Pros and Cons of The California Single Payer Bill

The California state Senate passed SB 562 on June 1. The California Single Payer Bill would put an end to private health insurance, as well as Medicare and Medicaid, and replace it with a single-payer health care system. Under a single-payer system, all California residents will be eligible to receive health insurance from a single state-sponsored insurance system called Healthy California. All funding for insurance will come from the state government, which means that there are no out-of-pocket costs for consumers.

Single-payer health insurance systems are widely used in European countries, and they have been lauded by Democrats in the United States because they guarantee health insurance for all. In many ways, a single-payer system seems like a dream come true—everyone is covered and consumers don’t have to pay a dime! But, like every health care system, a single-payer system has it’s drawbacks.

To better understand what the The California Single Payer Bill will look like, here’s a list of pros and cons:


California Single Payer Bill Means Insurance for everyone!

This is perhaps the greatest and most palpable benefit of a single-payer insurance system—everyone is eligible to enroll in Healthy California.

Under Obamacare, California’s uninsured rate dropped from 17 percent in 2013 to 7 percent today. This is a dramatic improvement, but there are still roughly 3 million people in California that are uninsured. This problem of access will be eradicated completely under a single-payer system.

In addition, consumers will no longer have to worry about being denied by insurance companies because of pre-existing conditions, or any other reason, because the government guarantees care for all. In fact, insurers like Aetna or Blue Shield, can’t even participate in California’s health care system because it’s fully sponsored by the state’s government.  

Expanded insurance can have a positive impact on public health, as one can expect the state’s overall health to improve under a single-payer system.

No out-of-pocket cost for consumers

Health insurance is expensive, and many Americans are forced to pay high premiums, copays, and deductibles. On top of that, prescription drugs can be extremely expensive—even with Medicare, citizens over age 65 sometimes have to pay full prices for their drugs when they reach the coverage gap, or donut hole.

Under a single-payer system, consumers will no longer have to pay any out-of-pocket costs—which means there will be no premiums, copays, or deductibles. Consumers won’t even have to pay for prescriptions. As a result, health care can no longer be denied because of cost.

While insurance for everyone fulfills a promise of accessibility, no out-of-pocket costs fulfills the promise of affordability.

It’ll be much easier to navigate the insurance system

Currently, our health insurance system is incredibly difficult to navigate. Some plans limit consumers to a certain number of in-network doctors, while restricting them from seeing out-of-network providers. This process of finding doctors within your network can be tedious and discouraging. Furthermore, if an individual’s employment or financial status changes, they may not be able to see the same doctors because they might have to change their insurance plan—this can hurt continuity of care.

Under a single-payer system, however, there is very little insecurity and confusion. Because the health care system is a single entity without conflicting networks, consumers can see any doctor they want. Also, they can continue to see their doctor of choice regardless of whether their financial or employment status changes.



The California Single -Payer Bill is expensive!

It costs a lot of money for a state to fund their own insurance system, especially for a large state like California, which houses over 39 million people. The Senate committee in charge of California’s single-payer bill estimates it’ll cost $400 billion to fund the health care system—this is more than twice the state’s current budget.

Where will all this money come from? Supporters of the bill hope to use around $200 billion that was originally intended for Medicaid and Medicare. However, this will be difficult because it’ll require waivers from a reluctant Trump administration and Republican regime that is strongly against a single-payer system. The state may also have to raise taxes in order to fund the system, which is a huge drawback because no one likes higher taxes.

California’s State Assembly will have to get creative when figuring out how to pay for the bill, considering all the hurdles that are in their way.

You can’t keep your existing plan even if you like it

Imagine you like your private health insurance plan as it is—the prices are fine and the coverage is good. Well, this won’t matter under Healthy California because private insurance will cease to exist. All individuals will only be able to receive government insurance, regardless of whether the quality worse. This may not necessarily feel fair to individuals who like their current plans, and it can be seen as an example of how overbearing the government can be in people’s lives.

Quality of care may worsen

Healthy California will cover almost all types of medical care, including dental, vision, and other types of long-term care. Consumers will not have to worry about their essential health benefits being stripped away—which the American Health Care Act might do.

However, while Healthy California promises to provide an array of services, the quality of care may actually worsen. Doctors may face lower reimbursement rates under the single-payer bill, which may force them to see even more patients each day. As a result, doctors may not be able to spend enough time with each patient, considering the increased demand. This will put a strain on the patient-doctor relationship, and ultimately hurt care. 

Image Source: Flickr | Travis Wise

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Imaz Athar

Imaz Athar is a senior undergraduate student at the University of Pittsburgh, double majoring in Neuroscience and Sociology. He aspires to become a physician and plans on attending medical school in Fall 2017. Imaz fell in love with the art of writing at a young age and is currently the Publisher of Pitt's undergraduate-run science magazine The Pitt Pulse. When he's not writing or keeping up with classes, Imaz enjoys running, playing basketball, watching Empire, singing (in the shower), and listening to all kinds of music.