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Dems and ‘single payer’ — a house divided?

Lt. Gov. Gavin Newsom, a candidate for governor, attends a 2017 nurses union gathering in support of singe payer. (Photo: Chris Allan)

It goes by various names: universal health care access; national health care; Medicare for all; government-run health care; even socialized medicine. Most news reports call it “single payer.” It threatens to tear asunder California’s Democratic Party.

Single payer, in which the government ultimately covers the cost of health care, has become the bright line of demarcation between the more liberal Berniecrats and more moderate Establishment Democrats. Among party activists, it is an emerging litmus test for party purity.

“If single-payer healthcare is going to mean complete takeover by the government of all healthcare, I’m not there yet.” — Dianne Feinstein.

Opposition is fierce. The influential California Medical Association said in January that single-payer legislation in the Capitol, SB 562,  “would eliminate Medi-Cal, Medicare, all private insurance and the Covered California exchange for a singular health care insurance product provided by the state, without offering any way to pay for it.”

The danger to Democrats is that disagreement over the issue could depress their turnout, with some more left-leaning Democratic activists refusing to support fellow Democrats who are not sufficiently enthusiastic about single payer.

The Democratic disparity is wide and public.

“If single-payer healthcare is going to mean complete takeover by the government of all health care, I’m not there yet,” Democratic Sen. Dianne Feinstein said at a town hall in April of 2017.

But three months later, her fellow Democrat, Sen. Kamala Harris, said she intended to co-sponsor Sen. Bernie Sanders’s Medicare for All bill “because it’s just the right thing to do.”

Feinstein’s likely opponent as she seeks a fifth term this November is Kevin de Leon, another Democrat and until recently the leader of the California Senate.  He’s all for single payer. So is his successor as Senate leader, Toni Atkins.

De Leon in February received an endorsement from the California Nurses Association, the chief sponsor of Single Payer in California, and declared:

“… I voted to pass single payer legislation because our representatives in Washington, D.C. have wavered on this issue for far too long,”

“We’re talking about a sea change – it’s absolutely breathtaking. Nothing in our lifetime is as significant as single payer.”– Dr.  William Bronston

But on the other side of the Capitol, Democratic Assembly Speaker Anthony Rendon shelved SB 562, the Senate-passed single-payer bill that Atkins supported. Rendon says he’s for Single Payer as a concept, but SB 562 lacked any details on financing.

That move outraged longtime single-payer supporters, such as retired Dr. William Brownston, who heads the Sacramento chapter of Physicians for a National Health Program.

Bronston contends single payer is more than merely a good idea — it’s a society-transforming phenomenon.

“We’re talking about a sea change – it’s absolutely breathtaking,” he told Capitol Weekly in a telephone interview. “Nothing in our lifetime is as significant as single payer.”

Foes of  single payer are led by vested interests who want to preserve their financial advantages, he said.

Antonio Villaraigosa believes single payer, as advocated by rival Gavin Newsom, would force seniors off Medicare.

“The insurance industry makes no contribution to health care. We’ve been flooded with corporate propaganda against single payer,” he says, arguing that significant campaign contributions from the insurance and medical industries are the reason Gov. Brown and Assembly Speaker Rendon have not been more enthusiastic about single payer.

“There has to be enough of a grass-roots uprising to force the corrupt Democratic Establishment to accept single payer,” he says.

Single payer has already become one of the major issues in the race to become California’s next governor.

Lt. Gov. Gavin Newsom, the Democrat leading the race for governor, is unabashedly in favor of single payer.  But fellow Democrat Antonio Villaraigosa, running against him, says he favors the concept of single payer, but not SB 562.

Villaraigosa says single payer, as advocated by Newsom, would force seniors off Medicare; the California Nurses Association, backing Newsom and Single Payer, called Villaraigosa’s accusation “fear mongering” and “disgracefully intended to alarm seniors about their Medicare coverage.”

In another sign of the party’s shift to the left, delegates to the February 2018 convention in San Diego refused to endorse Feinstein for re-election.

California’s most famous Democrat, Jerry Brown, voiced a similar concern in March of 2017. “Where do you get the extra money? This is the whole question,” the governor said in a Washington exchange with reporters.

Thirty-six years ago, however, Brown wasn’t so doubtful about Single Payer.

“My preference is that we create a single system, put everyone under a universal health care system. We treat health care not as a commodity to be played with for profit but rather the right of every American citizen when they’re born,” he said in April 1992 in a debate with Bill Clinton when both were seeking the Democratic presidential nomination.

The California Democratic Party’s platform is forthright on single payer:

“California Democrats believe that health care is a human right not a privilege. The CDP recognizes that the health and well-being of Californians cannot continue to be based on arbitrary private and public financial decisions and therefore advocates legislation to create and implement a publicly-funded single-payer, privately delivered, fiscally tractable, affordable, comprehensive, secure, high quality, efficient, and sustainable health care system for all Californians.”

In another sign of the party’s shift to the left, delegates to the February 2018 convention in San Diego refused to endorse Feinstein for re-election. They didn’t endorse de Leon either, but the non-endorsement of an incumbent Democratic senator was a major slap in the face to Feinstein. She had 37 percent of delegate votes and de Leon had 54 percent, just short of the 60 percent needed for endorsement.

In June of 2017, The Pew Research Center reported a jump in Democratic approval of single payer.

But will a civil war between two camps of Democrats really affect how voters behave this June and then in November?

It may be firing up party activists, and may affect how hard they push voters, but among the larger electorate so far, the intra-party squabbleseems to awash in contradictions.  A Public Policy Institute of California poll in February had Single Payer doubter Feinstein leading Single-Payer enthusiast de Leon 46 percent to 17 percent, with 33 percent of likelyvoters undecided.

In June of 2017, The Pew Research Center reported a jump in Democratic approval of single payer:

“Among Democrats, 52% now say health insurance should be provided through a single national insurance system run by the government, while fewer (31%) say it should be provided through a mix of private companies and government programs. The share of Democrats supporting a single national program to provide health insurance has increased 9 percentage points since January and 19 points since 2014.”

“It will cost $400 billion. Wrong. Over 90 percent of that is what we already spend on healthcare.” — Deborah Burger

The 43,000-member CMA worries about the cost. In its Jan. 17 statement, it said: “What’s more, the Legislative Analyst’s Office (LAO) found that the proposal could ‘require new state tax revenues in the low hundreds of billions of dollars and ‘could result in a lower minimum funding requirement for schools and community colleges’ under Proposition 98. In other words, SB 562 would pit health care groups against public education advocates in an annual battle for state budget dollars…”

In a Jan. 24 op-ed in the San Diego Union-Tribune, Deborah Burger, co-president of the California Nurses Association, challenged such cost assumptions:

“It will cost $400 billion. Wrong. Over 90 percent of that is what we already spend on healthcare,” she wrote.

“Savings from a single-payer system on funds insurers siphon off for profits, paperwork for denials of care insurers don’t want to pay for, and lucrative executive pay packages, and the state’s ability to use its bulk purchasing power to lower drug costs, will further reduce the overall spending. No other proposed approach to ‘cost containment starts with $37.5 billion in savings, as Senate Bill 562 does, and then constrains prices and costs in the most effective ways.”

With battle lines already drawn, the intraparty battle is probably going to become more heated in coming months, likely forcing Democratic candidates who have so far avoided the issue to take a stand for or against – either losing or gaining votes.


  • Nick Dermott

    Democrats have a bigger problem. Single-payer advocates are basically unAmerican. Turning over money and my healthcare decisions over to government is about as far from the Constitutionally limited scope envisioned by this country as is Stalinism. The extremism of Democrats will drive them further into minority status.

    • ruby2zdy

      But you’re happy with your medical decisions being made by insurance companies trying to maximize profits?

      • San Bernardino Nick

        Actually, since I can FIRE my insurance carrier, yes, I would rather have them involved under a legally binding contract then a government bureaucrat who has the power of the government to cut off my healthcare, like what is happening in Great Britain.

        • DaMaestro

          Nick – as an American who regularly guest works in both the UK and Canada, and has been treated under both countries’ public healthcare systems, let’s have some proof of your accusation. And I mean REAL proof, and not hearsay from a right-wing source. Because I’ve BEEN there, I RETURN there, have resident FRIENDS there and: your statement is by no means supported by the preponderance of reality – THERE.

          • San Bernardino Nick

            https://www.rt.com/news/uk-nhs-health-crisis-049/

            The articles are literally everywhere about the British system….LOL

          • DaMaestro

            So you claim that confirmation that’s somehow the opposite of what I have personally experienced is “literally everywhere” – and you respond with “information” from a Russian website? Nick – RIGHT THERE ON THE WEBSITE YOU OFFERED AS confirmation for your absurd thoughts: “RT is publically financed from the budget of the Russian Federation.” Sure. Right. You buy what the Russian Federation says, huh? Why is it you set yourself up like that? And I’m not EVEN going to bother joking about what the Russian Federation means to Trump. Wow. Keep it up, Nick – you’re doing a great job of proving my points for me.

    • DaMaestro

      Sure! Because it’s much better to value profits over human lives. After all: our US Constitution decrees that capitalism WILL be our form of government, right? Nick, you really need to think twice about the BIGGEST problem of all: the takeover of our lives by corporations, as aided and abetted by the GOP and its minions. THERE’S the UN-AMERICAN problem you really need to consider – and why the sort of mis-application and deliberate lack of comprehension of the US Constitution (and its perversion by those on the right) are the true enemies of this nation, and are anathematic to what the Founders wrote of, created – and believed.

      • San Bernardino Nick

        It’s funny watching democrats complain about corporations, when they are heavily supported by them. Big Government and Big Business go hand in hand. Big business supports the regulatory state, because they can use it to crush small business competitors. It’s why major corporations love regulations they can manipulate through democrat regimes, just like Google and Facebook did with the FCC regulations on “net neutrality” which doesn’t apply to them. The hypocrisy here is so deep that even the usually unengaged public doesn’t by the communist mantras of the left. BTW, I also like the option to pay for my healthcare out of my pocket, so I know I am getting my money’s worth and I can go to ANYONE for my care, instead of having a government puke or an insurance agent tell me what I have to do. You Nazis don’t allow for that possibility.

        • DaMaestro

          And there we have it: you create straw man and all-encompassing artificial pronouncements such as “Big Government and Big Business go hand in hand” and “democrats (sic) complain about corporations, when they are heavily supported by them” – and then insult those with whom you disagree by called them Nazis, Communists – and of course, that old standard: “government puke.” All the hallmarks of someone without a leg to stand upon, but who still insists upon trying to kick other people. Sorry, S B Nick (which – presumably is another nom de plume for Nick Dermott) but you need to seriously re-think whether you want to be strangled by privateers or protected by a GOVERNMENT plan like Medicare. Which – despite all you may wish to sling at it: works pretty darned well, and with a fraction of the overhead private insurers force you to cover.

          • San Bernardino Nick

            No need for a Straw Man. The evidence from government run programs is everywhere to be seen: at the Veterans Administration, Great Britain, and elsewhere. Your worship at the feet of government is why Democrats lost the House and Senate, and why they are in the minority of over 30 statehouses. The idea of government running our lives is great for a George Orwell book and for democrats, but the country isn’t buying the socialist/communist/nazi authoritarian failure that democrats are pedaling. You folks keep pushing down this path and see just how small a minority you can become. Please, please please!!!!

          • DaMaestro

            Yup – exactly as I knew: You’ve got NOTHING. Thanks for confirming what I wrote, Nick.

    • Nicholas Aikens

      From the declaration of independence: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, — That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.”

      A. Life is contingent on good health. Our lives are a right, not a privilege.
      B. The current way of government relates to healthcare and the lobbying that goes on is destructive toward the ends of supporting our current life and happiness. A majority of Americans support single payer and we, the people, will work to alter the government to be happy and healthy with a system of government that supports us.

      • San Bernardino Nick

        No, Americans don’t support government run healthcare. Not even in California. BTW, healthcare is a comodity. It is provided by trained payed professionals, who should be able to charge what the market will bear for their services. Government mandated healthcare is nothing more than bonded servitude masked as some kind of civil right. Of course, Democrats have been big propone ts of slavery

        • Nicholas Aikens

          https://www.washingtonpost.com/news/the-fix/wp/2018/04/12/about-half-of-americans-support-single-payer-health-care/?utm_term=.61bd7258e908
          perhaps you have different information, but I’m seeing more than 50%
          Is there some healthcare that is a commodity? Sure, like plastic surgery and hair implants. I can’t disagree with you there, and lets work to make sure that this will not be included in single payer. I would also say that a good portion of healthcare, such as treatment for preventable illnesses is a human right.
          Related to political parties: I agree that the Democratic party has some problems. Lets vote the issues, not the party, to make this a better country together.

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