Wednesday, October 18, 2023

Gavin Newsom’s Single-Payer Bill Epitomizes Socialist Overreach

The news media are already working overtime to portray Gov. Gavin Newsom, D-French Laundry, as moderating his positions ahead of a possible presidential run in 2028. Don’t you believe it.

Legislation that the governor recently signed into law would take new steps to foist a single-payer health care system on the nation’s largest state. That Newsom would have few qualms about doing so demonstrates an ideology far more radical than his allies would like to portray.

Big-Government Outline

The legislation does not on its own establish a single-payer system in California. Doing so would cost significant sums of money, even as the state had to scramble to close a $30 billion budget deficit this summer.

Instead, the bill directs the state’s secretary of health and human services to spend the next two years developing a waiver application to the federal government. Lawmakers hope the waiver would give California federal resources to achieve its supposed socialist utopia.

As such, the five-page bill only includes broad-brush parameters of how the single-payer system will work, relying on state bureaucrats to flesh out the details over the coming two years. But the parameters provide a troubling view of the road ahead for the Golden State.

Among other provisions, the bill states that the new system should provide:

“Services that will not vary by age [or] employment status.” This provision implies that California residents who currently receive health coverage through their jobs will no longer do so. Or, to put it more bluntly, “If you like your plan, you can’t keep it.” Likewise, saying that services will not vary by age implies that seniors will transition out of their current Medicare plans, once again demonstrating that a single-payer health system represents not “Medicare for All,” but “Medicare for None.”

“Services that will not vary by … immigration status.” This provision indicates that California will continue its efforts to expand health coverage to illegal immigrants in the state. As it is, the state will already spend more than $2 billion to cover all illegal immigrants beginning next year. It is doing so despite the fact that no less a leftist than Hillary Clinton admitted to Congress that “illegal aliens” migrate to the United States in part to obtain “free” health coverage.

“The absence of cost sharing for essential services and treatments covered under the program, including primary, preventive, and wellness care services.” This bullet, when viewed in conjunction with a later bullet that talks about capping individuals’ costs on a sliding scale based on income, may or may not mean the new system will provide services “free” at the point of care. But if cost-sharing does largely disappear, the amount of “free” care provided will soar, because individuals will attempt to consume more care. A 2019 paper by the Urban Institute, a leftist think tank, found that a single-payer plan that eliminated virtually all cost-sharing would increase national health spending by as much as nearly $1 trillion per year.

“A ratesetting process that could use Medicare rates as the starting point for the development of final rates.” The bill hedges on whether or not to use Medicare payment levels — which are generally lower than the rates paid by most private health insurance — to reimburse doctors and hospitals. But if California decides to use Medicare reimbursement rates, or even something approaching Medicare rates, layoffs and job losses would result. In addition, morale among doctors and nurses would likely plummet, as the government would effectively pay them less to do more work.

The downsides to this alleged socialist paradise seem obvious. Ironically enough, Newsom might see those downsides too — just not enough to rein in the radical leftists in the California legislature.

Political Punt

Believe it or not, the bill Newsom signed got attacked from the political left in California. Groups like the California Nurses Association think that requiring another in a long line of studies regarding a single-payer system, rather than pushing to enact legislation immediately, represents a delay tactic.

Indeed the bill does amount to a punt of sorts. If a Republican gets elected president next November, Newsom can claim a new administration would deny California the waiver authorities it needs to bring single-payer to fruition — thereby allowing Newsom to dodge the tough policy choices associated with crafting a new socialized health care system.

That Newsom chose to take this gamble rather than alienating the left speaks to the nature of his own politics. It also means that many Golden State residents may want to follow the trend of other Californians and move elsewhere before Newsom and his leftist legislature impose their socialist designs on the state’s health system.

This post was originally published at The Federalist.