Close to Home: The path to universal health care

Friday, August 25, 2017

Readers of The Press Democrat have seen opinion pieces on Senate Bill 562, the “Healthy California Act.” That bill, often called single-payer or Medicare for all, is being held in the state Assembly, and I have been criticized for not doing more to overturn that decision.

Let me be clear, I have always supported health care for all. I am a health care provider, chairman of the Assembly Health Committee and strongly believe that health care is a right.

We all know the dangers of empty promises – remember when President Barack Obama said you could keep your doctor? We know that was his intent, but it just didn’t end up that way. So when supporters of this bill say it will eliminate premiums, deductibles and co-pays and guarantee that everyone receives all medically necessary care, including hospitalization, dental, vision, mental health and long-term care, I am skeptical and concerned. More than 60 countries worldwide have universal health care, and while no two are identical, none offer unlimited benefits.

Here’s what I believe must be part of a successful system:

You can’t manage a system with a nine-member statewide committee. The one-size-fits-all approach of SB 562 doesn’t consider the many unique regions within California, especially rural areas. We need at least a dozen regional committees to the development of policies and reimbursement rates, for example, that would incentivize providers to practice, especially in areas where the number of providers is already inadequate.

Business must be involved in any discussions about abolishing our employer-based health insurance system. We must bring in employers before we develop a transition plan, timeline and the necessary payroll tax. Once a bill is passed, it will still take years to unwind the current system.

Medicare for all has been a term used to describe the bill, and it is a concept I can actually support, but that’s not what SB 562 is. As an employee, you pay Medicare tax your entire working life, and when you turn 65, you enroll in Medicare and continue paying a premium. You also have copays for doctor visits and hospitalization, but may you not have prescription coverage. Medicare recipients have the option to purchase a supplemental policy that provides prescription coverage and may reduce or eliminate co-pays and shared cost. What would seniors think of folding their well-liked program into a state program?

We are all frustrated with health care as it exists today, and with the rhetoric coming from Washington, I understand people’s fear of the uncertainty. Our current health care system depends on federal funds, and although a single-payer system may reduce some costs, at a time when Washington is actively undermining the progress we have made during the past eight years, that federal support isn’t guaranteed.

As a legislator, I am doing whatever I can to protect the progress we have made with the Affordable Care Act. In addition, Assembly Speaker Anthony Rendon announced this week that I will join Assemblyman Joaquin Arambula, who is a physician, to co-chair the Assembly Select Committee on Health Care Delivery Systems and Universal Coverage, which will hold hearings beginning in the legislative interim so the committee can develop plans for achieving universal health care in California. My priority will be to ensure that whatever system is proposed is sustainable.