We like Assemblywoman Sharon Quirk-Silva. She’s the best Assemblymember the OC has. She has recently been a leader on housing, homelessness, mental health, and a veterans’ cemetery.
We realize she can’t be a leader, or expert, on everything. And she is not an expert on healthcare reform. But our hearts sunk with disappointment last month when she responded to our friend Matt Leslie’s tweet with a piece of false health insurance industry propaganda:
Well! It’s simply WRONG to mention the “COST” of a program, or the cost of anything, without subtracting its SAVINGS. And if the savings are bigger than what it “costs,” then there IS no cost, or a negative cost. And that’s the case with single-payer health care. In fact it’s the whole idea of single-payer! (Along with covering everybody, and saving and improving lives.)
So “What would you cut?” is a nonsensical question. The question should be “What should we do with our savings?” [For details, see “Into the weeds” below***]
Sharon used to know this. When I first met her about 15 years ago I was running the OC chapter of Health Care For All California (which I started with Allan Beek in 2005), and I think she was running for Fullerton Council with her friend Pam Keller. Our grassroots group was trying to get Senator Sheila Kuehl’s SB 840 passed, and Sharon and Pam signed on. (We had a decent number of conservatives too, ones that understood the unnecessary waste of the current profiteering non-system.)
I devoted years to trying to pass single-payer in California, and not because I’m a nice person who thinks about health care a lot, but because I saw the health care industry (especially insurance) as one of the most egregious examples of big unethical corporations, with the government in their pockets, swindling The American People while causing unnecessary death and misery.
Eventually I got ADHD and handed the OC chapter off to friends, and it still carries on under Janet Meslin. Senator Kuehl has long been termed out, and is now an LA Supervisor (a long journey from Dobie Gillis and the Beverly Hillbillies!) Now we’re fighting for a similar bill, Ash Kalra’s AB 1400. Assemblyman Kalra has tabled his bill until FEBRUARY, because it lacked sufficient support in assembly committees. OC’s fine senators Josh Newman and Dave Min are down with the bill, but it needs more Assemblymembers like our Sharon and Cottie Petrie-Norris. Governor Newsom, a longtime single-payer advocate, would sign it, and California would once again be leading the way for the rest of the nation.
We don’t expect Sharon to be a leader on health care reform, she’s doing enough on other fronts. But we hope she will be a yes vote on AB 1400, and we urge her not to thoughtlessly pass on falsehoods from an industry that doesn’t want to be canceled.
* * * “Into the Weeds” * * *
Or, Skip to the Lou!****
If you want to hear the details about why we say Single Payer saves, rather than COSTS, money: It’s generally estimated California spends $450 billion a year on healthcare; under a single-payer bill such as AB 1400 that would become $400 billion, for a savings of $50 billion. And at the same time EVERY CALIFORNIA RESIDENT would be covered, much more thoroughly than most of us are: “including all primary and preventive care, hospital and outpatient services, prescription drugs, dental, vision, audiology, reproductive health services, maternity and newborn care, long-term services and supports, prescription drugs, mental health and substance abuse treatment, laboratory and diagnostic services, ambulatory services, and more. Patients will have freedom to choose doctors, hospitals, and other providers they wish to see, without worrying about whether a provider is ‘in-network.'”
- Here is the text of AB 1400 “CalCare”
- Legislative Fact Sheet on the Bill
- Open State’s Abstract of the Bill
In 2017 a team of economic analysts from the University of Massachusetts studied California’s previous single-payer bill, SB 562, which is very similar to AB 1400; the “abstract” of their study is worth copying here:
The State of California is considering a bill to create a statewide single-payer health care system. This study provides an economic analysis of the proposed measure, The Healthy California Act (SB-562). The study includes four major sections: 1) Cost Estimate of Universal Health Care Coverage in California; 2) Cost Saving Potential under Healthy California; 3) Financing Healthy California; and 4) Impact on Individual California Families and Businesses.
The primary goal of Healthy California is to provide high-quality health care to all California residents, including those who are presently either uninsured or underinsured. The study finds that the providing full universal coverage would increase overall system costs by about 10 percent, but that the single payer system could produce savings of about 18 percent. The study thus finds that the proposed single-payer system could provide decent health care for all California residents while still reducing net overall costs by about 8 percent relative to the existing system.
We propose two new taxes to generate the revenue required to offset the loss of private insurance spending: a gross receipts tax of 2.3 percent and a sales tax of 2.3 percent, along with exemptions and tax credits for small business owners and low-income families to promote tax-burden equity. Within this proposed tax framework, Healthy California can achieve both lower costs and greater equity in the provision of health care in California for both families and businesses of all sizes.
Thus, net health care spending for middle-income families will fall by between 2.6 – 9.1 percent of income. Small firms that have been providing private health care coverage for their workers will experience a 22 percent decline in their health-care costs as a share of payroll. The small firms that have not provided coverage will still make zero payments for health care under Healthy California through their gross receipts tax exemption. Medium-sized firms will see their health care costs fall by between 6.8 and 13.4 percent as a share of payroll relative to the existing system. Firms with up to 500 employees will experience a 5.7 percent fall, and the largest firms, with over 500 employees, will experience a 0.6 percent fall as a share of payroll relative to the existing system.
- Here you can read the entire 85-page analysis, and
- Here is an 8-page explanation of how they compute the SAVINGS under this bill of families of various means, and businesses of various sizes.
**** Skip to the “LOU”
On the national level, single-payer is more of a far-off dream than it is in California, and that dream is currently incarnated in Bernie Sanders’ SB 1129, which had 14 senate co-sponsors last year. But there IS a house bill that’ll do a pretty large chunk of what single-payer would do, i.e. bring American DRUG prices down substantially. That’s Frank Pallone’s HR 3, nicknamed the Elijah E. Cummings Lower Drug Costs Now Act, and it would accomplish this goal mainly by allowing the government to purchase drugs in bulk, negotiating prices down.
And THAT bill, HR 3, seems to have a good chance of passing, just to judge by all the fear-mongering ads Big Pharma has been running against it. The ones they repeatedly show on TV (MSNBC) don’t mention the bill’s name, just darkly that there’s a bill out there that will allow the government to negotiate-down drug prices, and that this will lead to rationing health care, an end to research, long waits, a denial of medications to seniors, and, you know, DEATH PANELS.
These ads are purposefully being shown HERE, targeting the Anaheim / Santa Ana district of Congressman Lou Correa, at the same time as Big Pharma has sent out at least three mass mailers lauding and thanking the conservative Democrat for supporting and assisting “innovation” in the drug industry. Remember, I wrote about the first one that came in August, a mailer that gave Lou the coveted “Healthcare Innovation Award,” and asked his constituents to thank him for standing against the feared reform. Lotsa free campaign ads for Lou, as well as encouraging public lobbying of the dude!
As I’ve written there and elsewhere, Lou’s always been frustrating on things like health care reform, or anything that threatens big corporate profits. What was he up to now, why was his “no” vote on HR 3 so important to Big Pharma, and could they really count on it? Lou had avoided talking to me since 2018 when I called him “anti-immigrant” for endorsing anti-immigrant Don Barnes for Sheriff. But we saw that he was making an appearance at a Santa Ana Senior Center, so I thought that’d be a good opportunity to ask him why he was opposing the best chance we have to keep drug costs down!
And I got a SORT of answer from him – he says he is fine with the bill, fine with allowing the federal government to negotiate drug prices down, fine with everything in HR 3 WITH THE EXCEPTION OF THE PROVISION IN BOLD BELOW:
The Elijah E. Cummings Lower Drug Costs Now Act would lower the cost of prescription drugs by:
Empowering the Secretary of Health and Human Services to negotiate better prescription drug prices in Medicare and make those negotiated prices available to commercial health insurance plans:
Capping Medicare beneficiaries’ out-of-pocket spending on prescription drugs at $2,000 per year;
Reversing years of unfair price hikes by requiring drug manufacturers to pay a rebate back to the federal government if they increase prices faster than inflation; and
Reinvesting federal cost-savings in the National Institutes of Health and the Food and Drug Administration to support research and development of new breakthrough treatments and cures, as well as making investments in combatting the opioid crisis.
Claimed Lou, “I can’t get behind that rebate part, and I told Pramila Jayapal that in a letter. YOU like Pramila Jayapal, don’t you?” I hadn’t really thought about whether I like Jayapal (right) or not, but paying more attention to her on TV since that day, I suppose I do like the head of Congress’ progressive caucus – she’s tough, smart and realistic, sort of like a Pelosi for Progressives.
But in any case, that’s what Lou told ME about his position on HR 3, the Lower Drugs Costs Now Act – he only disagrees with one provision. Meanwhile his Big Pharma financers want him to tank the whole bill. So let’s see what actually happens, if that provision stays there, and how Lou actually votes.
Meanwhile he has a Progressive Challenger next year, name of Mike Ortega, campaign kickoff this Sunday at Twila Reed Park:
Press Advisory
Wednesday, December 1, 2021
Contact: Alex Coronado alex@ortegaforcongress.com
Mike Ortega (D) to Formally Launch His Campaign for the CD 46 U.S. House Seat on Sunday, December 5th,at Twila Reid Park in Anaheim
Democrat Mike Ortega will hold the official kick-off event of his bid to unseat incumbent Rep. Lou Correa this weekend. Mike is running on a platform of returning government to the people of the district instead of the special interests who hold too much sway in Washington.
Mike’s platform contains raising wages, including raising the federal minimum wage, Medicare for All, and far-reaching criminal justice and immigration reform. A key issue in the campaign will be Lou Correa’s public leadership in watering down President Biden’s Build Back Better plan, including by actively protecting the ability of big drug companies to gouge consumers and by fighting efforts to stop large profitable companies from parking profits overseas to avoid U.S. federal taxes.
“I am anxious to begin the conversation with the people of the 46th Congressional District about how we build an economy that benefits middle class and working families,” said Mike Ortega. “For too long the ultrarich and large corporations have had their way in Congress. Sadly, Lou Correa is a leader in putting the Special Interests ahead of the public interest. He was one of a handful of U.S. House members who worked against the agenda of the President and his fellow Democrats. The people of this district deserve better.”
Mike’s launch event is free and open to the public.
Interested media is asked to contact the campaign.
WHAT: Mike Ortega’s Official Campaign Kick-off
WHEN: 1 pm, Sunday, December 5, 2021
WHERE: Twila Reid Park, 3100 West Orange Ave, Anaheim, CA 92804
Update Dec. 5
Great writing Vern. You got it exactly right. Sharon and Lou both know better. Very disappointing. Cottie Petrie-Norris, Tom Daly, and Tom Umberg have all been quiet on this, and shouldn’t of course. And Lou has the dubious honor of being the only Democratic Member of Congress from OC who has not signed onto both Medicare for All and the Green New Deal. Geesh!!
You definitely like Jayapal, Vern! Pramila was the Squad in Congress before the Squad even existed — and is even known by them as their “Squadmother.” She was the first Socialist elected to Seattle’s City Council, and was so popular, effective, and respected that she vaulted upwards from there.
If Jayapal can get this through the House without Correa, she should. But if she needs to give up the provision to get Lou’s deciding vote, she should — the first two provisions are worth it. The fourth provision doesn’t mean that much because money is fungible.
As for Ortega, Lou can do a lot to ensure that he doesn’t have to face him in a runoff. (He’d rather face a Republican or a Libertarian or an actual Nazi if he could arrange it.) First he’d ensure that one and only one viable Republican runs. (The GOP will run a weak one, because Lou is the Republican Party’s de facto candidate in this leftward district. And Lou will show his appreciation with his votes.) Second is to ensure that multiple Democrats run — and since Ortiz is progressive then the DPOC will endorse Correa, forgetting that they recently censured him for endorsing Sheriff Barnes. (Go ahead, DPOC, prove me wrong!) Of course, some stronger and less establishment Republican could make it a race no matter who the RPOC endorses: not Tait, of course, but some conservative Latino, from any part of the state, could give it a shot. I believe that we had at least one in the recall.
As for the likelihood of single-payer in California — and I know that Dr. Bill disagrees with me — I doubt that it will happen under current law. The reason is that, unlike the US, California does not even theoretically control its own borders — and it would become the dumping ground for hard cases bused, flown, or shipped here from other states.
(1) The first thing to understand is that there is a constitutional right — one of those not expressed explicitly in the Constitution, as if Justices Thomas and Alito really care about that — to travel to and settle in any state in the country. So someone could have been living tax free in Florida most of their life, get brain cancer, and get shipped here by their insurer or their state. Either our quality of care goes down, or eventually Sharon’s dire prediction comes true.
(2) The killer argument against a federal “public option” is that insurers would take the least costly cases and ship the rest onto the public run insurance. (This is pretty much what charter schools do in the field of elementary education, by the way.) If California — or even a “WONCH” coalition of Washington, Oregon, Nevada, California, and Hawaii — set up their own system, then that becomes the equivalent of the public option. Repeat the last sentence of the previous paragraph.
This could work if, as part of its Commerce Clause powers, Congress found a way to take money from other states and subsidize medical care in either California or the WONCH states. Or perhaps it could allow California to limit coverage to people who had lived here for a certain number of years. But that could mean that someone like me — born and raised in California, but absent between ages 24 and 42 — literally could not afford to move back because there was only a single-payer system and I could not get insurance for medical expenses here. So — I’d never have left California, to ensure that I’d have medical care if I ever wanted to come back. (You think that the state is crowded now?)
By far, the best way to do single-payer is to do so on a national level — just like Canada does — so that these problems just melt away. (Visitors to the county would probably have to take out some sort of travel insurance. Unauthorized immigrants to the country might or might not be screwed, depending on what states could agree to do.)
Now it may well be that California saves money even with the likelihood of other states using it as a dumping ground, because so much would be saved by eliminating what we used to call “the middlemen”. (Is there a better term for this now?) And if there is a study that shows that we would make out fine even if other people did try to screw us over — using the principle that there’s nothing so insidious as a good example of something you say can’t happen — then Sharon should see that and I hope that she’d go along with the program. But the studies I’ve seen on this do not really account for the extra costs that I’d expect to see here.
Maybe this will give Sharon the cover she needs to give her opinion on the issue.
By the way, I’m in favor of passing these bills regardless of the problems they raise — because once they are passed then lots of smart people will have to come up with ways to make the system work. I just don’t happen to know, at this moment, what those solutions might be.
One last point on federal single-payer: there has to be a completely ironclad way to keep the mitts of a President who is bent on destroying the system without regard to legalities from getting ahold of the bureaucracy and destroying it, as Trump tried to do with the Post Office. I’m not entirely sure how to do that either, but running it through Medicare seems like a smart possibility.
Hey guys, thought I’d chime in on this one.
Pricing doesn’t magically balance supply and demand because the government sets a price ceiling.
Single payer only saves money if doctors and nurses agree to take a substantial pay cut in line with their peers in other countries with government run healthcare.
The Assemblywoman is 100% correct. In fact healthcare already sucks up a huge chunk of CA’s budget.
Mike Ortega today – finally a decent progressive challenger to Lou Correa! Dec. 5, 2021 at Twila Reid Park….
Vern – loved seeing you at my event yesterday! I look forward to raising some hell here in CA-46 and giving the Lou machine a run for its money. Hope you had a good time.
Ortega is Spanish for “Lou rolls over him”
*Single Payer sounds like a “Catch Phrase” for “what are you talking about again?”
As Ross Perot would say: “The Devil is in the details…”
Does this mean the end of “co-pays”? Does this mean that “Designer Drugs” will be covered?
Does this mean there are no annual Premiums?
Does this mean “Complete Families will be covered including Grandma and Grandpa?
The list is endless……..so before you sign up for the Coverage and whether you get a choice of Medical Providers…….we should probably just wait and see.