With a budget surplus of more than $200 million, the California legislature is thinking big, really big, and that means one thing: single-payer government health care, which recently was introduced as AB 1400.
“The purpose is to cover everyone and reduce health care costs by eliminating private insurance overhead and profit—and negotiating lower provider fees and drug prices. There’d be no premiums, co-pays or deductibles. And many services would be added, including dental, vision, hearing and long-term care for Medicare beneficiaries.”
Supporters’ implication is that nothing would change in the creation and sale of health care services except that the manner of payment would be taxation and everyone would have all the services they need with no price. All that is needed is “political courage” to vote “yes” and then to enable the California bureaucracies to install the new system.
Yet that hardly is the case. Single-payer would mean that medical care would be purely a state-run affair, which means that all factors of production going into health care in California would be directed by the political system. (Yes, bureaucrats work for the government, and the last time we checked, government still was political.) If California politicians and regulators are determining the services eligible for payment—and the payment amounts—then they effectively control the entire system.
Anyone who believes that politically directed medical care would be a simple extension of the present system—but made affordable—should look at the behavior of both the state and federal governments during the first six months of the COVID-19 pandemic. Governments essentially commandeered hospital resources, ordering them to be devoted almost exclusively to treating COVID-19 patients.
“Not rural hospitals. Many in the Missouri and Illinois countryside are nearly empty, hospital officials and industry leaders say. Residents are avoiding them out of fear. But coronavirus patients also haven’t appeared, at least not in the numbers anticipated.
“Now, with many beds empty, rural hospital administrators are increasingly worrying about how they’ll pay their bills.”
Elsewhere, people who needed heart surgery or had scheduled treatments for cancer had those procedures postponed. It didn’t matter if they were in dire need. The only thing that mattered—at least to medical bureaucrats—was clearing the hospitals and redirecting other medical resources to dealing with COVID-19. The value of all other medical resources was driven near zero, not because the actual medical situation required such extraordinary measures, but because government agents wanted to be seen as in charge and leading the fight against a pandemic.
While some claim that COVID-19 was an extraordinary circumstance that required radical measures, there is no doubt that if California authorities impose a single-payer model, the scope of medical care will change and probably change significantly. Politicians through their medical bureaucrats will demand that medical facilities, along with doctors and nurses, direct resources toward things that score political points with progressive constituencies, such as abortion on demand, COVID-19, monkeypox, or whatever is on the horizon that grabs the headlines.
The real costs of a California program are not the monetary outlays but rather the medical care that will be shoved aside to satisfy political pressure groups. Moreover, the increased state scrutiny that will come from this kind of a system will ensure that administrative actions will be substituted for medical care, as politicians and regulators will act like, well, politicians and regulators.
California progressives have turned their largest showplace cities into sewers of homelessness and crime, and their mismanagement of water resources has become a thing of legend. One only can wait with dread as those same progressives move to do with medical resources what they have done with everything else that has been good in this state.