Editorial: How Newsom, California Should Approach Single-Payer

A single-payer health care system may yet prove to be the best alternative for California and the nation. But Gov.-elect Gavin Newsom should make clear that the Legislature shouldn’t waste time on any legislation in 2019 unless it includes a prudent financial plan that makes sense for California consumers, health care providers and business interests.

Newsom called for installing a single-payer system during his campaign but has been tamping down expectations since July — with good reason. California can’t possibly make it work unless Congress and the president cooperate.

The federal government would need to turn over to the state all the Medicare and Medicaid money it spends in California. That’s about $200 billion annually. How far do proponents think they will get as long as Republican Mitch McConnell is Senate Majority Leader and Donald Trump sits in the White House?

Until there’s a viable financial plan, the governor should instead prioritize other pressing California issues that demand immediate attention, including tax reform, wildfires and paying down pension debt.

Meanwhile, single-payer proponents should use 2019 to bring together the broadest range of interested parties possible to explore the issue in detail. It’s the best way to bring forward a credible plan that can win widespread support throughout the state and in Washington, D.C. It also would serve to put health care front-and-center, where it belongs, in the 2020 presidential campaign.

Warren Buffett has it right when he says “the ballooning costs of health care act as a hungry tapeworm on the American economy.”

In 2000, the United States spent only $4,881 per person on health care. That equals $7,312 in today’s dollars. Today, the United States spends $11,193 per person, or more than $3.3 trillion a year.

]Health care accounts for roughly 18 percent of the U.S. economy. The United States cannot expect to compete on the global level when its major Western competitors spend on average only $5,169 per person on health care, or less than 10 percent of their economies. Especially when those same competitors enjoy better outcomes than their American counterparts.

Ultimately, this is a problem that requires a national solution. Jeopardizing state finances is not the way to solve it. California shouldn’t waste time as it did earlier this year debating SB 562, Sen. Ricardo Lara’s single-payer plan. Assembly Speaker Anthony Rendon killed the effort, accurately calling it “woefully incomplete.”

appalling that the state Senate passed the legislation despite, as Rendon noted, failing to address such critical issues as financing, delivery of care, cost controls and the need for federal cooperation. Keep in mind that if California were to adopt a single-payer plan, it would mean, for example, that nearly 6 million senior citizens would no longer be covered by Medicare.  They would instead be placed under the new state plan along with every California resident. That level of change demands a broad, transparent public debate before passage and implementation.

California has made great strides under the Affordable Care Act in bringing down the number of uninsured residents, but the state and the nation clearly need major changes to get health care costs under control. Further exploration of the merits of a single-payer system has merit, but California’s new governor should only move forward when a prudent financial plan with broad support in Washington and Sacramento that has been developed and fully vetted.


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