It’s single-payer o’clock in California. We are, in the words of Funkadelic, “standing at the verge of getting it on.” Or we may end, in the words of Oakland’s own Fantastic Negrito, “lost in a crowd.”
Senate Bill 562, to create single-payer health care in California, was sponsored by senators Ricardo Lara and Toni Atkins and passed the Senate in June. Assembly Speaker Anthony Rendon has not yet scheduled the bill in the Assembly, so supporters turned up the heat. Everything from protests to threats of recall to blaming him for patients dying under our current amoral health system.
Let’s assume, for the sake of discussion, that we all support single-payer with equal fervor. If you hate your doctor but love Aetna, read no further. This isn’t for you. This is not an argument about whether single-payer is urgently worth fighting for, but how.
The explosive energy of the Bernie Sanders movement has moved single-payer from the margins to the mainstream of Democratic politics. Now, enthusiasm for single-payer is spreading like a virus that requires out-of-network treatment.
Presumably, people who believe in single-payer can disagree about details and strategy to win it. Hopefully, we can resolve those disagreements without denouncing each other as puppets of pharma. No less a single-payer champion than Steffie Woolhandler of Physicians for a National Health Plan in March on the Behind the News podcast warned against getting too excited about state-based single-payer because of federal obstacles.
Passing single-payer in California will require a two-thirds vote of the legislature (because of the tax increase), which is a tall order considering that the current Democratic supermajority is already threatened over the recent gas tax vote. It would also require a ballot measure to exempt single-payer from the spending requirements of Proposition 98, and would require a federal waiver (from Trump!) and possibly an act of Congress (from Paul Ryan!) to be able to use existing federal health funds on a state system. We should assume the insurance industry would go to the ballot to block any single-payer plan. If Big Plastic Bag, Big Menthol and Big Landlord can wield the ballot to thwart the legislature, Big Co-Pay definitely will. It’s a fight to the death.
Single-payer is the cheapest way to get the most health care to the most people. From the perspective corporate America, single-payer is an existential threat. An entire industry of behemoth insurance corporations would be shuttered. Business also recognizes, correctly, that single-payer would shift bargaining power toward workers. Winning single-payer means ending our 40-year losing streak in the class war. And it’s a slippery slope to diminishing market dominance of everything else. The 1 percent is afraid that socialized medicine will lead to socialized utilities, transit and housing. (Yes, everybody loves a slippery slope.)
Democracy can kill an industry, of course. How often do you get campaign mailers from Big Asbestos? But, to paraphrase “The Wire,” “If you come at the king, you best not miss.”
A lot of supporters of SB 562 tell me they’re in a long game and don’t expect to actually pass it. They want the legislators to vote and be held to account. If the goal of a state campaign is not to pass a bill but advance political narrative, then mission accomplished!
If we are to battle the health insurance industry to the death, why not finish the job and focus on HR 676, the federal single-payer bill? This California stuff feels like a lot of tsouris to end up having to go federal anyway before anything can be implemented. It’s not clear winning single-payer at the state ballot is harder or faster than winning federal single-payer, which would moot the state ballot question.
None of this helps the patients suffering today, but there’s no time to squander on outrage. There’s a world to win.
Nato Green is a San Francisco-based comedian and writer and union organizer with SEIU. Catch him live with Francesca Fiorentini and Natasha Muse for Verdi Wild Things Are at the Verdi Club on Thursday, July 13.