State Dems champion single-payer system
Jim Steinberg, Staff Writer
Posted: 05/08/2011 03:05:40 PM PDT

Democrats in California have revived a bill that would create a single-payer health care system that would provide health care for everyone, including illegal residents.

It would replace President Barack Obama’s health care reform legislation with a more comprehensive system – one its advocates say would cost everyone no more than what we already pay.

Opponents emphatically deny that assertion.

And one academic observer of health care policy said, “If you think the fight over affordable care was nasty, you haven’t seen anything yet.”

“This plan is going to gore a lot of oxen,” said Gerald F. Kominski, associate director for UCLA Center Health Policy Research. “No.1 is the insurance industry. They are not about to see their business go up in smoke.”

Kominski said that the federal Patient Protection and Affordable Care Act “is a very moderate, middle- of-the-road approach to health care reform. It fills the gaps in the current system.”

On the other hand, he said the state proposal “is a fundamental reform.”

Last week, the Senate Health Committee approved the California Universal Health Care Act, authored by Sen. Mark Leno, D-San Francisco.

Senate Bill 810 would create a public-private partnership to provide every California resident with medical, dental, vision, hospitalization and prescription drug benefits, while still allowing patients to choose their own doctors and hospitals.

This plan would set up a single- payer “Medicare for All” type of program by pooling the money that government, employers, and individuals already pay and using that money more efficiently by cutting out the middle man – insurance companies.

The federal health care reform legislation allows states to set up their own health care systems if their program does not obligate Uncle Sam to shell out more money.

“We applaud the president’s affordable-care program, but we know it leaves 3 million Californians without insurance,” Leno said, in a telephone interview last week.

The new federal program covers legal residents.

The California proposal to replace it would cover legal and illegal residents.

“Infection and disease does not recognize immigration status,” Leno said.

The universal care plan would provide comprehensive dental care – something largely not addressed in the federal plan.

How will the health care world created by S.B. 810 not cost more than we are paying now?

Advocates say a big reason will be in the reduction of administrative expenses of health care by reducing the involvement of insurance companies – and trimming administrative expenses of doctors’ offices – and other medical providers – as they seek payment from insurers.

“There are some 6,000 health plans in California, and health care providers spend about one-third of their resources just getting paid,” Leno said.

And there will be other saving opportunities as well – in unprecedented bulk purchasing power for everything from pharmaceuticals to hearing aids, eyeglasses and the investment in primary and preventive care, Leno said.

S.B. 810 is estimated to save California about $20 billion its first year through reduced administrative costs, based on a study conducted in 2006, for an earlier go-around with this proposal.

Leno said the bill will not advance this year and that the 2006 study will be redone to bring up-to-date figures to a campaign for its approval next year.

Single-payer systems were passed twice by the Legislature in recent years, only to be vetoed each time by then-Gov. Arnold Schwarzenegger.

The proposal was tabled in 2009. Leno reintroduced it in January, making this the fourth effort.

Leno said he has not sat down and discussed the plan in detail with Gov. Jerry Brown, but noted that when Brown ran against former President Bill Clinton in the 1992 presidential primary, he said he favored a nationwide universal health care plan.

Leno said he hopes to have that in-depth conversation with Brown soon.

The quest for this kind of radical health care reform is occurring in only one other state.

Vermont is rapidly pursuing a similar program and most observers expect it to become a reality there. Advocates in that state have been pushing for this to happen for some 20 years.

Vermont has a population just shy of 700,000 – or about one-third the population of San Bernardino County.

Patrick Johnston, the president and CEO of the California Association of Health Plans, said S.B. 810 “has no chance of becoming a law.”

The association represents 39 public and private organizations that provide health care coverage to more than 21 million Californians.

He said an analysis of the bill in a previous form determined there would be a shortfall of $45 billion three years after its implementation.

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