The opinion piece, “Wood performs dog & pony show for supes,” written last week by Mr. Winchell Dillenbeck, faithfully reiterates the basic talking points of the advocates for SB 562, the bill that provides an undeveloped solution for single payer health care.
The statistics he quotes about the cost of health care are important — we all know that the U.S. spends too much on health care compared to other countries, so no argument there. My arguments for a more thoughtful solution to reach universal health care for all come from wanting a real solution that could become law and provide affordable health care for individuals and for the state. Mr. Dillenbeck says that Governor Brown would likely not sign SB 562. Exactly! Why would you move a bill forward without bringing the Governor’s office along with you?
I am not interested in providing a simple answer to a complex issue — that would be irresponsible. I have chosen to take a different approach when speaking about the issue, explaining it in more detail and trusting the intelligence of my constituents and readers to understand its complexity. The California Health Care Foundation, a nonprofit that supports “health care that works for all Californians,” says it very well, “The California health care 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 SB 562 state that are not true:
They say I don’t support health care for all. Not true. I have said time and time again, I support universal health care and believe it is a right.
They use scare tactics claiming that community clinics are closing and that one out of four seniors has gone into bankruptcy because of health care. Not true. In May 2017, an article in Money stated that “…bankruptcy filings dropped about 50 percent, from 1,536,799 in 2010 to 770,846 in 2016.” They went on to say that “Those years also represent the time frame when the ACA took effect. Although courts never ask people to declare why they’re filing, many bankruptcy and legal experts agree that medical bills had been a leading cause of personal bankruptcy before public healthcare coverage expanded under the ACA.”
They say our Select Committee on Universal Health Care 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. Future meetings will allow others to share their specific solutions. Our mission is to produce, early this year, actionable recommendations that could be used to develop a comprehensive and workable health care 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 they commissioned that shows how they would fund the system, Senator Ricardo Lara, SB 562’s author, for whatever reason, did not incorporate that funding language in the bill.
I want a system that works for all Californians, especially rural California. Health care providers have to be paid fairly so that they will move to rural areas to meet the need. We know how unsuccessful the Medi-Cal system has been in attracting health care 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, mental health professionals as well as physicians.
They claim I am beholding to corporate interests like insurance companies and pharmaceutical companies. Not true. This year alone I authored or co-authored multiple bills that the pharmaceutical companies and the insurance industry put all their muscle behind to kill. Two of the drug pricing bills were signed into law and will make it difficult for pharmaceutical companies to randomly increase prices and market their high-priced brand name drugs. Bills specifically opposed by the insurance industry are still under consideration and I will work hard to get them to the Governor’s desk this year. I am not viewed as friend by either of those industries.
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. 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 the 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 health care – which they do not support.
SB 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 health care 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 life. 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 SB 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 develop a universal health care system that works for everyone and is affordable and sustainable for the long term.
Assemblymember Jim Wood (D-Healdsburg) serves Assembly District 2, including the North Coast.