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Tags: california | newsom | nhs

Golden State May Learn Single-Payer Mania Has Hefty Price

alleged healthcare inefficiencies in the golden state

Los Angeles, Calif. People without medical insurance wait in long lines that stretch around the block to see doctors at a sports facility in Los Angeles, at a free medical clinic event .(Gerry Boughan/Dreamstime.com)

Sally Pipes By Wednesday, 21 February 2024 01:54 PM EST Current | Bio | Archive

The California legislature will soon consider yet another bid to launch a government takeover of the state's health insurance system.

Known as the California Guaranteed Health Care for All Act, AB 2200 seeks to ban private health insurance and enroll all state residents — including those currently covered by Medicare and Medi-Cal, the state's Medicaid program — in a single government health plan dubbed "CalCare."

A similar proposal, introduced in 2021, died in 2022 before coming to a vote.

This one deserves the same fate. Single-payer a la AB 2200 would force Californians to endure lengthy waits for subpar care — and tax them dearly for it.

Democratic Assemblyman Ash Kalra, who represents a district in the San Jose area, is again leading the charge for single payer.

His latest bill, he says, "will start the necessary process of revolutionizing health care access in this state and asserting that health care is truly a human right."

If the experiences of countries with government-dominated health insurance systems like Canada and the United Kingdom are any indication, that revolution will result in less access to care.

A Canadian patient seeking specialist care faced a median wait of 27.7 weeks last year for treatment following referral by a general practitioner, according to the Vancouver-based Fraser Institute's latest analysis.

That's a record high. In some parts of the country, including Nova Scotia and New Brunswick, the median wait is roughly a year.

The number of patients waiting for routine hospital care in England's National Health Service was more than 7.7 million as of October 2023. Last September, about 1 million people in England were on two or more wait lists for treatment.

More than one in three patients in England with an "urgent suspected cancer referral" must wait more than two months — the maximum recommended wait — to start treatment.

In January, junior doctors went on strike for six days seeking higher pay. It was the longest work stoppage in the NHS's 75-year history.

More than 1 million appointments have been canceled due to strikes by NHS workers since December 2022, according to the BBC. Those canceled appointments have doubtless led to longer wait times.

It's not at all surprising, then, that after his recent cancer diagnosis — which he received at a private hospital — King Charles III waited less than two weeks to begin his treatment.

He isn't the only British patient to opt out of the NHS. According to survey data released in April 2023, 13% of Britons had paid for private health services within the last year.

Under AB 2200, Californians would have to wait their turn or leave the state and pay out of pocket for care — just like those subject to single-payer health care in other countries.

California's doctors are unlikely to relish their status as de facto public-sector employees under AB 2200. Many will flee to greener — and more lucrative — pastures outside the state.

Others may retire early or seek employment in other sectors of the economy.

With fewer doctors available in California, the waits for care will only grow.

Then there's the financial fallout. According to one recent estimate, a single-payer revamp on the scale of AB 2200 will cost taxpayers as much as $391 billion a year. To put that in perspective, the latest state budget included just $226 billion in general fund spending.

CalCare, in other words, would more than double the state's financial obligations. And it would do so at a moment when Sacramento is scrambling to close a state budget deficit that could be anywhere from $38 billion, by Gov. Gavin Newsom, D-Calif.'s reckoning, to $73 billion, if the California Legislative Analyst's Office is right.

Gov. Newsom came to office promising a statewide single-payer overhaul.

But he has yet to deliver. Just last year, he signed a bill aimed at securing a waiver allowing California to free up federal Medicare and Medicaid funding for use on other state healthcare priorities — a stepping stone to single-payer.

He may have endorsed that half-measure to buy time.

But California can't afford single payer. Its dire budget math may be the reason in the short term. But the long-term human cost — in wait times, doctor shortages, care delayed, and care denied — is why Californians must resist a state takeover of the health insurance system.

Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.

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The California Guaranteed Health Care for All Act, AB 2200 seeks to ban private health insurance and enroll all state residents, including those currently covered by Medicare and Medi-Cal, the state's Medicaid program, in a single government health plan.
california, newsom, nhs
Wednesday, 21 February 2024 01:54 PM
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