Opinion: California can’t afford single-payer health care fantasy

By Sally C. Pipes | January 28, 2018 at 8:30 am A civil war is brewing within California’s Democratic party. Progressives — led by Lt. Gov. Gavin Newsom, the frontrunner for governor, and the politically powerful California Nurses Association — plan to fight for a single-payer healthcare system this year. Their more moderate rivals — among them Assembly Speaker Anthony Rendon — are pushing back. Unfortunately, the progressives seem to be winning. Newsom has a 10-point lead over his nearest competitor for the Democratic nomination. If his faction emerges victorious, Californians had better prepare to lose their existing health plans — and pay billions of dollars in new taxes for the privilege. The California Nurses Association says it will push to revive Senate Bill 562, the Healthy California Act.  Nurses recently rallied outside of the state capitol to urge Rendon to move the bill ahead. The bill would effectively take away the health coverage that Californians currently have — including Medicare and Medi-Cal — and replace it with a single government-run plan for all residents. The state government would decide which procedures and drugs to cover. The plan wouldn’t charge premiums, deductibles or co-pays — but it would still cost a fortune. According to an analysis by the state Senate’s Appropriations Committee, the bill would cost $400 billion a year. Of that, $200 billion would supposedly come from repurposing federal dollars earmarked for programs like Medicare and Medi-Cal.  The remaining $200 billion would come from state funds. California’s government currently spends around $183 billion a year.  So, SB 562 would more than double the state budget. The bill contains few specifics about how the state would raise the revenue needed to do so. The Senate Appropriations Committee analysis suggests a 15 percent payroll tax hike.  The California Nurses Association claims Continue Reading

California health bill pushes unrealistic, empty promises

The Affordable Care Act (ACA) helped California lead the way in expanding health care coverage to millions of previously uninsured people. In San Diego County, more than 385,000 people who were previously without insurance now have health coverage — a drop of almost 30 percent in our county’s uninsured rate. We must continue our work to ensure that all Californians have coverage and access to timely and quality care. Working within the current pluralistic approach to health access, we must achieve this in an affordable — and realistic — way. But to disrupt access and the current health care market with unrealistic and empty promises from the currently proposed single payer and government-run system, which would cost over twice the amount of the entire budget of California, makes little sense. Related: California needs SB 562 to guarantee health care for all Thanks to the ACA, California has improved preventative care and patient access to their doctor, instead of emergency rooms. We must continue to reduce unnecessary emergency room visits by the uninsured and underinsured, especially for the one-third of Californians who rely on MediCal; provide a wide variety of coverage options; and maintain the safety net for those who need public support. Unfortunately, the gains of recent years are now under threat. Congress has repealed one of the central tenets of the ACA, which could have ripple effects throughout the entire health care system, negatively impacting millions of Californians. Some well-meaning but misinformed state legislators are pushing a bill, Senate Bill 562, which promises “coverage for all,” but in reality would further throw our health care system into turmoil. Senate Bill 562 is an irresponsible plan that offers no realistic way to pay for the estimated $400 billion cost associated with the measure. Implementing the bill would require the largest (personal and business) tax increase in state history, and it could Continue Reading

Proposed Medicaid change is bad for Missouri’s health

At the start of Missouri’s legislative session, Sen. David Sater, R-Cassville, introduced SB 562, which would change funding for Missouri’s Medicaid program into a dangerous block grant. Currently, 64.1 percent of Missouri’s Medicaid budget is paid for by the federal government. In other words, for every $1 Missouri spends on Medicaid, the federal government matches $1.83. Changing the funding to a block grant would stop this federal match, and Missouri would instead be given a pre-set amount to spend on Medicaid each year from the federal government. Generally, fixed block grant amounts are initially determined by a state’s current or historical spending, with yearly increases happening much more slowly (i.e. at the rate of inflation) than the projected growth for federal Medicaid spending. This means that federal financial assistance for Missouri’s Medicaid program will fall every year. If an unexpected emergency like a flu epidemic or natural disaster occurs, if more people are added to Medicaid, or if health care costs rise faster, our state government will have to foot the bill. SB 562 is especially concerning given the prospect of a revenue shortfall in Missouri with tax cuts. If Missouri is unable to generate adequate funds for Medicaid, the state will have to cut eligibility, covered services, and/or provider reimbursements for the program. This means that more than 965,000 people covered by Medicaid — mostly seniors, people with disabilities, and kids — will be cut off from health care in some capacity. I am a future health care provider, and SB 562 makes me worried about the health of my future patients and the state of Missouri. Akua Nuako  •  St. Louis Continue Reading

The biggest California political questions of 2018

By Casey Tolan | [email protected] | Bay Area News Group PUBLISHED: January 1, 2018 at 12:55 pm | UPDATED: January 1, 2018 at 12:58 pm With two competitive top-of-the-ticket races and a national spotlight on the state’s congressional districts — to say nothing about the Legislature’s busy agenda coupled with a growing sexual harassment scandal in the state Capitol — 2018 will be a blockbuster year for California politics.  President Donald Trump’s tumultuous first year in office has sent political shockwaves across the continent, rearranging California’s political map. If Democratic presidential nominee Hillary Clinton had beaten Trump in 2016, Sen. Dianne Feinstein might have scooted into her fifth full term without a serious challenger because she wouldn’t have irked liberals by being too soft on Trump. Democrats wouldn’t have had a chance at reclaiming Congress, and Golden State Republicans wouldn’t be tarred by association with an unpopular president. Instead, Trump’s presidency has buoyed Democrats’ hopes in races up and down the ballot. In 2018, as Trump and congressional Republicans move forward with entitlement reform and other policies that could further destabilize the Golden State’s finances, California politics will continue to be shaped by the New York billionaire’s peculiar presidency. To keep it all straight, here’s a cheat sheet with some of the biggest political questions that will be answered in 2018. Who will step into Gov. Jerry Brown’s shoes? A large field of contenders are facing off with the hope of succeeding Brown, a fixture of California politics for almost half a century who will wrap up his 16th year as governor in 2018. The front-runners are Lt. Gov. Gavin Newsom, a former San Francisco mayor who has come out on top in every public poll, and former Los Angeles Mayor Antonio Villaraigosa, both Democrats. Continue Reading

Who’s been naughty and who’s been nice this year? Boy, have we got a list

Naughty, nice — so judgmental, yes, but, well, that’s what editorial writers do. We pass judgment. Here’s our list of folks deserving coal, or worse, and those who can line up for virtual candy canes.President Trump. Because.Harvey Weinstein, Roy Moore, Al Franken, John Conyers, Trent Franks, Matt Dababneh, Garrison Keillor, Israel Horovitz, Matt Lauer, Charlie Rose and scads of other cads outed for alleged sexual misbehavior ranging from boorish innuendo to outright assault. And an extra “naughty” for the institutions that protected many of them for so long.The National Rifle Assn., for its long-running efforts to make this a more dangerous society. This year's outrages: pushing a federal concealed-carry reciprocity law, opposing a ban on bump-fire stocks, and callously disregarding life in defending access to semiautomatic weapons.North Korean dictator Kim Jong Un, for allowing himself to be baited into a war of words with Trump that could turn into a war with nuclear weapons.The party-pooper state lawmakers who killed a bill that would have let bars stay open past 2 a.m.The Los Angeles parks officials who closed a much-loved hiking trail to the Hollywood sign to settle a lawsuit and appease nearby homeowners, leaving Angelenos with less access to public open space.Amazon, for picking a location for a $5-billion second corporate headquarters through a “Bachelor”-like competition that’s really just a cynical hunt for tax breaks.Environmental Protection Agency head Scott Pruitt, for abjectly refusing to recognize the scientific consensus on the human actions propelling climate change and, by undercutting related regulations, putting business profits ahead of public health and environmental safety.The black-clad “anti-fascists” who committed acts of violence and property destruction in Berkeley, making a mockery of the university town’s reputation as a citadel of free speech.USC, for covering up the Continue Reading

Berkeley/West County letters: A better response to GOP tax bill

A better response to GOP tax bill While the GOP obviously deserves our derision for this monstrous tax bill, the left needs a better response than “this is bad.” So here are a few: Let’s not pass bills that are blatantly designed to enrich our donors. In fact, let’s change the process to empower small donors. We are already at pre-Depression levels of wealth inequality. Let’s actively try to shrink the gap between rich and poor. Financial insecurity is a way of life for at least half the country. Let’s address that directly through an unconditional basic income. These are big political lifts, but, critically, they can inspire voters. Democrats can be more than the party that cleans up the mess. We can present a vision that is equal to the challenges we face and our potential to lift the standard of living for every single person. Owen Poindexter Berkeley Recent Oakland Hills fire echoed 1991 blaze Panic set in for many of us in the Oakland Hills on Dec. 11 close to midnight when neighbors woke neighbors with shouts of “Fire! Get out now!” Looking outside to see the sky raining embers forced us to immediately grab children, elderly and animals, get in the car and get out. Thank God Colton Boulevard was wide enough for us coming down and fire engines coming up. Many of us gathered in our pajamas and stocking feet clinging to our families and neighbors wondering if we would ever see our homes again, and hopeful that neighbors made it out. With fire devastation in Northern and Southern California, and memories of Oakland’s great fire in 1991, we wondered what our fate would be. Two and a half excruciating hours later, our city’s firefighters courageously and miraculously contained the four-alarm fire. Endless gratitude and appreciation to the Oakland Fire Department for saving us and our homes. Linda Olvera Oakland Healthy California Act the solution to CalPERS’ problem There is a good solution for Continue Reading

Since When Is It Not Okay to Play Hardball With the Democrats?

“We have not made a single gain in civil rights without determined legal and nonviolent pressure.… It is an historical fact that privileged groups seldom give up their privileges voluntarily.”—Dr. Martin Luther King Jr., “Letter From Birmingham Jail” Despite efforts by the political establishment to shut it down, the quest for a state-based, Medicare-for-all type system in California, based on patient need, not corporate profits, rolls on. After SB 562 passed the California Senate in early June, California Assembly Speaker Anthony Rendon unilaterally blocked the bill from advancing before a single hearing could be held or a single amendment could be considered. Nurses, the lead sponsors of the bill, and thousands of health-care and community activists who have organized and mobilized in support of SB 562, responded with multiple protests at the State Capitol, canvassing and hosting a town-hall meeting in Rendon’s Los Angeles–area district, and flooding social media in protest. They are far from done. Activists will work to hold every member of the California Assembly accountable, insisting all sign on as co-sponsors of the bill and declare whether they agree that insurance companies should be the determinants of our health. They are also reminding Rendon that there is still time to move the bill in a legislative session that does not end until mid-September. With Rendon claiming he acted because the bill is “woefully inadequate,” many have wondered what the job is of elected representatives if not to hold hearings and make amendments to legislation they think need changes. Corporate-media critics have been quick to inflate the projected cost of a system to guarantee health care for all Californians, with real patient choice, and no premiums, deductibles, or co-pays that reinforce an inequitable system based on ability to pay. But economist Robert Pollin, lead author of a study on the potential costs, Continue Reading

Can California Achieve Universal Health Care in the Age of Trump?

The battle over the American Health Care Act has devolved into a question of whether Paul Ryan can save face by passing something out of the House that he knows can’t advance in the Senate. That Republican leadership is considering placating Trump and the Freedom Caucus right by including insurance market changes that have no budgetary component and cannot be part of a Senate bill that goes through reconciliation shows the futility of the exercise. The AHCA is dead. All that’s left is determining who the public will see holding the bloody knife. What comes after the AHCA? That’s a useful question. As I reported in February, the worker bees inside the Health and Human Services Department are already busy undermining the individual exchange market and implementing President Trump’s blame-game strategy of tagging Democrats with Obamacare failure. “Let it be a disaster,” Trump has said, “and we can blame that on the Democrats and President Obama.” There’s reason to question whether pointing fingers as millions lose access to care will work. But all of this assumes that the fight will play out only on the terrain of a degrading health-care system. What if the nation’s largest state, the capital of liberal America, goes their own way and shows a counterpoint, by improving a flawed system and realizing the goal of truly universal coverage? Gavin Newsom, currently the favorite to win the California governor’s race in 2018, wants to create this contrast. So does the state Legislature. And they are following different paths to get there. Last month, the Legislature introduced SB 562, which would create a single-payer system for all of California’s 38 million citizens, including the undocumented. The Legislature has passed this concept twice, both in 2006 and 2008, only to have it vetoed by Arnold Schwarzenegger. But “concept” is the key word. There aren’t many details in the bill Continue Reading

The California Senate Just Passed Single-Payer Health Care

If health care is a right—and it is—the only honest response to the current crisis is the single-payer “Medicare for All” reform that would bring the United States in line with humane and responsible countries worldwide. It is unfortunate that Donald Trump, who once seemed to recognize the logic of single payer, has aligned himself with House Speaker Paul Ryan’s scheme to make health a privilege rather than a right—and to use a “reform” of the Affordable Care Act as a vehicle to reward wealthy campaign donors with tax cuts and sweetheart deals. The debate in Washington is so cruel and unusual that it is easy to imagine that the cause of single payer must be doomed in America. Not so. The movement for single payer is for real, and it’s winning in California. The state Senate voted 23 to 14 on Thursday in favor of SB 562, a single-payer proposal that would guarantee universal health care to all Californians. “What we did today was really approve the concept of a single-payer system in California,” declared state Senator Ricardo Lara, a key advocate for the bill, following the vote. “California Senators have sent an unmistakable message today to every Californian and people across the nation,” declared RoseAnn DeMoro, the executive director of the California Nurses Association and National Nurses United, which led the fight for the “Healthy California Act.” “We can act to end the nightmare of families who live in fear of getting sick and unable to get the care they need due to the enormous cost,” DeMoro continued. “We’ve shown that healthcare is not only a humanitarian imperative for the nation, it is politically feasible, and it is even the fiscally responsible step to take.” That’s true. According to a review of a new NNU-sponsored study by the Political Economy Research Institute at the University of Massachusetts Amherst: “SB 562 Continue Reading

Some states see opportunity for single-payer health care

As Republicans continue to push reforms reducing the government's role in health care, some opponents are emboldened in their support for the opposite approach, one that would greatly increase government involvement.Progressive politicians and activists see a future in single-payer health care, the term for a government-run health insurance program that would be available to any American. While a Democratic-backed federal bill has no future in the GOP-led Congress, backers have had more success at the state level.On Thursday, Senate Republicans unveiled their plan to overhaul the Affordable Care Act. By Monday, the Congressional Budget Office estimated that 22 million fewer people would have health-care coverage by 2026; a similar plan that the House passed was expected to leave 23 million Americans uninsured and increase out-of-pocket costs for the sick and elderly.Following the election of President Trump, Jimmi Kuehn-Boldt of Palm Springs, Calif., began advocating for single-payer health care with the grassroots group Courageous Resistance. At 63, he doesn't expect anything to take effect before he's eligible for Medicare in a little more than a year, but he said he's worried about seeing care for others deteriorate if Republicans are successful. ► Later: Senate leaders delay health care vote, lacking GOP support ► Next: What's to come on health care now that the Senate has punted? The Senate proposal makes any talk of single-payer, either in Washington or Sacramento, "just as important, if not more than before," he said."We've got to see how it's fleshed out in Washington, but we can still move forward here," Kuehn-Boldt said.More than 100 Democrats in the House have signed on to a single-payer bill introduced by Rep. John Conyers of Michigan called Medicare for All because it would eliminate the current 65-and-older requirement for Medicare. Sen. Bernie Sanders of Vermont has talked about introducing his own Continue Reading