Why California Never Will Have Single-Payer Health Insurance

Dr. David Millett checks up on a patient at Lestonnac Free Clinic in Orange, Calif., on April 1, 2021. (John Fredricks/The Epoch Times)

Commentary

The latest attempt to impose a single-payer, socialist health system on California predictably failed. As Politico headlined, “California liberals seethe after Democratic Legislature kills single-payer.” Why?

The reason is because almost all California politicians think they’re special. And the most liberal elements in the Legislature believe they are leading not just the state, but the country, into the radiant future of socialized medicine.

That’s why almost everyone, beginning with Gov. Gavin Newsom and the other recent governors, often repeat how “California is the world’s fifth-largest economy.” Newsom even likes to refer to California as a “nation-state,” which it isn’t.

So some of them entertain the delusion they can enact their own vast policy changes, especially on medical care. Even Gov. Arnold Schwarzenegger tried to push a single-payer scheme in 2007.

But California isn’t the world’s fifth-largest economy. It’s just the largest subsection of the U.S. economy, which is either the largest or second-largest economy, depending how the numbers for China are figured.

Article I, Section 3 of the California Constitution of 1879 guaranteed, “The State of California is an inseparable part of the American Union, and the Constitution of the United States is the supreme law of the land.” That was enacted in reaction to the recent Civil War, in which parts of Southern California flirted with joining the Confederacy, although 17,000 Californians ended up joining the Union Army, out of a population of 400,000.

The current California Constitution contains those exact “inseparable” words, in Article III, Section 9.

Thus the state Constitution is wedded to the U.S. Constitution, which is clear in the Commerce Clause. Article I, Section 8, Clause 3 reads: “Congress shall have the power … To regulate commerce with foreign nations, and among the several states, and with the Indian tribes.”

It was that clause that turned the United States into a vast, continent-wide free-trade zone, a key to our prosperity. Given that almost all trade crosses state borders nowadays, it’s federal regulations on trade that rule the roost.

And that’s to the benefit of California. Silicon Valley companies don’t have to worry about different standards in 50 states. Instead, they go by rules enacted by Congress and enforced by the Federal Communications Commission and other federal bodies. It’s true some states, such as Florida, are challenging internet censorship by Facebook, Twitter, YouTube, and other social media companies. But the challenges are in the context of what’s allowed, or not, by federal law.

And California is against such interference by the states because doing so could harm its most powerful, productive, and influential companies.

Federal Medical Programs

Getting back to medicine, the first problem with any comprehensive state medical takeover is it has to deal with the four big programs already operated by the federal government, although sometimes in conjunction with the state.

The first is Medicare, which after Social Security is the most sacrosanct federal program. That’s because seniors are the biggest voting block. And many have the time and resources to bother local House and Senate members.

Having joined Medicare a year ago, I can report it is one of the better-run and more responsive government agencies I’ve dealt with, although not perfect. It’s far better than the California DMV or Employment Development Department, which would end up being the templates for running California single-payer medical insurance.

Medicare mostly arranges programs and payments with private insurance companies and medical providers. All those private groups have their interests in keeping the system as it is. It’s also a national system, meaning it’s the same in every state. Moving from California to another state doesn’t change eligibility.

The second is the Veterans Administration, which has hospitals and clinics throughout the state. As a veteran, I also use the VA, which has improved in recent years due to reforms by President Trump, which have been continued by President Biden.

Like a lot of vets, I choose what I think is the best care at the lowest price among Medicare, VA, and private resources. I don’t want those choices consolidated in one state-run program. And given the VA is a cabinet-level department, how would California split its care off from federal control? It is also the same across state lines.

Third is Medi-Cal, the state’s iteration of Medicare, the federal program for the poor. I’ve never been on it, but know people who have. They seem to get excellent care, at little or no cost. And Newsom recently boasted in his Jan. 10 announcement for his new budget that all Californians without coverage, including illegal immigrants, will be covered by 2024.

Fourth is Covered California, the state’s version of Obamacare. Although there no longer is a national mandate for coverage, there is one in this state. As the Covered California website explains, “Having health insurance isn’t just a good idea—if you live in California, it’s the law. In fact, 2020 marks the first year that Californians are required by state law to have health insurance. This law is referred to as the individual mandate because it means that all individuals in California are mandated to be covered by health insurance” (emphasis in original).

It’s a messy system, but one Americans like. And it isn’t going to change.

Views expressed in this article are opinions of the author and do not necessarily reflect the views of The Epoch Times.