but undertake a comprehensive socioeconomic overhaul of California that would eliminate disparities and inequalities.
It is, however, just as vague as the Health Care Commission’s report on how these miraculous goals would be achieved.
About the Author
Dan Walters has been a journalist for nearly 60 years, spending most of those years working for California newspapers. He began his professional career in 1960, at the age of 16, at the Humboldt Times. For more Walters chronicles, go to calmmatters.org/comment.