SB810, Single-Payer Healthcare for All Californians, Reintroduced

Single-payer healthcare reform has a new bill number and a new sponsor. With my former State Senator Sheila Kuehl termed out, Mark Leno has stepped up to carry SB810, which in the past was known as SB840. The bill would, in the words of the press release, "guarantee comprehensive health care benefits to every California resident and streamline claims and reimbursements, which will save billions of dollars in health care administrative costs." Here's Sen. Leno:

“As a nation, we spend twice as much per person on health care as other wealthy countries, with the hope that our families will be protected from illnesses, yet most insured Americans still worry about how they will afford critical care if they become sick,” said Senator Leno. “In California, 7 million people do not have health insurance. Wasteful health care spending is crushing our economy and forcing families to forego basic medical care. With the money we spend today on health care, California can have a modern, universal health care system that provides high quality care for everyone,” he said.

A version of this bill has basically already passed the California Legislature, only to be vetoed by the Governor. So it shouldn't be a surprise that 43 lawmakers, including both leaders in the Assembly and Senate, have already signed on as co-sponsors.

Given the conservative veto and the 2/3 rule for revenue, SB810 lacks a funding source, so even if it were signed at some point - and realistically, Governor Schwarzenegger won't be the one to sign it - supporters wold have to go to the ballot to raise the necessary revenue to fund the bill.

There is no question that our health care delivery system is grossly inefficient, and insurance company profit and overhead is a pool of money that does little to provide quality care. As a nation we spend an extreme amount on health care - $2.4 trillion dollars in 2008, closing in on 20% of GDP - without a proportional increase in health care outcomes over the rest of the industrialized world. In fact, we pay more for care while ranking below dozens of nations in quality. Single-payer care, while varied in different nations across the world, has generally been proven to offer the best quality at the most reduced cost.

But of course, that is on a national level. And even though with 38 million people we have as many citizens as several other nations which have implemented single-payer, universal health care, what we lack is a printing press to coin our own money. Given the constraints of a balanced budget, given the far more onerous constraints of the conservative veto, and given that states have little control over the boom and bust cycles of the national economy, universal health plans have largely come ashore and beached when they are done at the state level. There are certainly reforms that can take place here, but we need the structural reform to set the table for them, and even with that, I am highly dubious (though willing to be convinced) that any state can manage UHC on their own without the tool of deficit spending that would occasionally be needed. And history bears this out.