Yes, health care can be this simple. We just have to choose it. Californians will be able to choose it very soon.by Gaius PubliusAs we wrote recently, California has a unique opportunity to both resist the Ryan-Trump destruction of the ACA and establish a state-wide single-payer health care system. Two state senators have introduced legislation to do just that.Emily Green, writing at the SF Chronicle:
California legislation would create single-payer health care systemA push for a single-payer health care system in California is making a comeback.State Sen. Ricardo Lara, D-Bell Gardens (Los Angeles County) plans to introduce legislation Friday to create a single system that would provide health insurance to every California resident.“This is our opportunity to put ourselves on the record and be proactive against a Trump administration that is hellbent on eliminating the Affordable Care Act,” Lara said.The two-page bill contains no specifics. Friday was the deadline for introducing new legislation, and the bill will be fleshed out over the coming month, Lara said. It will first head to the senate Health Committee and then to the senate Appropriations Committee, which Lara chairs.
As Green notes, this is not the first time that single-payer health legislation was introduced in California:
Previous efforts to create a single-payer system have failed. At least eight bills were introduced between 1992 and 2009 that attempted to create one. They failed to get through the Legislature or were vetoed by Republican governors.Efforts to create a single-payer system in California ended after the passage of the Affordable Care Act under President Obama.
More on those previous attempts in a moment.Will Democrats Support or Help Defeat This Bill? The question for California state Democrats is this — Will enough of them support single-payer legislation to get it to the governor's desk?If they do, the Resistance — the Revolt, really — will take a huge leap forward. It will show the Trump-Republican national government that denying what almost everyone in the country wants is not going to work. It will also embolden other states to likewise resist, both on this issue and many others. If there's to be a fight against the backward-facing federal government, states like California must help lead it, if only for the momentum they will provide.But there's a catch — Democrats. In particular, money-fed mainstream Democrats, the same people who got us into this Trumpian nightmare to begin with by being far less interested in what people wanted this time around than in what they wanted for themselves, the power to enact more pro-austerity, incrementalist policies. (Remember, the 2016 electoral squeaker should have been a landslide, and not just at the top of the ticket.)It will do no good for most state Democrats to support this legislation, if they let just a few cross the aisle to defeat it (keeping the rest of their fingerprints off of the kill). The insurance industry hates single-payer, because it would put them out of business. If the Party lets some of its members help defeat this legislation, the Party is responsible for the consequences, which may be momentous. One more test for the "reborn" Democratic Party. The question: reborn as what? In this newborn Trumpian Age, the entire country is watching.Why do I worry about Democrats helping kill this attempt at single-payer in California? Mainstream Democrats Helped Kill Single-Payer in ColoradoLet's look at the last attempt to enact single-payer health care, this time in Colorado as recently as 2016. Ace corruption reporter Lee Fang at The Intercept, wrote this in May 2016 (my emphasis):
Prominent Democratic Consultants Sign Up to Defeat Single Payer in ColoradoINFLUENTIAL DEMOCRATIC CONSULTANTS, some of whom work for the Super PACs backing Hillary Clinton, have signed up to fight a bold initiative to create a state-based single-payer system in Colorado, according to a state filing posted Monday.Coloradans for Coloradans, an ad-hoc group opposing single payer in Colorado, revealed that it raised $1 million over the first five months of this year. The group was formed to defeat Amendment 69, the ballot measure before voters this year that would change the Colorado constitution and permit a system that would automatically cover every state resident’s health care.The anti-single-payer effort is funded almost entirely by health care industry interests, including $500,000 from Anthem Inc., the state’s largest health insurance provider; $40,000 from Cigna, another large health insurer that is current in talks to merge with Anthem; $75,000 from Davita, the dialysis company; $25,000 from Delta Dental, the largest dental insurer in the state; and $100,000 from SCL Health, the faith-based hospital chain.
Here's what this sweeping legislation would have done:
Under the new system, there would be no health insurance premiums or deductibles, and all health and dental care would be paid for by the state through a new system called ColoradoCare. The plan calls for raising $25 billion through a mix of payroll taxes, along with bringing down costs through negotiations with providers.
Needless to say, the effect would be sweeping. Here's who to blame for its failure to pass:
The filing reveals that the anti-single-payer group has retained the services of Global Strategy Group, a Democratic consulting firm that has served a variety of congressional candidates and is currently advising Priorities USA Action, one of the Super PACs backing Clinton’s bid for the presidency.Last month, Global Strategies Group circulated a polling memo that contends that the single-payer ballot measure can be defeated because voters “overwhelmingly reject” the idea.But, the memo warned, the measure “has some traction with key groups,” including Democrats and millennials, and that the 2016 election year has proven difficult to predict. “[A] sustained campaign pointing out the many flaws in Amendment 69 is essential, especially in such an unpredictable environment,” the memo concluded.
It's not just Global Strategies Group. Other Democratic Party-associated consulting firms were involved:
A number of other Democratic firms have signed up to help defeat single payer, too. Hilltop Public Solutions, a firm managed by former campaign staffers to Barack Obama, was paid $45,000 by the group. Hilltop has also provided consulting services to Ready PAC, another Clinton-supporting Super PAC that eventually folded into the Clinton campaign.The Trimpa Group, a consulting company run by Democratic strategist Ted Trimpa, also received a payment from Coloradans for Coloradans.The Democratic consultants are listed alongside several Republican firms, including Brandeberry-McKenna Public Affairs, a GOP company that also lobbies for the drug industry.
Let's be plain. Manistream, health care industry-fed Democratic consulting firms took money from a secretly-funded ad hoc organization to defeat single-payer health care in Colorado. And they succeeded. That effort — Democrats defeating single-payer in Colorado — got some press, but not enough, given the broader public interest in the national campaign for the presidency (and the anti-Trump press's interest in protecting, to the extent it could, the reputation of the Democratic Party and its lead candidate, Hillary Clinton).They won't get that protection this time, given the visibility of the effort and the press's interest in "the Resistance." Democrats Have Consistently Helped Kill Single-Payer in CaliforniaCalifornia has a long history trying to enact single-payer health care. Above we noted the SF Chronicle saying this: "Previous efforts to create a single-payer system have failed. At least eight bills were introduced between 1992 and 2009 that attempted to create one. They failed to get through the Legislature or were vetoed by Republican governors."Here's some of that detail. Larry Potash in Labor Notes writes this about the 2012 effort (h/t Naked Capitalism for the link; my emphasis):
Why Did Single Payer Health Care Fail in California?Though it’s passed the legislature twice before, a bill to establish a single-payer universal health insurance system in California failed in the state senate in January.Not surprisingly, the bill received no Republican votes, but it fell just two votes short of passage when two Democrats voted no and four Democrats failed to vote, despite intense lobbying efforts by community and some labor health care activists.Angry activists pointed to the fact that five of the six errant Democrats had received money from the insurance industry and Big Pharma, ranging from $100,000 to over $250,000. Three of the six senators had been endorsed by the California Labor Federation which, along with unions such as the Service Employees and AFSCME, was on record supporting the single-payer bill. The California Democratic Party was also on record supporting it.
I'm certain that some (or many) yes-voting Democrats sincerely supported the bill. I'm also certain that some (or many) other yes-voting Democrats were thankful that those six Democrats helped kill it ... so they didn't have to. What percentage of politicians in both parties, do you think, take money from the health insurance and Pharma industries? Most, would be my guess.Other efforts in California failed because these same Democrats could count on a Republican governor's veto to make their Yes vote meaningless:
Similar bills passed the legislature fairly easily in 2006 and 2008, only to be vetoed by then-Governor Arnold Schwarzenegger. At a time when premiums were rising and there were few other proposals out there, it was an easy vote for Democrats certain of the governor’s veto.
Then came Obamacare, and the Obama-era effort failed out of "party loyalty":
But when Congress passed federal health reform in 2010, defending that bill, as well as President Obama, became paramount for many Democrats. It became more difficult for legislators to vote for a single-payer bill that might be interpreted as deserting the president, and the Democratic leadership refused to put the bill up for a final vote in the Assembly.
Which led to the 2012 effort, which failed because six Democrats helped kill the bill so the rest wouldn't have to. Again, since 1992, not once were Democrats able to pass single-payer in California. It would break the mold if they succeeded this time. Will they succeed this time?Will Democrats Support the People or the Money That Pays for Campaigns?There's more than just single-payer health insurance at stake here. First, if the ACA is gutted or repealed, people will die in every state. It's that simple.Second, how many more tries will the Democratic Party get to prove they are worth a second look in this new era, the era that sent Trump to the White House instead of Clinton?Predicting the future is almost has hard as predicting the past, but I will say this: If Democrats don't get on the people's side in an obvious way — by deeds and not just by "messaging" — they may wander the wilderness for a generation. That's far too long, given the nation's actual need for a strong, hard U-turn now.Support SB 562 in California, starting today. If single-payer health care wins there, it could win in many more places. Scheduling note: My comments appear regularly here on Monday and Thursday, or Tuesday and Thursday if Monday is a holiday.GP