Another View

Time to lead
By: Randi Swisley
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We have all heard about the federal government efforts to improve our current health care programs in America. The Affordable Care Act (ACA) remains in effect for now but alternatives for healthcare are picking up steam.

The next big healthcare showdown is shaping up in California. It is a stark departure from the ACA and other efforts going on at the national level.

On Feb. 17, state senators introduced the Healthy California Act, legislation that would establish a single-payer plan for all residents in our state. Based on the principal that everyone has a right to healthcare, this legislation assumes that 100 percent healthcare is possible if California leads.

Single-payer health care is not a new idea for California. In 2006 and in 2008, similar bills were passed by state legislative bodies and vetoed by the governor. In 2017’s version of single-payer, tagged S.B. 562, the state would negotiate prices for services and prescription drugs with healthcare providers and pharmaceutical companies, similar to the way Medicare is managed. All Californians would participate in the program and private insurance companies would go away.

More than 10 other states have tried — and failed — to adopt single payer. Deep pockets in the insurance industry stoke public fears about costs. In reality, eliminating private insurance and giving the government a bigger negotiating advantage means better health care at a lower cost for all of us.

A single payer movement started at the state level can quickly spread across the nation. In 1947, Saskatchewan, Canada established the beginning of Canada’s single-payer healthcare system. The idea spread from province to province, and by 1984, it was instituted nationwide.

The California Nurses Association, with its 100,000 members, and other activists have mobilized in support of S.B.562. They expect it will likely be the catalyst for single-payer to spread across this country.

S.B. 562 would provide all residents in California a free choice of health care professionals and services. Covered benefits would include emergency services, surgery, hospital stays, home healthcare, hospice, prescription drugs, vision, dental, mental health and chiropractic services, as well as other services that private insurance covers today.

Payroll and income premiums, higher for upper-income earners, would replace the insurance company premiums we pay today. There would be no co-pays, no deductibles and the result would be lower out-of-pocket costs to the patient.

How can we receive better, more comprehensive care at a lower price than what we pay today? Health insurance companies marketing and profits currently consume 25 to 30 percent of health premiums. Health insurance premiums have increased more than five times the rate of inflation in the last 10 years. Inflated health-insurance executive salaries and the price of pharmaceuticals are the main culprits in addition to the marketing costs required to compete.

California, the world’s sixth largest economy, has the power to negotiate better pricing for drugs and services.

Eliminating costs of marketing, advertising and exorbitant executive salaries, combined with increased negotiation power, establishes single-payer as the only plan for 90 percent of Californians, including businesses, to spend less money on health care with access to equal or better services than they currently receive.

Insurance executives will fight this bill hard. A plethora of misleading and even inaccurate advertising paid for by the health insurance industry is expected to fight against S.B. 562.

ACA has an approval rating of 55 percent. Perhaps more significantly, 52 percent agree with the statement that “it is the responsibility of the federal government to make sure all Americans have health care coverage,” versus 45 percent who disagreed, which is a sharp turnaround in the last couple of years.
Those majorities may seem less than overwhelming but the trend lines are clear. If tens of millions of Americans lose their insurance coverage and the most popular provisions of Obamacare are nullified, public opinion will evolve along this trend.
Every other rich industrialized nation has found that truly universal health coverage is like what Churchill said about democracy: It’s the worst system, except for all the others that have been tried.

Health insurance is not like other insurance. Fire insurance and car insurance are protection against the unlikely. Everyone uses health care. It is inevitable.

In a state as wealthy as California and in a nation as wealthy as the U.S., it is inexcusable that healthcare is not provided for all Californians. We are the only developed country not to do so. The time has come for us to lead.


Randi Swisley of Auburn is the League of Women Voters of Placer County president.