Californians better get comfortable. The wait time to see a doctor in the Golden State may be about to skyrocket.
Last week, California Assembly Speaker Anthony Rendon and a select committee of representatives held two days of hearings in Sacramento on Senate Bill 562 — the Healthy California Act — which promises to enroll all Californians in a government-run, single-payer healthcare system.
The controversial bill passed the state Senate on June 1. But Speaker Rendon “parked” it because he said it did not give enough details on cost and coverage. The California Nurses Association is pushing hard for the Assembly to pass the bill early next year. It is unclear whether Governor Brown would sign it.
Single-payer is not the cure for what ails California. The bill before the legislature would effectively bankrupt the state and, more important, force patients to wait interminably for care.
First things first — the bill’s cost. An analysis by the California State Senate Appropriations Committee set the price at $400 billion per year. That’s more than triple the current state budget. Even the bill’s supporters peg its price tag at well over $300 million — and that’s assuming some substantial savings that are unlikely to materialize.
How are they going to pay for it? By reaching into Californians’ paychecks, of course. The Appropriations Committee concluded that the state would need to implement a new 15 percent payroll tax to fund the system.
Californians won’t support a bill that confiscates their hard-earned money. When the nonpartisan Public Policy Institute asked California voters if they supported S.B. 562, 56 percent of them agreed. But only 43 percent would get behind the bill if it raised taxes.
Other blue states that have considered single-payer themselves have eventually backed away because of the cost.
Vermont, for instance, passed a bill in 2011 that would have established the first state-level single-payer healthcare system. But in December 2014, then-Gov. Peter Shumlin, a Democrat and champion of single-payer, pulled the plug on the plan. It would’ve almost doubled the state budget and required new taxes of up to 9.5 percent on income and 11.5 percent on payrolls — on top of the income and payroll taxes that workers and businesses already faced.
When he announced that he’d be shelving the state’s single-payer plan, Shumlin said, “In my judgment, the potential economic disruption and risks would be too great to small businesses, working families, and the state’s economy.”
Assembly Speaker Rendon and company would be wise to commit that quote to memory.
Then there are the human costs associated with government-run health care. Just ask the 13 million Californians — one-third of the population — that are on Medi-Cal, the joint federal-state health plan for the poor.
This summer, a group of beneficiaries launched a class-action lawsuit against the state, claiming that the program’s low payment rates to doctors have consigned them to a second-class healthcare system.
They’re right. Many doctors won’t accept Medi-Cal patients because of the program’s low reimbursement rates — which run about half what Medicare pays. More than one-third of primary care physicians treat no one on Medi-Cal, according to the California Health Care Foundation.
That leads to long waits, even for necessary care. The Los Angeles Times reported that one plaintiff in the class-action suit waited more than a year to have her gallbladder removed. Eventually, she traveled to Mexico to have the procedure done.
Other beneficiaries have been victims of bureaucratic snafus. Last year, Medi-Cal had a backlog of nearly 25,000 applications for renewals of coverage in Los Angeles County alone. Many patients who were eligible for coverage — and had applied for renewal appropriately — were booted for no reason other than government incompetence.
Military veterans may have things even worse. They’re trapped in the VA’s single-payer system — with few options for seeking private-sector care. More than 100 vets in Los Angeles County died over a nine-month window while they waited to see a doctor, according to a VA investigation.
S.B. 562’s proponents say that the single-payer system they have in mind will be similar to those in other countries, like Canada. Earlier this year, they visited our neighbor to the north to “identify key elements of the Canadian healthcare system which can be emulated in California.”
Waiting for care is part and parcel of the Canadian system. Patients now wait an average of 20 weeks between referral by a general practitioner and treatment by a specialist. That’s more than twice the wait time of 25 years ago.
Patients who need joint replacements can expect to wait six months for treatment — more than double the amount of time that doctors consider clinically reasonable.
The driving force behind last week’s hearings, Speaker Rendon, called the Healthy California Act “woefully incomplete” and plagued by “potentially fatal flaws” back in June when he opted not to advance the bill in the state Assembly.
That’s as true today as it was four months ago. Fatal flaws are endemic to every single-payer system — literally.