Friday, March 31, 2017

California’s single payer bill - full text of bill released

Bill Text - SB-562 The Healthy California Act.

Comment by Don McCanne

Now we have the
full text of California’s new single payer bill - SB 562. It calls for
comprehensive health care coverage for all residents of California with
no premium, copayment, coinsurance, deductible, nor any other form of
cost sharing, for all covered benefits. “Resident” means an individual
whose primary place of abode is in the state, without regard to the
individual’s immigration status. It’s the real thing.

week, Gov. Jerry Brown seemed to dismiss the idea of a single payer
system with this response to reporters, “Where do you get the extra
money? This is the whole question.”

Of course,
the money is already there and being spent on health care. Current
government and private spending combined is enough to pay for a
comprehensive system for all residents wherein the administrative
savings and other efficiencies frees up enough funds to pay for those
currently uninsured and underinsured.

There are
two issues that may have prompted the governor’s response: transferring
current federal health care funds to the state, and establishing a
state tax system to replace current private spending.

excerpts from SB 562 posted above indicate that it is the “intent” to
obtain “waivers and other approvals” that would enable the federal
government to transfer to the state funds from Medicare, Medicaid, Chip,
ACA, and other federal programs. The problem is that current waiver
programs are inadequate to fully accomplish that, and new federal
legislation would be required. Considering the composition of the
current Congress, that could be a difficult task (a comment that does
not require a mastery of understatement).

care spending through the private sector is relatively inefficient
compared to spending in government programs such as Medicare. Yet when
the taxes that would replace private spending are spelled out
specifically, they seem overwhelming to the average individual with an
aversion to taxes in general. It is difficult for them to see what they
are already paying for our health care system that is not particularly
transparent such as the component of employer-sponsored health plans
that are only nominally paid by the employer, the tremendous tax
expenditures for employer-sponsored plans that go disproportionately to
higher income individuals, the huge spending for government employee
health plans on the federal, state, and local level, and the costs of
health care built into the prices of services and products to pay for
employee coverage, worker’s comp, liability coverage, and the like. When
that spending goes away and is replaced by government spending, the
taxes to pay for that can look formidable. Just ask former Gov. Peter
Shumlin of Vermont. Then try to sell that to the residents of
California. When you try to explain to them that the tax system would be
more equitable and efficient, and most would actually pay less overall,
they are already blinded by the proposed tax increases that they do see
(but are not yet spelled out in SB 562).

we need is a well designed, national single payer health program. We
should continue to pull all stops toward that goal, though it is
difficult to see when we will reach the political threshold that will
make that possible. Until then we should also support state efforts to
relieve the physical suffering and financial hardship that is being
wrought on our people by our dysfunctional health care financing system.

we should strongly support SB 562. We should make every effort to
obtain “waivers and other approvals,” as difficult as that will be. We
should increase our efforts to educate the public on what a really good
deal this would be for them, otherwise our efforts could be sunk by a
few soundbites from the industries that profit excessively from our sick
system (as they were in prior ballot measures in California, Oregon and

But while we do this, we cannot let
up the least in our advocacy for a national health program. Our
brothers and sisters in other states desperately need our help.

1 comment:

Craig said...
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