Next Steps On Healthcare In California

A controversial California bill (SB 562) has falsely been characterized by its promoters as a “single payer” healthcare bill even though it lacks the essential ingredients of single payer healthcare systems such as those of Britain and Canada, which are defined in large part by cost and utilization controls and impartial governance. (To learn more see T.R. Reid’s The Healing of America or my summary here.) SB 562 contains no such controls and laughingly even puts spending recipients in charge.

By adopting the term but not the substance of single payer, SB 562’s promoters are misleading citizens. If legislators really want a single payer system, they must establish a funding mechanism and modify SB 562 in at least two ways:

  • Governance uninfluenced by spending beneficiaries. SB 562 takes the opposite approach, as explained here and here.
  • Cost and utilization controls. As Reid notes, in Britain “the government controls what doctors can do and what they can charge” and in Canada governments control costs “by limiting the medical services they will pay for or by making patients wait to be treated.” SB 562 takes the opposite approach, as explained here.

Legislators should also study the “multi payer” systems of France, Germany, Japan, the Netherlands and Switzerland. Reid points outs that no-one goes bankrupt in those countries because of medical bills and the Commonwealth Fund ranks them as good or better than single payer systems. Impartially governed and with cost and utilization controls, multi payer systems can work as well or better than single payer systems.

As currently written, SB 562 is just a power play. Californians deserve the truth. They also deserve more studious behavior by California’s legislators before those legislators seek to modify the financing and provision of citizen health care.

Written by

Lecturer at Stanford University and president of Govern For California

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