Single Payer in California?

The national debate over health care can be summed up in a bill being debated in Sacramento.

Supporters of Senate Bill 810 say the legislation would be the only way to provide medical coverage for every Californian.

Opponents deride the measure as socialized medicine.

The California Universal Healthcare Act was introduced by Sen. Mark Leno, D-San Francisco. The bill would initiate single-payer universal health care for the state of California, Leno said. “What that means in short is Medicare for all,” he said.

Supporter Keith Ensminger, a Merced resident and owner of Kramer Translations, said the largest benefit of the legislation probably would be that it would include everyone. “Everybody would have insurance, regardless of their income and regardless of their position in life,” he said. “One of the bigger benefits for us is that nobody in the Central Valley would be required to remain poor for Medi-Cal. They would still have their insurance paid.”

A high percentage of Central Valley residents are on Medi-Cal.

There would be other positive effects from the bill, said Ensminger, who's a member of Health Care for All, a statewide organization that helped developed the bill. It would lower the cost of insurance for most people, everybody in the state would have a health insurance plan and it would aid people in having medical conditions treated early rather than waiting.

In addition, it would prevent medical bankruptcies, he said.

Dr. Bill Skeen, executive director of the California's chapter of Physicians for a National Health Program, said the organization supports the legislation because it's the only way of providing coverage for everyone and controlling the skyrocketing costs of the health care system. The organization advocates for a universal, comprehensive single-payer national health program. “I think it would be a win-win situation for almost everyone,” he said.

Providers would also see gains from the plan, Skeen said. “One of them is (that) with a single-payer (system), there would be a simplified electronic billing system,” he said. That would help providers cut clerical costs.

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However, Ensminger said, part of the bill that could draw criticism is that everyone would be a part of the same plan.

Organizations such as the California Chamber of Commerce and the Child and Family Protection Association strongly oppose the bill.

The CFPA refers to it as socialized medicine. “SB 810 would destroy our choices in health care and force us to pay for and exclusively use a government-controlled socialistic health care system — regardless of what the courts or Congress do with the Obamacare,” the organization said on its website.

Marti Fisher, a policy advocate with the California Chamber of Commerce, wasn't available for comment Monday. In a letter she sent to members of the Senate Health Committee on behalf of the chamber, she said the group opposes the bill because “it creates a new government-run, multibillion-dollar socialized health care system that would conflict with recently enacted federal health care reform and built from a yet-to-be-specified premium structure.”

However, Leno said the bill wouldn't conflict with federal health care law. He said the federal law would proceed while California considers the single-payer system.

In 2017, the federal law would let states apply for federal waivers, which would allow California to use federal dollars on health care in the state for a single-payer system, he said.

The waivers are intended to allow states to provide broader coverage without increasing the federal deficit. Leno said the single-payer system in California would cover everyone, while the federal law would leave about 3 million state residents without coverage. In California, there are about 12 million people without coverage at any given time, he added. “The single-payer would cover everyone and will reduce the cost and the growth in health care costs,” he said.

In the letter, Fisher of the Chamber of Commerce said the bill would “establish a premium commission to impose a premium for all employers, which is essentially a tax.”

The bill would use federal and state dollars — as well as employer and individual contributions — to fund the system.

The state spends about $200 billion on its health care system every year. Leno said the state would use the same money it now uses to pay for the single-payer system. “We will use that money much more efficiently,” he said.

The legislation is a two-year bill, Leno said, and its backers hope to have it on the governor's desk in the summer of 2012.

A similar bill was introduced in 2006 and in 2008 by former Sen. Sheila Kuehl, D-Los Angeles.

The bill was vetoed twice by Gov. Arnold Schwarzenegger.

© 2011 McClatchy-Tribune Information Services

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