There is a small and very vocal group who continue to criticize and mischaracterize my position on Senate Bill 562, The Healthy California Act, which advocates for a single-payer healthcare system ("Healthcare for All," Nov. 30, "Mailbox," Dec. 7 and 14). They have used a technique of boiling this very significant and complex issue into a chant that I and others in the state Assembly do not want a single-payer healthcare system. To be very simple about it, this is not true.
I have chosen to be a little more complicated about it, explaining the issue in more detail and trusting the intelligence of my constituents and readers.
So, since it's the holiday season, let's talk turkey.
The California Healthcare Foundation, a nonprofit that supports "healthcare that works for all Californians," says it very well: "The California healthcare system affects tens of millions of lives, provides hundreds of thousands of jobs and costs hundreds of billions of dollars each year. Any major proposed reforms to that system warrant a rigorous analysis and a shared understanding of the goals and implications of reform."
Here are some of the "facts" the advocates of S.B. 562 state that are not true: They say I don't support healthcare for all. Not true. I have said time and time again, I support universal healthcare and believe it is a right.
They use scare tactics saying that community clinics are closing and claiming that one out of four seniors have gone into bankruptcy because of healthcare. Not true, certainly not since the Affordable Care Act has been in play.
They say our Select Committee on Universal Healthcare was created to stop policy from moving forward. Not true. Our committee, which has now met for nearly 20 hours, and will likely meet another 20, has already given the issue 10 times the attention it would have gotten in a typical Assembly Health Committee hearing. Our mission is to produce, early next year, actionable recommendations that could be used to develop a comprehensive and workable healthcare system for all.
They say they have addressed the funding issue. Not true.
No funding mechanism language is in the bill at all and, although the advocates refer to a report that shows how they would fund the system, Sen. Ricardo Lara, S.B. 562's author, for whatever reason, did not incorporate that funding language in the bill. And is the public ready to pay for this system through another payroll tax as they suggest?
I want a system that works for all Californians, especially rural California. Providers have to be paid fairly so that they will move to rural areas to meet the need. We know how unsuccessful the MediCal system has been in attracting healthcare professionals by paying them pennies on the dollar. Adequate funding is needed to make sure we can provide fair pay for nurse practitioners, physician assistants, nurses and mental health professionals, as well as physicians.
They claim I am beholden to corporate interests like insurance companies and pharmaceutical companies. Not true.
This year alone I authored or co-authored three bills that the pharmaceutical companies put all their muscle behind to kill. Two were signed into law and will make it difficult for pharmaceutical companies to randomly increase prices and market their high-priced brand name drugs. I am not a friend of that industry.
They claim that health insurance companies spend 30 to 35 percent on overhead. Not true. State law holds health insurance companies to a 15-percent "medical-loss-ratio," which means they can only spend 15 percent on administration — the rest must go to patient care. Any healthcare system will require administration — are we sure a government program can be as efficient?
They say that we could easily roll Medicare, Veterans' care and Medicaid into a single-payer system. Not true. Federal law establishes a Medicare Trust Fund and rules for how the money can be spent. None of those rules allow for a transfer of the funds to a state for the purpose of a single-payer system. That would require a change in federal law. And what about federal law regarding ERISA plans? Another complication they often dismiss.
Waivers needed to roll Medicaid or Veterans' care into a California system, along with current federal funding, are highly unlikely. Anyone who follows how much the Trump administration dislikes California would realize how uncooperative it would be in helping us — especially providing universal healthcare — which they do not support.
S.B. 562 advocates claim that for any state that discovers a means to more economically provide healthcare than through the Affordable Care Act, subsidies cannot be withheld. And they also state that there are various other legal remedies and precedents to rebut such unilateral withholding. Not true. Even if that were true, it would only apply to the Affordable Care Act, not a California single-payer system.
They want no healthcare premiums, no co-pays, no limit to benefits, no insurance companies and often refer to it as Medicare for All. But Medicare has premiums, co-pays, cost containment and is funded by a Medicare tax people have been paying their entire employed lives. And yes, you can get a more comprehensive benefit package, sometimes without co-pays, by paying for a pretty affordable supplemental "Medi-gap" plan.
So let's start 2018 by being real and dealing with the facts — which are complex. I will not promise everyone the world, as the S.B. 562 advocates have done, just to get support at the front end and then not deliver at the back end. I will take the time we need to create a universal healthcare system that works for everyone and is affordable and sustainable for the long-term.
Jim Wood represents the North Coast in the California Assembly. He is a Democrat from Healdsburg.
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