Wed, Nov

California Dems Split on Single-Payer vs. ‘Ideological Purity’


EASTSIDER-For those living under a rock, California Senate Bill 562 is a California Only, Single-Payer Healthcare Bill. After passage by the Senate and moving to the Assembly for a vote, Assembly Speaker Anthony Rendon (D-Lakewood) pulled the bill from further action this legislative session. He did note that since this is the first of a two year session, the bill can be revisited next year. 


Well, you would have thought the sky had fallen, or that Rendon was a Benedict Arnold turncoat, as was implied by John Queally in a CityWatch, aricle, “Outrage Quake Rattle Golden State!..Democrat Pulls Plug on California's Single-Payer Bill.” As Queally noted, Bernie Sanders himself was “deeply disappointed.” 

But the personal attacks on Rendon went beyond the pale. You can get a taste of the rallies, rhetoric, and even death threats here.   

So What’s Actually In the Bill? 

I would suggest that people actually read the text of the bill itself before they get too revved up. You can find it here.   

Normal for legislation, the bill is about 39 pages of dense legalese. Major changes the bill would: 

            - create a new Healthy California Program for single-payer healthcare. 

            - incorporate the healthcare benefits of a number of benefits and services. 

            - incorporate benefits and standards of existing federal and state programs. 

            - incorporate ADA, Knnox-Keene & Medicare programs. 

            - require various federal payments to go to Healthy California. 

            - require follow-up legislation to establish a revenue plan and appropriations. 

            - create a nine member Healthy California Board to govern the program. 

            - block healthcare providers from offering benefits outside of the program. 

            - block implementation of the Program until it is fully funded. 

As you can see from this summary, big chunks of the bill require further legislation -- and this is only a partial list. There are a lot of moving parts that would need to come together to realistically calculate the how much money is needed to fund the Healthy California Program, as well as how much of a tax increase on you and me would be necessary to move forward. 

First, the Math 

Oh drat, I know, math again. But let’s be honest. Realistically, if we want single-payer healthcare in California (and I do), there are two separate components to get there. First, there is the desire, and there’s clearly no doubt that an overwhelming majority of Californians think single-payer would be great. As a recent LA Times article noted, something like 2/3 of Californians like the idea. 

The second part, however, is the question of how much people are willing to pay. According to the California Legislative Analyst’s Office, the total tab could be about $400 billion - that’s right billion.  The Legislative Analyst’s Office is our version of the Federal CBO. Optimists say only $330 billion, but that’s still a very large spread. 

Of that, about half could be repurposed from the existing budget, but that still leaves upwards of $200 billion for the taxpayers to pony up. Unsurprisingly, less than half of the electorate has any interest in coming up with this kind of money. 

Further, while the exact amount is unknown, the scary problem is that no one can actually say with certainty how much new money would be needed. In large part, this is because no one, not even Donald Trump, Mitch McConnell, or Paul Ryan (much less the Democrats) knows what the Federal government is going to do this year with healthcare and the ACA. Nobody. 

Guess what? That also makes it impossible to calculate how much (if anything) is going to come to California to make healthcare work. Period. So you can’t do the real math of estimating exactly how much money would be available to us from the Feds, even as folks try to make those estimates. 

While proponents of the Bill float out numbers of somewhere between $300 - $400 billion bucks, their assumptions and numbers are like economists: get three of them in a room together and you will get five answers. Again, no one really knows. 

And that’s good reason for Rendon to delay action on the bill until next year. 

Fault Lines 

From the time it was muscled through the Legislature until the day that Anthony Rendon pulled the plug, SB 562 has been incredibly contentious and ideological, dividing the Democratic Party in California. 

Bernie Sanders, unsurprisingly, is 100% in favor of the bill, as are a number of other folks, including friends of mine. In the opposite camp, a lot of quietly worried Dems are opposed to the bill for some very logical reasons, like Basic Math 101, not to mention worries about their election or reelection. 

At the risk of being drummed out of the Democratic Party, I’d like to spend some time going over who backed the legislation and how it got through the legislature, as well as why there should be a legitimate debate among us Democrats as to whether or not it is good legislation. 

My personal belief is that the bill is not a bottom up grassroots piece of legislation; rather, it’s a top-down law pushed by special interests within the party. SB 562 is, in fact, the product of the California Nurses Association, and its head, RoseAnn DeMoro. 

Making no bones about her wishes, she has openly threatened to campaign against Democrats who don’t vote for SB 562. Just ask Anthony Rendon. 

At the same time, lest you think RoseAnn is some sort of present-day Cesar Chavez leading the charge for social justice, it is only fair to point out that she makes something like $350,000 a year in her position, and prior to her husband’s retirement from the California Nurses Association, their combined income was about $700,000 per year. You can read the Calmatters article here.  

This is not the $15 buck grassroots in action. 

The Takeaway 

Anthony Rendon has taken an incredible amount of heat for killing the bill for this year. If those who shout loudest about ideological purity would calm down for a minute, this is a good thing. We will know enough about what the Federal government is going to do about healthcare by next year. This will give people time to build a consensus as to how to deal with one of the most important facets in their lives. 

And even though no one seems to want to talk about it, I’m not sure if the Democrats are going to be able to keep their supermajority in the Assembly and the Senate with funding for this issue front and center. Remember, the Dems already have their hands full explaining how and why Californians are going to have to pay a huge gas tax increase (a flat 12 cents/gallon), which is regressive and disproportionately affects lower income folks -- not to mention the “transportation improvement fee.”  

I should also point out that the reason Jimmy Gomez is in Sacramento instead of Washington is to deliver a couple of key votes so that the Dems can push through their legislation, like cap and trade.  So I wouldn’t bet that the supermajority is a lock. Plus I find it interesting that it is evidently ok for the Dems in California to ram through anything they want without talking to the Republicans, while it’s a major crime and betrayal of trust when the Republicans in Congress do the same to the Dems. 

A little time, some hard numbers, and fleshing out SB 562 would be nice. Nicer would be to take the time to explain in an open and transparent way exactly how all the parts of this plan will be implemented and why it’s worth the tax increase to Californians. Remember, the differences between $300 billion and $400 billion is not a rounding error.


(Tony Butka is an Eastside community activist, who has served on a neighborhood council, has a background in government and is a contributor to CityWatch.) Edited for CityWatch by Linda Abrams.