Last Thursday, the California state Senate made the bold move of voting to create a single-payer health system without having any idea of how to pay for it.
Ostensibly spurred by concerns over the future of the Affordable Care Act at the federal level, Senate Bill 562 by state senators Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego, would create a single-payer system which would cover health expenses for every resident in California.
Considering the magnitude of such a proposal, the very least that is owed is a thorough accounting of how exactly such a program would be paid for. After all, according to estimates from a legislative analysis provided to the Senate Appropriations Committee on May 22, the proposal is anticipated to cost $400 billion per year, more than double the state budget. While half of that could be covered by existing federal, state and local funding, the other $200 billion would have to be covered by new tax revenue.
Even those figures could be off, because as the legislative analysis explained, “there is tremendous uncertainty in how such a system would be developed, how the transition to the new system would occur and how participants in the new system would behave.”
But rather than provide the sort of thorough vetting such a massive overhaul demands, the bill’s authors instead pushed for a vote on a half-baked proposal advocated by the California Nurses Association and many progressive Democrats.
“There’s no funding mechanism within this bill because we want to further study and ensure that this becomes a program that is viable,” Lara told colleagues on the Senate floor, seemingly unaware of the implications of what he had just said.
The vote came as a poll was released last week by the Public Policy Institute of California showing most Californians support changing the state’s immense, insurance-based medical care system to one in which the state provides universal coverage.
But, the 65 percent support dropped to 42 percent if a single-payer system requires new taxes, which, of course, it would.
The absence of a complete proposal led many lawmakers who are otherwise sympathetic to its aims to either vote against it or abstain.
“Rather than rushing to pass it before it’s complete, we should keep it here and finish the work,” said state Sen. Steve Glazer, D-Orinda, who voted against the bill.
Whatever the merits of single-payer health care in the abstract, what the Senate voted on was a proposal lacking critical details without which a responsible vote in favor is impossible. The prospect of an unvetted bill with hundreds of billions of dollars in proposed annual costs becomes even less sensible in light of the state’s inability to balance the budget it already has.
The proposal would not only cover all Californians who now have some form of health insurance, but nearly 3 million more — mostly undocumented immigrants who lack coverage, and would eliminate out-of-pocket costs for everyone.
Such numbers are a guarantee of higher costs, not to mention additional expenses as co-pays and deductibles are eliminated and more people move to California for free health care.
As state Sen. Jeff Stone, R-Temecula, pointed out, California is already the highest-taxed state in the country. What SB 562 guarantees is the placing of greater burdens on taxpayers, employers and medical professionals. “If you want California to be competitive in the job market, which is very challenging these days, you’ll vote no on this bill,” Stone said.
Rather than voting down a clearly deficient bill, the Senate voted 23-14 in favor of it.
This is a glorified political stunt which, if it proceeds with the same thoughtlessness shown to date, could do real harm to the state of California.