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Karl Marx could have been forecasting the future ofCalifornia when he said that history repeats itself – first as tragedy, then as farce.
The tragedyisa state budget of $225.9 billion this year, with a budget deficit equivalent to nearly one-third of that figure – $73 billion, according to the latest estimate from the state Legislative Analyst’s Office.
The farceisCalifornia state Assemblyman Ash Kalra, a Democrat, re-introducing legislationto ban privatehealthinsuranceandforce allCaliforniansinto a single, publicly runhealthplan – at a cost estimated at $391 billion a year the last time he brought it forward,in2021.
Supporters of single-payer health care march to the Capitol, April 26, 2017, in Sacramento, California. (AP Photo/Rich Pedroncelli, File)
Spoiler alert: It hasn’t gotten any cheaper since then.
SINGLE-PAYER HEALTH CARE: WHAT IS IT?
This fixation onsingle-payerhealthcareisnot just unrealistic. It’s sadistic, given thatsingle-payerforces people to waitinlong lines for subpar treatment,inlarge part because low government payments resultinpersistent shortages of doctors.
Look at Britain’s NationalHealthService. British junior doctors have gone on strike 10 times since March 2023. They’re paid a pittance to keep a lid on costs.
The strikes have only delayed treatmentsandmade waiting timesworse. Since December 2022, morethan1.2 million appointments have beencanceledthanks to a severe shortage of doctors, nursesandparamedics.
VideoRoughly 6.3 million people were on waiting lists for morethan7.6 million treatmentsinEngland as of the end of December.That’s morethan10% of the population.Ghastly stories abound of patients waiting years for critical treatment, or stuffedinhospital hallways until a bed frees up, or watching their fellow patients dieinwaiting rooms.
HEALTH CARE PRICE TRANSPARENCY COULD SAVE AMERICANS $1T ANNUALLY
To escape these horrors, around oneineight Brits pay for privatehealthcareoutside the public NHS.
Our neighborsinCanada face similar woes under theirsingle-payerhealth care system. According to research from the FraserInstitute, a Vancouver think tank,Canadians face a median wait of nearly 28 weeks forcarefrom a specialist following referral by a general practitioner.
VideoInCanada, privateinsuranceisillegal – unlikeinthe United Kingdom. SoCanadians must leave the country if they want timeliercare. A 2019 report fromSecondStreet.org, aCanadian think tank, found thatCanadians made morethan200,000 trips abroad to seek medicalcarein2017.
AreCalifornians ready to wait seven months for crucial treatments? Or will they leave the stateandpay out of pocket forcaremore quickly?
MONTHLY HEALTH INSURANCE PREMIUMS FOR NEARLY 2 MILLION CALIFORNIANS EXPECTED TO RISE NEXT YEAR
Kalracalls his latest bid forsingle-payer– officially dubbed AB 2200, theCalifornia GuaranteedHealthCarefor All Act – an improvement on his previous efforts.It’s hard to see how.
VideoHe proposes to pass the bill, then ask the federal government for a waiver to divert all the money it delivers to the state for the likes of MedicareandMedicaidinto a new “CalCare”healthplan.
There’s no plan for how to come up with the rest of the money needed to pay for it. But given the estimated cost of previoussingle-payerplans, it could require doubling the state’s tax take.
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Thisis, to be blunt, unlikely. The last timesingle-payeradvocatescame knockinginSacramento, they were counting on Gov. Gavin Newsom going along with them to fulfillcampaign promises.Staring down a record budget deficit, the governorishighly unlikely tobacka wholesalesingle-payersystem.
VideoInfact, it’s unclear how he’ll come up with the $2.6 billion a year he’s committed for state-funded coverage for illegal immigrants through Medi-Cal, the state’s Medicaid program.
Even manyCalifornia Democrats recognize thatsingle-payerisa pipe dream. “I’m just stating the obvious, that’s always been the concern aboutsingle-payer– the cost,” Assembly Speaker Robert Rivas said last month.
Fiscal reality may be the death knell forsingle-payerinCalifornia this year. But it’s safe to assume that the state’s progressives– not to mention theCalifornia Nurses Association, which has been a driving force behind AB 2200andits predecessors – will resurrect the idea againandagain.
Patients should take note of how government-run systemsinother countries delayanddenycare–andmake clear that they won’t stand for such tragedies or farces here.
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Sally C. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is “False Premise, False Promise: The Disastrous Reality of Medicare for All“ (Encounter 2020). Follow her on X, formerly Twitter, @sallypipes.
