“We’re going to be living with Obamacare for the foreseeable future.”
And with that, Paul Ryan the Republican speaker of the House threw in the towel on his sweeping plan to replace the ACA (Obamacare).
But political leaders in California plan to take the refinement of the state’s healthcare system into uncharted territory. During February of this year, state senators Ricardo Lara and his colleague Toni Atkins wrote proposed legislation to replace private health insurance in California entirely with a publicly-funded system operated by the state’s government known as a “single-payer” system.
That system, also referred to as “Medicare for all,” makes use of a single public or hybrid agency which, while it organizes health care financing, delivers that care through private means. The differences between ObamaCare and a pure, single-payer system are that, while millions remain under-insured or uninsured under the current Affordable Care Act, it doesn’t guarantee coverage, it only guarantees access to health insurance if an individual can afford it. A “single-payer” system guarantees coverage regardless of income.
That’s a big deal indeed when you stop to consider that California is now the sixth-largest economy in the world. The state economy blew past the nation of France last year. While France is the world’s seventh-largest economy and generates more than $2.4 trillion annually according to International Monetary Fund data, California’s diverse economic sectors from Silicon Valley to Hollywood, from manufacturing to agriculture, means the most populous U.S. state has run beyond the rest of the nation in job growth. The California finance department says their gross state product amounted to $2.46 trillion during 2015 alone.
The Lara bill fails to spell out details of how California would pay for what’s expected to be a multibillion-dollar program, but it does point out that the legislature is to enact wording that “would establish a comprehensive universal single-payer health care coverage program and a health care cost control system for the benefit of all residents of the state.”
And the plan is already gaining traction among candidates. California Lt. Gov. Gavin Newsom says he’s already working with health care experts to hammer out a plan for a single-payer system.
According to the LA Times, Lara says the Republican defeat in Congress over the repeal and replace strategy to wipe out Obamacare clears a path toward for a single-payer system in his state.
“It’s easier to expand health care than make up lost ground as we would have had to do,” Lara said. “We really have the chance to make universal health care a reality now.”
But one controversial element of this latest proposal diverges widely from the current ACA model: Lara’s plan includes all state residents – and without regard to their immigration status. Obamacare explicitly left out undocumented immigrants, though children in California receive basic coverage.
Those who argue for a single-payer program say the plan would bring down costs and encourage preventive care, but opponents counter that stance and say such a system would result in less consumer choice and cut down on efficiency in medical care. Those naysayers add that taxes would ratchet up for all residents to fund the plan.
The major hurdle legislators will need to clear hinges on the fact that health care players – doctors and nurses, hospitals, clinics, drug companies, pharmacies, medical equipment manufacturers, health insurance companies, ambulance services and a host of others, will surely require that their input is acknowledged and included.
Outside of America, such single-payer systems cost less per capita – and consumer a much smaller percentage of GDP – while covering all their citizens.
As a point of fact, experts say the United States ranks 36th in average lifespan among all nations despite leading the world in healthcare innovation and practice. But critics the U.S. system say not a single free market health insurance system – anywhere in the world – actually works.
The bottom line is likely to be that, as California goes, so goes the rest of the nation when it comes to policy. What’s more certain is that no one likes the health insurance system as it stands now and not many were impressed with the Ryan-led effort to effect change…
