Single-Payer Would Cost A Third of Current Health Care Costs Per Family

The argument for single-payer health care is primarily moral. It’s just wrong to make anyone’s ability to get the health care they need dependent on their ability to pay.

Still, even when we win the moral argument, we still have to figure out how to get the system up and running – and how to fund it. It’s a sign of just how quickly the politics are moving on this in California, as the single-payer debate is increasingly about “how” and not “whether.” As will be shown below, the first analysis out of the state legislature suggests that single-payer would cost Californians just a third of what they currently spend on health care – and likely even less.

To that end, the Senate Appropriations Committee published today their fiscal analysis of Sen. Ricardo Lara’s SB 562. The headline that the media has run with is that the total cost would be $400 billion per year, and the state would need to cover about $200 billion of that cost (the other half comes from existing health care spending). Due to other savings, they conclude that “total new spending required under the bill would be between $50 and $100 billion per year.”

The analysis doesn’t make clear exactly how that sum was reached. But $400 billion is 16% of California’s overall GDP of about $2.5 trillion. That is in line with the current percentage of GDP that the United States as a whole spends on its inefficient, privatized health care system in which many people don’t get the health care that they need.

As the Senate Appropriations analysis notes, however, that $400 billion sum is about twice the amount spent in other industrialized nations. The Organization for Economic Co-operation and Development (OECD) published an analysis using 2013 numbers that showed the average percentage of GDP for health care spending in an industrialized nation is half the sum of the United States – about 8.9 percent.

Canada is a useful point of comparison, as a fellow North American economy with a population similar to that of California (36 million in Canada, 40 million in California). The OECD reports they spend about 10% of GDP on health care. In 2016, Canada’s actual sum spent was $228 billion.

So it stands to reason that a California single-payer system would be cheaper than the Senate Appropriations analysis assumes, and their figure should be considered as conservative.

But let’s say they’re right and the cost is closer to $400 billion overall, and that $100 billion in new revenues is needed (the high end of their $50b-$100b scale). That would pencil out to a monthly cost to each Californian of $208. ($100 billion / 40 million = $2500, which is the annual sum; divide that by 12 and you’re at $208.)

The average monthly premium for a Californian, as of 2016, was just under $600. For a household, it’s just above $1600.

In other words, even assuming the fiscally conservative analysis of the Senate Appropriations Committee and spreading the cost evenly across every Californian, single-payer would cost a third of what it currently costs Californians – just for health insurance alone. And unlike the present system, this would mean Californians don’t have to pay anything else beyond that $208/mo. No copays. No co-insurance. No out of pocket costs (at least within the Golden State). The ultimate savings would therefore be even greater. Californians could wind up paying just a quarter of what they pay now, if not less.

Of course, you wouldn’t actually pay for single-payer by levying just a flat fee across the state. A low-income family would pay far less in taxes than a wealthy family. The Senate Appropriations committee assumes using a 15% payroll tax to pay for single-payer, but there’s no reason we have to actually do it that way. A mixture of corporate and income taxes, especially geared toward the higher end of the scale, could bring down the cost to the median-income household even more.

Finally, the analysis notes that this would require voter approval because of the idiotic Gann Limit adopted in 1979 in the wake of the passage of Prop 13. If this does go to voters, I’d love it to be in the form of a constitutional amendment that, among other things, eliminates the Gann Limit for good.

The media will crow about the cost of single-payer. They should be emphasizing the savings. And we as activists should bring it back to the moral argument. If you can guarantee health care to every person in California as a right of being alive, and do it so for no more than a third of what people spend right now, why the hell would you say no?

The Quest for Single Payer Continues

Sens. Atkins and Lara keep up the fight

by Brian Leubitz

There is content on Calitics about single payer from the early days.  Shiela Kuehl was pushing it back then, but the legislation goes back to the 90s.

A grassroots movement for the establishment of a single-payer health care financing system in California (CA) has been building since the 1990s. In 1992, state Senator Nick Petris introduced a single-payer bill in the state legislature. Insurance Commissioner John Garamendi created a plan for universal coverage with a modified single-payer approach that passed the legislature, but was vetoed by Governor Pete Wilson. In 1994, a single-payer ballot initiative, Proposition 186, was defeated in the face of strong opposition by industry stakeholders. The initiative increased public awareness of single payer and was followed up in 1998 by introduction of Senate Bill (SB) 2123, calling for establishment of a universal single-payer system in the state. This bill led to a resolution calling for a study to compare different models of financing universal health care, including single payer. (Healthcare For All)

The history goes on and on. And it is still going today:

California lawmakers are considering an audacious proposal that would substantially remake the state’s health care system by eliminating insurance companies and guaranteeing coverage for everyone.

The idea known as single-payer health care has long been popular on the left. It’s gaining traction with liberals as President Donald Trump struggles with his efforts to repeal and replace the Affordable Care Act(AP)

Given Gov. Brown’s previous hesitance and the many outstanding questions surrounding the future of Obamacare, this is a big lift. Ultimately, single payer is the way we have to be going if we are to truly control health care costs. But for a California single payer system to work, it would need a lot of federal money and a lot of federal waivers. Federal waivers that are very unlikely to come under the current administration.

That being said, the bill, co-authored by Sens. Ricardo Lara and Toni Atkins, is important if for nothing else than getting stories like the AP story above. If we are to move towards a more fair health care system, we need to do whatever we can to move the ball forward, even if it is just the smallest amount. Senators Atkins and Lara are doing just that.

Schwarzenegger Continues His Gerrymandering Crusade

I’ll admit it. I was against changing how we did our redistricting. Perhaps it was fear of change, but ultimately, it didn’t turn out that badly. California has largely sorted itself politically anyway, with progressives on the coast, and more conservative voters inland. Gerrymandering can’t change that, but at the margins, differences can be made.

And while there wasn’t a whole lot of turnover after the 2010 census redistricting that was the first under our new redistricting system, there were a handful of districts that became more competitive. Cook puts the following districts as “competitive”:

Lean Dem Toss-up Lean Rep Likely Rep
CA-07 Bera CA-49 Issa CA-10 Denham CA-21 Valadao
CA-24 Carbajal CA-25 Knight CA-39 Royce
CA-45 Walters
CA-48 Rohrabacher

Now, that’s just 9 of the 53 California districts that can even be considered competitive. I suppose you never know what will happen given the craziness of the last election and the current administration, but let’s just go with this list.

I actually think Schwarzenegger means well here. Gerrymandering is a problem, to the extent that we have not already sorted ourselves. Where the problem is really acute, and Republicans have drawn themselves outlandishly favorable maps, it will make a difference. And so for that, this is a worthwhile effort.

To be clear, the reason Congress is worse than herpes goes far deeper than gerrymandering. But if Arnold is only going to take on one thing, there are probably worse uses of his time than this.

Dana Rohrabacher: Macedonia “is not a country”

Well, that went over well in Skopje

by Brian Leubitz

US Congressman Dana Rohrabacher is one of the most significant people in the House of Representatives. Or at least that’s what the Google translate says of the Albanian text from the video below, where the OC Republican says that Macedonia is not a country. It’s in Albanian, so, there’s that.

From Vision Plus Albania (via Google Translate)

US Congressman Dana Rohrabacher is one of the most significant people in the House of Representatives. As a former aide to President Reagan, Mr. Rohrabacher likes to give a jolt of internal policies and external. He expects enthusiastically carrying out such a policy by the new President of Vizion Plus Trump.Kamera was within the Congress, Mr. Rohrabacher’s office a few days after he sent a letter to Serbian President Nikolic, in which, sought to examine the possibility of exchange of territories in the north of Kosovo as the best solution. Rohrabacher goes further: Let’s change the boundaries of Macedonia.

And from the UK Independent:

“Kosovars and Albanians from Macedonia should be part of Kosovo and the rest of Macedonia should be part of Bulgaria or any other country to which they believe they are related,” he told Albanian TV channel, Vizion Plus. “The idea is to keep Macedonia alive because someone 30 years ago decided it is a configuration that should come out of the dismantling of Yugoslavia, does not lead to an explanation that this idea is still held.”

I’ll not claim to be an expert on the Balkans, but I am confident that there is, in fact, a Macedonian people that speak Macedonian. And, for some reason, they don’t take kindly to American Congressmen saying that they shouldn’t exist:

“His expressed views generated immense anxiety regarding Macedonia and the region,” [the Macedonian government] said in a statement. “They inflame nationalist rhetoric in the neighbouring regions, taking us back into the past. We believe that the US State Department will adequately remove any doubt about the stated positions and will affirm its policy towards Macedonia and the Balkans.”

Described by Republican Senator John McCain as one of the party’s “lunatic fringe”, Mr Rohrabacher is a staunch defender of Russia. In the past he has called accusations of human rights abuses in the country, “baloney”.

And yes, Rohrabacher is down with Putin’s Russia. Click the read more button to see a fun video of a tussle between Joe Scarborough and ol’ Dana where he thinks that Putin is just the strong man we need to help defeat terrorism, just like our old friend Stalin. Continue reading Dana Rohrabacher: Macedonia “is not a country”

Ron Calderon Gets Sentenced

Former Senator Ron Calderon will be heading to prison soon.
Former Senator Ron Calderon will be heading to prison soon.
Way back in 2008, I called out a Senator for a bill that I thought invaded medical privacy. The original post was fairly policy focused. His chief of staff didn’t much care for what I wrote, and let me know. I told him that I would republish his email, and he said go for it. So, I did just that right here in a response and further analysis of the bill. Just for giggles, here is that fun email:

Brian,

You should go back to public policy school and learn how to read a bill. You apparently don’t know how to or are too lazy. If you had bothered to do that, rather than taking the word of others who haven’t read the bill either, you’d have known how inaccurate your misinformed little column is. And accuracy should be important, even for bloggers. If you would like to discuss you can reach me at (916) xxx-xxxx.

Chief of Staff
Senator Ronald S. Calderon
30th Senate District

Ah, good times. Even more fun was the conversation I recalled in that post with the CoS, wherein he told me that elites (like me?) would never get Calderon like his district got him.

All that is to say, Ron Calderon is about to go to jail. But it was probably all because of the elites who, according to his lawyers when this all first came out, entrapped him into taking bribes.

Charged in a corruption scandal that could have sent him to prison for three lifetimes, former Sen. Ron Calderon dropped his entrapment defense, pleaded guilty and admitted taking bribes in exchange for his influence in Sacramento.

As he faces sentencing Friday, though, prosecutors say Calderon is not taking responsibility for his actions and has presented a “whimsical and revisionist view of his conduct” in an effort to serve no time behind bars for graft that lined his own pockets and helped put his children through college.(AP 10/21/16)

Ron Calderon’s removal and term limits now means that only Ian Calderon, a 31-year old Assembly member from Whittier, is the last of the Calderon family political machine left in office.

The Election That Was

Hillary Clinton and Kamala Harris lead the way for a strong night for Democrats

by Brian Leubitz

While the presidential race wasn’t as close as some had expected, the election results were good for the Democratic Party. In the Senate race, AG Kamala Harris got over 40% of the vote, and will face Rep. Loretta Sanchez in a D-on-D statewide race. Think about that fact: there will be no Republican competitor in the Senate race of the largest state of the union. The Republicans can point at Schwarzenegger or Abel Maldonado for that, but a dysfunctional Republican party that has the same xenophobic tendencies as the larger national GOP looks to be the real culprit. The Nation has a good look at the CRP in tatters:

 Under California’s nonpartisan “blanket primary” law, which was enacted by the voters in 2010, Tuesday’s Senate primary ballot featured all the candidates on one list. Democrats, Republicans, and several dozen third-party and independent candidates competed against one another in a race where only the top two finishers could earn a place on the November ballot. That would not have been much of a challenge for a functional Republican Party. But it was an insurmountable challenge for the California Republican Party. Several GOP contenders hit the campaign trail, but none of them got anywhere close to being competitive. They simply split a minority of the vote and languished in single digits.

California is a minority-majority state already. This is the way the rest of the nation will look soon enough, and if the Republicans continue on this Trumpian path, they will find this fate on a larger scale.

On another note, Andy Pugno, the Prop 8 lawyer who fought to the bitter end to protect inequality and who supports a complete abortion ban, appears to have lost in his attempt to get to the Top-2 portion of the AD-6 Race.

More locally, the San Francisco Bay Area passed a $12 regional parcel tax, even with the 2/3 requirement, that will go to help fund projects to save the Bay. And DCCC races across the state may take a little while to fully sort out.

There are still a few “close contests“, but in the one statewide race, you would have to say the big loser is the California Republican party.

Munger spending on Sundheim’s Senate Campaign?

Wealthy Bay Area businessman tries to get a Republican in the Senate general election

by Brian Leubitz

It is June 1, and the polling on the open Senate seat here in California isn’t looking very good for the Republicans. Now, they were never very likely to put a bunch of resources into California, but you would have thought that they would have at least liked to have a candidate in the race. That now seems unlikely given the latest polling which shows Kamala Harris and Loretta Sanchez far ahead of the array of Republicans in the race.

But it seems Charles Munger hasn’t completely forgotten about the race:

Now, an outside group funded by the California GOP’s most devoted benefactor is trying to push one of the three major Republicans into a top-two position.

Charles Munger Jr., the Palo Alto physicist whose father is the business partner of Warren Buffett, initially kicked in more than $50,000 to assist Senate candidate Duf Sundheim, a former state GOP chairman polling in single digits alongside fellow Republicans Tom Del Beccaro and Ron Unz.

A new Super PAC funded by Munger, Californians for Fiscal Responsibility, reports spending nearly $540,000 to date to boost Sundheim and sink Del Beccaro. The mailings focus on Del Beccaro’s record as state GOP chairman, blaming him for electoral, voter registration and funding woes it suffered.(SacBee)

If this is their attempt to unify Republican votes, it doesn’t seem to be working. The latest ABC7/Survey USA poll has Sundheim and Del Beccarro in the low single digits. There are still a lot of undecideds on that poll, but it seems either Republican will be able to catch up to Sanchez or Harris.

Hey, Charles, if you have so much money to burn, maybe you can help build some affordable housing in the Palo Alto area? That would probably do a lot more good.

Today is the Last Day to Register to Vote

by Brian Leubitz

I’m sure you are already registered to vote, but have you moved lately? Do you have a friend that moved or needs to register for the first time in California? Well, fortunately enough, we have a great online registration system, and you (or your friend) should mosey on down to said website and just do it.

Click here for the California Voter Registration Site.

Voter numbers will come out shortly, but we can probably expect pretty decent voter turnout come June 7. So, go ahead, get that registration in now, and get ready to vote in a couple weeks!

Moving on Up? John Chiang and Fiona Ma Announce Campaigns

California_State_Treasurer_John_ChiangGovernor’s Race Begins Very Early

by Brian Leubitz

Lt.Gov. Gavin Newsom has been running governor for the better part of this century, or so it seems. And for a while it looked like his fundraising may have deterred anybody else from officially announcing their candidacy for the 2018 contest.  That changed this week:

California Treasurer John Chiang has made it official: He’s running for governor in 2018.

The Democrat made the announcement in a statement Tuesday morning.

“As your next Governor, I have a blueprint for expanding and renewing the California dream through fixing our crumbling infrastructure, making retirement security our generation’s call to arms, and rebuilding California’s middle class through better jobs and improved educational opportunities,” Chiang said. (LAT 5/18/16)

First, let me say that I’ve always been impressed with John Chiang, as both Controller and Treasurer. He fought Governor Schwarzenegger during the worst of the Budget fights, and has been a competent manager of the office. As to whether he can compete with the fundraising of Gavin Newsom is an open question. Chiang has some money in his treasurer account that he can transfer over to this race, but he is already over $2million behind the former SF Mayor.

And right after that announcement, BoE Member Fiona Ma (and CPA!) announced that she would be seeking Chiang’s Treasurer gig. In an email sent to supporters, she outlined her qualifications:

As a Certified Public Accountant, Chair of the Board of Equalization, and state and local official, I’ve put my skills to work for Californians. I’ll be ready on Day One to serve as California’s treasurer and invest in the people and small businesses that are the foundation for California’s economic success.

An open statewide office is likely to attract competition, but Ma will be a formidable candidate. She has a history of fighting it out in San Francisco politics, and can be a formidable fundraiser herself.

Welcome to 2018? Oh, right, 2 more years of this?