Hold off on single-payer

Jeff vonKaenel

I support the idea of a single-payer health insurance system. But I have to agree with California Assembly Speaker Anthony Rendon’s shelving of the single-payer legislation, Senate Bill 562, the Healthy California Act, which was recently passed by the California Senate.

In a press release, Rendon explained “… there are potentially fatal flaws in the bill, including the fact it does not address many serious issues, such as financing, delivery of care, cost controls, or the realities of needed action by the Trump Administration and voters.”

A single-payer health care system—sometimes called “Medicare for all”—would use tax funds to pay the health care costs of all residents, regardless of income, occupation or health status. It would replace the current system, in which select individuals or employers purchase health insurance from private companies that offer varying levels of coverage and cost.

In other words, goodbye insurance companies, hello government. Advocates for the single-payer system believe that a major reason why health care is so expensive in America, even though we don’t provide universal coverage, is because of our for-profit health insurance system. Annual health care costs per capita in the United States are $9,024 on average, compared to $3,620 in other developed countries, according to a June 2016 report from the Organisation for Economic Co-operation and Development.

After comparing American health care costs and those of our sister countries, any rational person would want to adopt the Canadian or European health care model, with the obvious exception of the beneficiaries of our current bloated system—insurance companies, doctors, pharmaceutical companies and politicians receiving campaign donations.

A recent Morning Consult-slash-POLITICO poll showed that 44 percent of Americans support single-payer health care, where “all Americans would get their health insurance from one government plan.” Only 36 percent of those surveyed were opposed.

We should move to a single-payer system. But we can make things worse if we don’t plan carefully. SB 562 is not a carefully worked-out plan. It does not include cost controls, address funding sources or map out the logistics of a transition. And the fact that it is being used as a political football by the California Nurses Association and others is not helping the situation. Besides, the plan would work only with federal cooperation, which seems unlikely.

I would love to see the California Legislature sort this all out and come up with a workable plan. However, a more attainable approach to reforming health care and moving toward a single-payer system might be for California to set up a government-run public-option plan. That is what Nevada’s Democratic legislators recently passed, only to have it vetoed by their Republican governor.

The Nevada Care Plan, while separate from the state Medicaid plan, would have offered benefits similar to those provided by Medicaid. Anyone, regardless of income, could choose to participate in the plan. It would compete with the other plans in the marketplace. I believe, and the insurance companies fear, that the government-run public-option program would be more efficient than our current for-profit insurance system, just as our government-run Social Security system has lower administrative costs than for-profit retirement plans.

This would not be single-payer, but it would be a move in the right direction. We’d be able to determine whether the government could run the public-option system more effectively than the for-profit insurance companies. If the government can do that, then over time we could move toward a much saner health-care system.

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About the Author

Jeff vonKaenel
Jeff vonKaenel is the president, CEO and majority owner of the News & Review newspapers in Sacramento, Chico and Reno.