The Real Reason Behind The CA Single Payer Proposal

Hint: It’s not about health

This past weekend the California Democratic Party of which I am a member held a state convention riven by the election of a new chairman. Behind that was a battle over a proposal to enact “Single Payer” (SP) health care financing in California. Behind that is a power play about money.

SP is a method by which health care expenditures are financed by public agencies. For example, Medicare and Medicaid are SP systems. Now, a powerful commercial and political interest (the California Nurses Association) is pushing legislation to establish a consolidated state-run SP agency. They want Medicare and Medicaid to run through the new agency and to eliminate private insurance so that all healthcare payments in California (~$400 billion per year) would run through that agency.

There can be benefits to SP systems but healthier populations are not necessarily one of them. Just compare the French and Swiss systems, neither of which is SP, with Canada, which is SP:

The Commonwealth Fund, 2014

So why the push for a consolidated state-run SP agency? The answer: to establish a single point of political power, which is more lucrative for cronies who derive revenues from government spending. The single point of political power in the case of the proposed SP system would be a nine-person board requiring the inclusion of at least one representative from the nurses union. That’s like requiring that a board managing military spending provide at least one seat to Boeing. If you want a sense of what’s in store for citizens if such a board manages healthcare financing in California, see what has happened to citizens as a result of pension financing managed by the boards of CalPERS and CalSTRS.

It’s about a single point of political power.

There is a reason the US healthcare-industrial complex has become the biggest recipient of government spending. Nothing helps them more than establishing a single point of political power. Political philanthropists and citizens should pay close attention to elected officials and candidates who curry favor with any member of the healthcare-industrial complex. As discussed here, California is already not getting results from doubling spending on cronies to more than $100 billion per year. The state’s goal should be greater citizen health, not greater crony wealth.