California Single Payer – The Cost Of Freedom.

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This year, in the middle of 2017, the California legislature is in the process of moving a bill that would convert the entire healthcare system from the insurance based system we all know and “love”, to a single payer system, that, quite frankly, is completely unknown to the average US citizen.

Well, not really. Our police and fire services are also “single payer”. The come, do their job, and unless a ticket is being issued, you the citizen don’t have to pay a bill for those specific services rendered.

You DO pay taxes, which pay for those services. But we accept that.

There are legitimate complaints against the Affordable Care Act passed by Democrats and President Obama in 2010. It has also been good for a lot of people. But it is complicated and convoluted, and a lot of things that were promised did not come to pass.

The health care proposal the Republicans in Congress are working on, the American Health Care Act, doesn’t seem to make anyone except Donald Trump, certain partisans, and a number of Republican politicians happy. The GAO score on the thing is abysmal. There are many who voted for Trump and Republicans, who wanted the ACA repealed, but now realize they will lose their health coverage if the ACHA replaces the ACA.

It’s a mess.

So, if healthcare were indeed converted to the same type of single payer system, here are some of the clear advantages:

You, the citizen, would no longer have to deal with all the paperwork and hassle of getting an insurance company to pay for medicines and procedures that you think they are contracted to cover, but they say they are not.

That is freedom.

You, the citizen, could see any doctor you chose*, because there would no longer be insurance companies, or government for that matter, to restrict you from seeing them. Government pays for all doctor visits, so it no longer matters which one you choose.

That is freedom.

* If the doctor is a quack, and is practicing non-science based medicine, then that should really come out of your own pocket.*

Since insurance would no longer be tied to employment, loss of health care coverage would not be a deciding factor on whether you should change jobs or not.

That is freedom.

If you are an employer, you would no longer have to shill out gobs of money to pay for health coverage for your employees.

That is freedom.

There would no longer be insurance based cost tabulations to administer, there should theoretically be far less paperwork that doctors would have to handle, which means they could spend more time with patients. This was one of the huge failings of the ACA; it created more paperwork, not less.

For doctors…. That is freedom.

Of course, this system is not perfect. If you examine single payer type systems in other countries, you will of course find problems with those systems. But, when all is said and done, health care administered in a “single payer” type model, especially those found in all the other developed first world nations except ours, they are rated better in almost all metrics of healthcare than that of our system.

Including cost.

Oh yes…. Cost.

According to the Los Angeles Times, the cost of implementation of a single payer system in California would be expensive. The estimates range around $400 billion dollars. Yes, that is expensive. But modern medicine is expensive. And here’s the deal. We will not be facing a tax increase of $400 billion dollars. According to the Times, approximately $200 billion would be covered through existing state and federal subsidies. And, remember those employers I mentioned earlier? the amount they pay per year to cover their employee’s healthcare is estimated to be somewhere between $100 billion to $150 billion dollars.

That leaves an unpaid deficit of $50 to $100 billion dollars that we would have to pay in the form of taxes or other revenue generator.

OK. Let’s assume that it’s the high figure of $100 billion dollars we must pay for healthcare. That is no pittance.


There is one basic question that I have yet to see addressed in this debate; what is the cost that the average Californian pays out of pocket in insurance premiums, deductibles, and co-pays? The latter two are complicated and hard to quantify, but insurance premiums are well documented. The average insurance premium for single coverage, excluding the contribution from the employer, is about $350 per month, or roughly $4,200 a year. California has a population of over 39 million. Multiplied together, that comes out to about $163.8 billion dollars a year. That total is far more than what would be needed to pay the remaining balance of the single payer system. But we know of course that not all 39 California citizens pay for their own insurance. Lets say only 25 million contribute. That still comes out to $105 billion, which, again, is over the high cost estimate that we, the taxpayer, would have to make up to pay for single payer healthcare in the state. To pay for the shortfall, California would implement a tax of some sort. If this was collected as part of the income tax, the cost would be spread out more. Therefore, people who currently pay insurance premiums would likely pay less of the healthcare taxes than they currently do for their insurance.

For arguments sake, let’s say the tax we would pay is still more than the average insurance premium. How much would it be worth to be able to walk into a medical center and get treatment at any time, without the hassle of insurance generated paperwork, without having to fight for coverage for even basic care….

That seems like a good deal to me.