Does the final report of the Healthy California for All Commission bolster single payer? Short answer: Yes! The 106-page report, which includes the studies and presentations prepared for the Commission during its two years of work, provides a clear rationale for single payer.
Most importantly, the report refers to the billions in savings a single payer system would achieve, while equitably meeting the comprehensive healthcare needs of all Californians. According to calculations presented to the Commission, a shift to single payer would be able to save roughly $500 billion over the next decade. In contrast, maintaining the status quo, with tens of millions of Californians still going without needed care, would end up costing nearly $160 billion more a year by 2031.
The Commission did not aim to lay out a specific plan for achieving single payer, so that was not reflected in the report–a lost opportunity bemoaned by Commissioner William Hsiao, the Harvard healthcare economist (a Newsom appointee) who led the team that designed Taiwan’s successful single payer system 25 years ago.
And the report does leave open the possibility of “intermediaries” in healthcare administration, while also listing a number of questions that remain to be addressed in considering a healthcare system based on “unified financing” (a vague term used in the commission’s official charge instead of “single payer”).
The situation we are left with is familiar: Once again, single payer policy has been proven sound. And still we have to win this politically. In this regard, it was meaningful that the state’s top health administrator, Newsom appointee Dr. Mark Ghaly, amid strong concerns from single payer activists about the initial direction of the proceedings, assumed greater control mid-way. His leadership produced much more open and fruitful communication among Commissioners about single payer health care and the myriad issues covered in the report. Definitely worth opening and looking through!