The premise is simple: the new healthcare system will be run by one public agency and the coverage will include everyone in California. This new entity will collect all contributions and pay all bills.

The study

According to Robert Pollen, Professor of Economics at the University of Massachusetts Amherst et al, findings show there could be as much as a net overall reduction of eight percent per person, per premium, relative to the current system, #Covered California, California's health care exchange.

The proposal offsets losses by the exit of private insurance companies by proposing new taxes to generate the revenue needed.

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They propose a gross receipts tax of 2.3 percent on LLC Corps and a sales tax of 2.3 percent on consumers. Current California sales tax is 7.25 percent. This would bring sales taxes to approximately 9.55 percent and LLCs would have to pay an additional 2.3 percent on their gross sales. C and S Corps maintain the status quo.

The study goes on to conclude that smaller firms will see a 22 percent decline in #Health Care Costs and smaller firms may have to pay nothing other than their gross receipt tax including possible exemptions and tax credits. In medium-sized firms, health care costs may fall between 6.8 and 13.4 percent. Larger firms may experience a 5.7 percent fall and even larger firms will experience a 0.6 percent fall as a share of payroll relative to the existing system.

The single-payer system counts on California's government to oversee a complex health care system that will replace premiums, co-pays, deductibles and other out-of-pocket expenses associated with health insurance plans.

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This is an aggressive proposal, however, the states were designed to be the incubators of new ideas and this is a proposal that is a long time coming. California, as a progressive state, should lead the way on single-payer.

The comprehensive coverage proposed is seen as equal for all residents. Some of the savings proposed by the group will by necessity come from negotiations with pharmaceutical companies for lower rates on drugs, lower pricing on labs and imaging, cheaper hospital rates and lower physician fees. The upside is that all people will be covered so medical professionals will be paid the same going price. This does not, however, take into consideration real estate values and cost of living in urban areas, but that is a consideration for another time.

Another revenue source is simply because people will no longer need to run to the Emergency Room for care. My last experience at our local hospital was an eye-opener. I had slashed my foot to the bone and another lady had broken hers.

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The rest of the waiting room was filled with people experiencing: an abscessed tooth, a migraine headache, an older person who had run out of oxygen and two cases of the flu. All of them could have been seen by their primary care doctor or dentist except they either didn't have one, didn't have dental insurance or could not afford the co-pay.

"After all," one person claimed, "the Emergency Room can't turn me away and my deductible is $7,500.00."

In June of 2017, California SB-562, a single-payer proposal, was put on hold due to funding and other concerns. While people supported the new bill, they did not support new taxes. Others felt that the bill didn't address serious issues such as delivery of care and cost controls which cannot be known until the negotiations begin and that would have to be after the bill was passed.

The outlook

While fraught with peril and voter nervousness, the time for single-payer has come. You cannot undo coverage for preexisting conditions or access to care based on ability to pay and even though it may, in fact, bankrupt the state, it is time to step up and take a chance. Let's make SB 562 a solid piece of legislation based on facts. It is never a bad thing to hear the truth and good decisions cannot be made without it.