So, the state legislature and assembly have approved single-payer healthcare in CA. The governor may (or may not) veto it. Thoughts?
I am very curious about how this will work if implemented. Thanks for letting us know. I’m sure many eyes are on this.
Covered CA was problematic for many, so much confusion about which providers participated in each plan. We need a safety net and perhaps single payer is the way to go. Need to read up on the details though, look forward to other comments.
The Massachusetts state legislature is considering a single-payer proposal as well.
http://masscare.org/legislation/
Not so fast.
http://www.latimes.com/politics/la-pol-sac-skelton-single-payer-bill-20170605-story.html
First step of a long walk. It’s inevitable, but may take quite a while to get there. Market based solutions have failed miserably. Income inequality is accelerating even faster than climate change and we’ll reach a point where too much of the population will be unable to participate in a market based system.
^ Well, if anything else, they made progress towards eliminating insomnia! 
This site has pretty much every fact you could possibly want to learn about health insurance and proposed legislation. Interesting to toggle between 2013 and 2015 to see how your state has reduced the number of uninsured during that time period. If California can build high speed train along the San Andreas fault, certainly we can lead the way in the establishment of a single payer health system. Kaiser Permanente has already laid the groundwork as bureaucratic behemoth of low cost healthcare that almost functions.
The bill, SB 562, has passed the State Senate. It is now before the Assembly. It has not been passed by the Assemby at this time.
Under this system, everyone in California would be covered, including undocumented residents. (California Medicaid already covers undocumented children.) There would be no copays or deductibles. Anyone could see any doctor they wanted, provided the doctor would see them, and could get any treatment they wanted and a doctor prescribed, provided it was “medically necessary.” Various analyses say that this system would cost, overall, a little bit more than what Californians now pay (I do not believe this, btw; I think the estimates are rosy.])
This bill doesn’t specify how single payer would be funded. One suggested way to fund it would be a 15% across-the-board payroll tax, perhaps 10% paid by employers and 5% paid by employees. If, as seems reasonable, lower-paid employees would be exempt from the tax or would pay less, then of course higher-paid people would pay more.
The bill would also require that California get waivers from the federal government so that the state could be paid directly for the money that would otherwise go to Medicaid, Medicare and VA patients. It would require a change in the federal ERISA law.
The California taxes to pay for single payer would have to go before the voters, and I believe they’d need a 2/3s majority to be enacted. The California constitution would have to be amended, because it now specifies that some certain percentage of California taxes have to go to education and that would have to be changed.
In other words, if this bill passes the Assembly and then Jerry Brown signs it, that would just be the first step in a years-long process that might, or might not, end with Californians having a single payer system.
@Cardinal Fang thanks for clarifying. I thought it had been passed by both the Senate and Assembly (I guess I didn’t read too closely).
" Anyone could see any doctor they wanted, provided the doctor would see them…"
Therein lies the rub, I think. I’m not sure how many doctors will want to sign up for a program that reimburses at the Medicare rate. I think the insurance through my husband’s employer pays the Medicare rate plus 40%.
Also, we are already taxed at a very high income tax rate in CA and our sales tax is pushing 10% as it is.
That’s one of the reasons I don’t believe the cost estimates. I’ve heard that private insurance reimburses hospitals at an average of Medicare plus 80%.
Our insurer reimburses at close to Medicare rates, I’ve been told. I’ve not looked very closely to check.
Along those lines, I wonder if California and/or California residents would get a tax waiver on any/all federal healthcare programs if California single payer were enacted. It would seem unfair for us to have to pay “twice” on healthcare programs through both the state and federal systems (i.e. medicare and ACA/AHCA).
No. The federal government would collect the taxes as they do now, and then whatever money would have gone to Californians would instead go to the Healthy California Board to spend on Californians. It would be a wash as far as that is concerned. You wouldn’t be paying twice. You’d be paying once.
Sounds like it would be very expensive to be a Californian with a job. Your taxes would go up significantly, your company would not have to provide you health care, but they would not pay you extra because of this. I wonder what motivation someone who already has employer paid healthcare would have to desire this program?
I have no issue with a Medicare available for all (based upon income), but this sounds like a massive mandatory charity program. Why work for a low income when you can get medical benefits for free, pick your doctor, get the best care at someone else’s expense. Make it over the border and you get the best free health care someone else’s money can buy.
It sounds like a lovely, compassionate dream, however it always comes down to who pays, and how much. The working middle class who are already scraping by will get even more burdened. Might be worth it to them if they didn’t have health care (though low cost Obama care should have helped people out), but if they did, and are getting stuck with even higher taxes…that could be a cause for trouble.
Not necessarily, busdriver. Your employer wouldn’t have to buy you insurance, but they would have to pay a 10% payroll tax to give you health care. That’ll probably be a wash for a lot of employees.
In California, people with low incomes already get government provided health care, either through Medicaid (we expanded) or through federally subsidized health insurance. Most able-bodied adults on Medicaid work.
The claim is that Californians would spend about as much as we do now, but we’d cover everyone. That’s not so terrible, to me.
^ Yeah but what about Medicare? According to the article above, CA single payer would replace all healthcare programs (including Medicare) for CA residents, so would we receive a tax credit/waiver on those other programs? It seems like we should, but for some reason I see the feds pushing back on that idea.
I don’t understand your arithmetic, fractalmstr. Californians would pay the federal government just as much for Medicare taxes under this waiver as they do now, and California would get just as much money from Medicare with this waiver as it would have gotten otherwise, Can you explain further what your objection is?