© By Mark Dempsey
April 26, I went to the nurse’s union rally for SB562, a bill proposing single-payer health care for California--a gathering of more than 1,000 people in Sacramento’s Convention Center, some from as far away as San Diego. We heard from public policy mavens, doctors and nurses, speaking in favor of the bill before walking over to the Capitol to fill the Senate hearing room with SB562 supporters.
It’s not really controversial that single-payer health care worldwide is cheaper, and provides better outcomes than the U.S. system. U.S. per-patient expenditure is roughly twice single-payer systems, and the 2000 World Health Organization survey ranking healthcare by outcomes--things like life expectancy, infant mortality and vaccination rates--placed the U.S. 37th in the world, between Slovenia and Costa Rica. The Bee said “It’s as though we get the health care of Costa Rica and pay six times more for the privilege.”
But did you know that California taxpayers are already paying 70% of the state’s health care costs? So saving tax dollars would occur with a cheaper health care system.
The opponents of this bill--the pharmaceutical and insurance lobbies, the Chamber of Commerce, Manufacturers and Kaiser--spoke up at the Senate hearing. They cited a study conducted during the Schwarzenegger administration demonstrating single-payer would cost more than California currently pays. (Schwarzenegger vetoed the previous single-payer proposal.) Opponents also cited a study of Vermont’s single-payer, saying it proved too expensive to implement in a smaller state.
They did not answer some questions about those studies, though:
Why is every other country’s single-payer health care cheaper by nearly half than the studies' estimate of California's costs with single payer? Opponents cited what amounts to educated guesses about future costs. But single payer is half as expensive on actual experience, not guesses. Could bias influence "facts" cited in this debate? And is that pope fellow still catholic?
Do the opponents’ cited figures deduct the population’s savings in health insurance premiums they are already paying?
Could the estimate of Vermont’s costs have been distorted because the author also helped shape “Obamacare” (which inserts insurance companies between patients and government payments), and had an investment in the status quo?
SB562 itself remains incomplete, with funding and administration yet to be fully specified. There’s also the matter of Federal waivers--California wants to distribute health care money collected for Federal programs. So uncertainty about the final form of single-payer remains.
Why is single-payer cheaper? Besides the fact that people can seek cheaper preventive care earlier, removing the need for expensive emergency care later, one reason is that government’s overhead is cheaper than private health insurance. Medicare has roughly 2% in overhead. Private insurers have to pay for marketing and C-suite salaries, so their overhead is 20 - 30%.
When we discuss it, my conservative friends have objections like the following:
We can’t have the (incompetent, blankety-blank) government administer anything that is a matter of life and death! ...Oddly enough, government administers life and death safeguards like fire, police and the military, but healthcare is apparently a bridge too far.
We can’t afford it! ...a puzzling assertion. What is it about “half as expensive as what we’re already paying” that’s not clear?
It will drive businesses out! … But Toyota said they built a new plant in Canada rather than Detroit because U.S. health care costs were so high. Couldn’t intelligent public policy like SB562 attract business too? You know, like clean air, or good schools would attract the most desirable businesses…?
That’s the state of play at present. Stay tuned for more developments.
April 26, I went to the nurse’s union rally for SB562, a bill proposing single-payer health care for California--a gathering of more than 1,000 people in Sacramento’s Convention Center, some from as far away as San Diego. We heard from public policy mavens, doctors and nurses, speaking in favor of the bill before walking over to the Capitol to fill the Senate hearing room with SB562 supporters.
It’s not really controversial that single-payer health care worldwide is cheaper, and provides better outcomes than the U.S. system. U.S. per-patient expenditure is roughly twice single-payer systems, and the 2000 World Health Organization survey ranking healthcare by outcomes--things like life expectancy, infant mortality and vaccination rates--placed the U.S. 37th in the world, between Slovenia and Costa Rica. The Bee said “It’s as though we get the health care of Costa Rica and pay six times more for the privilege.”
But did you know that California taxpayers are already paying 70% of the state’s health care costs? So saving tax dollars would occur with a cheaper health care system.
The opponents of this bill--the pharmaceutical and insurance lobbies, the Chamber of Commerce, Manufacturers and Kaiser--spoke up at the Senate hearing. They cited a study conducted during the Schwarzenegger administration demonstrating single-payer would cost more than California currently pays. (Schwarzenegger vetoed the previous single-payer proposal.) Opponents also cited a study of Vermont’s single-payer, saying it proved too expensive to implement in a smaller state.
They did not answer some questions about those studies, though:
Why is every other country’s single-payer health care cheaper by nearly half than the studies' estimate of California's costs with single payer? Opponents cited what amounts to educated guesses about future costs. But single payer is half as expensive on actual experience, not guesses. Could bias influence "facts" cited in this debate? And is that pope fellow still catholic?
Do the opponents’ cited figures deduct the population’s savings in health insurance premiums they are already paying?
Could the estimate of Vermont’s costs have been distorted because the author also helped shape “Obamacare” (which inserts insurance companies between patients and government payments), and had an investment in the status quo?
SB562 itself remains incomplete, with funding and administration yet to be fully specified. There’s also the matter of Federal waivers--California wants to distribute health care money collected for Federal programs. So uncertainty about the final form of single-payer remains.
Why is single-payer cheaper? Besides the fact that people can seek cheaper preventive care earlier, removing the need for expensive emergency care later, one reason is that government’s overhead is cheaper than private health insurance. Medicare has roughly 2% in overhead. Private insurers have to pay for marketing and C-suite salaries, so their overhead is 20 - 30%.
When we discuss it, my conservative friends have objections like the following:
We can’t have the (incompetent, blankety-blank) government administer anything that is a matter of life and death! ...Oddly enough, government administers life and death safeguards like fire, police and the military, but healthcare is apparently a bridge too far.
We can’t afford it! ...a puzzling assertion. What is it about “half as expensive as what we’re already paying” that’s not clear?
It will drive businesses out! … But Toyota said they built a new plant in Canada rather than Detroit because U.S. health care costs were so high. Couldn’t intelligent public policy like SB562 attract business too? You know, like clean air, or good schools would attract the most desirable businesses…?
That’s the state of play at present. Stay tuned for more developments.
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