Health care: Embrace single payer but maybe settle for less
By Elizabeth Aguilera
CALmatters, November 6, 2018
As the incoming Newsom administration prepares to unveil its legislative priorities, the single-payer health care concept he has touted will generate a lot of talk. But Capitol skeptics say that despite his promises to make it happen, action will be much more difficultāespecially given the ideaās federal obstacles and huge costs.
Newsom may be more likely to initially pursue a less ambitious strategy: getting more of the uninsured covered under current government programs.
Except that is not what he promised the California Nurses Association, the powerful union that then endorsed and enthusiastically campaigned for him. The union says itās not going to take no for an answer, and plans to insist on meetings with the governor-elect about how to move forward as soon as he takes office.
āGiven the statements that Newsom made at our convention a year ago, we believe he is fundamentally committed to changing the health care system,ā said Stephanie Roberson, director of government relations for the union. āHe said that in a room full of nurses. His sentiments were very clear.ā
Extending health care to all Californians has been, hands down, Newsomās signature health issue.
In a January gubernatorial debate, he said: āIām also very enthusiastic about taking a system thatās fragmented, thatās disjointed, thatās complicated and wasteful, and building a new system. Not on top of it, but replacing the existing system with a single payer financed system of universal quality health care.ā
Newsom, the one-time mayor of San Francisco, pledged to create a statewide universal health care program of the sort he backed when he was leading that city. The Healthy San Francisco program, primarily funded from city coffers, provides basic insurance to residents who lack access to health insurance regardless of legal status.
Although it is not a single-payer system, the governor-elect has often cited it to illustrate his commitment to coverage.
The model would not work across the state but it has the right goals and values, said Anthony Wright, executive director of Health Access California, which advocates for consumers.
āHeās talked about wanting to take concrete tangible steps toward to the goal of affordable health care for all,ā said Wright. āHeās talked about the vision of Medicare for all and universal coverage. Heās also been wide-eyed about the barriers to that goal.ā
Those challenges will likely keep Newsom from pushing for single-payer out of the gate, said Gerald Kominski, senior fellow at the UCLA Center for Health Policy Research. āHe understands the barriers are difficult to overcome,ā said Kominski. āI suspect heāll support ways to reduce the remaining uninsured further.ā
As lieutenant governor, Newsom praised a bill that aimed to set up universal health care, but failed. It would have barred private insurers, and set up a state system funded by taxes and required for all residents. It was a tough sell.
Roberson of the nurses union said a new bill in the works will be a fine-tuned version of that bill. āWhat itās going to take is political will, to sit in a room and not emerge until we find a way to reach that goal,ā she said.
California Dreaminā? With Newsomās Win, Single-Payer Unlikely To Follow Anytime Soon
By Samantha Young
California Healthline, November 6, 2018
Californians on Tuesday elected a governor who campaigned for a complete overhaul of how people get their health coverage ā but they shouldnāt hold their breath.
Rather, as Gov.-elect Gavin Newsom and the Democratic-controlled legislature take steps to provide more people with health insurance, theyāll likely approach it piecemeal over several years.
Newsom himself is already tempering expectations about Californiaās move to a single-payer system, saying it will take more than the will of one person to realize.
āIām not going to hesitate to be bold on this issue, and I also want to set expectations,ā Newsom told reporters last week at a campaign stop in Sacramento. āItās a multiyear process.ā
Undaunted, the California Nurses Association said it intends to bring another single-payer bill before the legislature next year and has launched a national campaign to pass single-payer in other states and convince Congress of its merits.
Lawmakers earlier this year directed a council to study the feasibility of a publicly funded health insurance plan, and its findings arenāt due until 2021 ā giving the new governor and lawmakers time to punt on the issue.
http://californiahealthline.org…
Comment:
By Don McCanne, M.D.
Single payer advocate Gavin Newsom has been elected governor of California, and it looks like he will have a supermajority of Democrats in the state legislature. Sounds like the ideal time to move forward with the first state-level single payer system to serve as an example for the nation, much as Saskatchewan did in Canada. Sounds like the ideal time, but is it?
In a personal conversation I had with Lt. Gov. Newsom a few years ago, he indicated to me his strong support for single payer as being the most efficient and effective model of reform, but he also indicated that there were many barriers that had to be negotiated and thus it might not happen on the state level in one piece of legislation, especially since federal cooperation would be mandatory (and that would not be forthcoming right now).
Single payer supporters understandably become nervous when Newsom emphatically endorses single payer but then expresses reservations, indicating, “it’s a multiyear process.” They seem apprehensive that he may be backing off on his promise to support single payer reform. But actually his position has been consistent all along. He wants single payer, but you cannot throw pragmatism to the wind. You can only do what you can do.
Nobody should be pessimistic. In fact, this is the time for optimism. Support for Single Payer Medicare for All has grown throughout the nation. California is in a position to take a leadership role in advancing the cause.
Right now California can move forward with whatever is possible on a state level while at the same time supporting work on a national level over the next two years so that in 2020 we will be ready with definitive federal legislation for a newly elected Congress and administration that is dedicated to enacting and implementing Single Payer Medicare for All. The homework has to be done in advance. We cannot let state hurdles and Fake Medicare for Some interfere with our progress. We’re perfectly situated for a two year plan, and the time to begin instituting it is yesterday.
Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.