Wednesday, May 5, 2021
Push for single-payer healthcare grows in CA

Push for single-payer healthcare grows in CA

Large crowd packs the state building to say that the current health-care system in not working -- and will just get worse under Trump


More than a thousand people (my estimate) showed up today at the state building to weigh in on health-care costs – and make the case for a single-payer system in California.

Former state Sen. Mark Leno managed in 2015 – over the fierce resistance of the health-insurance industry – to get a bill passed that requires insurance companies to provide some clear data on their rate hikes and the reasons behind them.

A large, loud crowd showed up to demand health-care reform
A large, loud crowd showed up to demand health-care reform

The bill also mandated that state regulators hold a hearing once a year, in either San Francisco or LA – and this year, it was in the Milton Marks Auditorium in the state building.

Outside, a huge and loud crowd of mostly labor folks marched and rallied and made clear that the current system isn’t working.

Inside, testimony made that even more clear.

Leno noted that price increases have been somewhat lower since his bill passed. Although the measure doesn’t give the state the authority to regulate rates, just the transparency requirements have helped keep costs a bit more under control.

But he noted (as did others) that pharma companies and hospitals continue to charge at times outrages amounts for goods and services – and “if the insurance companies can’t negotiate a better price, then maybe the government should take over that role with a single-payer system.”

That brought applause. Pretty much everyone in the audience agreed that single-payer would be cheaper and more effective.

Some of the information was just crazy.

The average cost for health care for a family of four is $25,000 a year. That’s many times higher than the cost in most Western democracies that have a national health-care system – and the outcomes, by any measure of health, are worse in the US.

A member of UNITE HERE Local 2, which represents hotel and restaurant workers, talked of how every year the union has to decide how much money to allocate to pay increases – and how much to health care. It’s painful: Older workers need health care, but younger workers can’t afford to live in the city without pay hikes.

“My employer pays $12 an hour for our health care fund,” one UNITE HERE member noted.

Mike Casey, a longtime Local 2 leader, confirmed that to me: $12 an hour, much of which could be going to higher wages, winds up in the pockets of the health insurance companies.

I have always wondered why industrial capitalists don’t support single-payer — it would make General Motors more competitive and profitable. But as Casey told me, the CEOs are all part of the same game: “Big investment groups own the hotels and the insurance companies,” he said.

That was a theme all afternoon. “Where did my raise go?” asked stickers worn by workers. “To the CEO at Kaiser,” one of them told me.

That, and Big Pharma.

Data that the state has gathered shows that a significant amount of the money that goes to health-insurance payments is spent on vastly overpriced prescription drugs.

“There is still a lack of transparency about pharmaceutical costs,” Li Lovett, a teacher and union activist at City College, testified.

Assemblymembers David Chiu and Phil Ting both send representatives to speak. Either one talked about single-payer as the only solution.

But that’s what many of the labor people on hand today are pushing – and it’s going to be a serious campaign this year. As the Trump Administration looks to gut and repeal the Affordable Care Act, California isn’t going to have many options: Either we accept that two million people will lose their health insurance, or we push back – seriously.

The regulators who held the hearing today have no authority to make policy; as a long line of people spoke of the horrors of the current system, they could do nothing but listen. I wish the governor had been forced to sit and listen.

But UNITE HERE had a videographer tape the whole event, and it was powerful and moving, and as Casey said, “it’s going on the road.”

And the Democrats who control California are going to have to make clear: Are they really going to oppose Trump (by supporting single-payer) – or are they going to let the insurance industry and Big Pharma continue to control a dysfunctional health-care system?

Tim Redmond
Tim Redmond has been a political and investigative reporter in San Francisco for more than 30 years. He spent much of that time as executive editor of the Bay Guardian. He is the founder of 48hills.


  1. Prior to the Affordable care Act, Americans were slaves of the oligopoly of health insurers, and consistently had to pay prices which rose at more than triple the rate of annual inflation, and used their market pricing power to pick and chose only the healthiest customers to insure. If you were poor and unable to get insurance you died.
    The Affordable Care Act was an incomplete measure because it did not completely eliminate the employer based insurance market, and it also did not provide for the government option. Two Democratic senators voted against the government option which would have been a precursor to the single payer health care system . Why should an employer provide health care? It doesn’t make any sense and this is the only country in the world that has that system. Its bad for everyone, and makes no economic sense.
    So many studies have consistently demonstrated that countries which have single payer systems not only have lower per capita GDP health care costs, but also have more favorable outcomes. Before people start ranting about the poor Canadians who have to wait for procedures, realize that the Canadians live on average one to two years longer than Americans.
    The problem is that many people who work for insurance companies will have to get other jobs, as the profits of the insurance companies in healthcare have declined under Obamacare. That is going to be a difficult transition but it is for the greater good which includes preventing death for people who will not be able to get insurance otherwise.
    In short, the Affordable care act was like putting a bandaid on a hemorrhage. It was insufficient. Going backwards isn’t going to work. America is the most stratified society on the planet, and the most stratified which has ever existed, and this includes lifespan. Poor people still die on average at least ten years earlier than rich Americans, and this will continue to exaggerate until the real solution is passed.

  2. Obama did nothing about cost.
    The middle class hollowed out and from the Dems, silence.
    ‘Let them eat chai-tea lattes and listen to NPR…’

  3. Weird that nothing new has been on 48Hills since this piece 2 days ago. Perhaps Tim will upload new articles tonight? GL.

  4. We can do this, we will do this, and if means sacrificing some “market efficiency” (most of which is profits that go to big pharma stockholders), then that’s a sacrifice we should all be willing to make – especially when it results in more health care for more people. For too long, we’ve basically sacrificed the hope of B+ care for the vast majority of ppl for the right of a few wealthy ppl to have A+++ healthcare.

  5. I don’t know as I’m not a physician or a pharmacist. But if a drug is approved by the FDA, it generally provides a benefit and if it’s financially successful then the patient population sees it as a good thing. I do know, for example, that Kadcyla, Genentech’s breast cancer drug, cost around $1.5 billion to bring to market and has been remarkably effective in the treatment of late-stage breast cancer.

  6. How many of those drugs provide real relief, as opposed to being patent-spinning knock-offs, or become “maintenance-based” rather than one-off vaccine or limited-series cures? Diabetes comes to mind here.

  7. Well, since neither of those is going to happen anytime soon, I’d suggest you come up with a more reasonable plan. Or consider investing in a biotech mutual fund so you can share in the wealth.

  8. No, Americans basically sustain the world’s pharma obscene profits and marketing budget through expensive drugs.

    I think that pharma should be a government operation or highly regulated, profit-wise.

  9. Correct – Americans basically sustain the world’s pharma R&D budget through expensive drugs. So the question arises – who’s going to pay for that once drug prices are controlled here too? And I could definitely get behind not allowing advertising of drugs.

  10. And yet, those drugs are sold for deep discounts in most other countries and the industry is profiting.

    How about making reducing the $30 billion+ marketing budgets of the pharmaceutical industry by making it illegal?

  11. It costs $800 million to $1 billion to bring a drug to market – on average. Almost ZERO of that is public money. Most of it is VC and money from stock offerings. The amount provided by the federal government to that total is less than $1 million. I don’t know where people get the idea the government is handing out cash to pharmaceuticals – it’s not.

  12. American healthcare will never recover from what Obama & Pelosi did. Single payer will NOT lower the price for Californians that have to pay $25k a year for health ins.

    Right now in CA:
    1.4m are on Covered California – 89% are on subsidies
    2.9m have no health insurance, many are middle class/sm biz because of that $25k a year for bronze, which is effectively no health insurance.

  13. Took the word right out of my mouth ! Now we just need someone to put it in some Cal legislators mouths (though I don’t think Moonbeam, in his dotage, would let it through).

  14. Whether we get Govmint-Payer or continue with Oligarchy-payer, the one palliative we really need is TRANSPARENCY.

    The Rs think they can just gut ACA and all will be fine (wrong). When even doctors don’t know the costs of the services they prescribe, then the system is definitely broken. How can any hope of a “market-based” or single-payer solution succeed if we don’t know the cost and the prices.

    However, the pending fight seems to ignore and eclipse this simple solution.

  15. I wonder if Tim has any idea how much time and money it takes to bring a successful drug to market. It’s an incredibly lengthy and expensive process, which usually results in failure. For every single successful drug there are 100+ that were abandoned because they failed their trials. How does anything think pharmaceutical companies are supposed to see a return on their investment without charging large amounts for these drugs?

  16. The testimony at this hearing was powerful and inspiring. Worker after worker spoke eloquently about the vital necessity of health care for all and that this is literally a life-and-death matter facing many people every day.

    But at the end of the hearing, the woman (I am sorry, I do not know her name) who was running the meeting for the California Department of Managed Health Care could only muster up a comment that they would come back in a year and hold another hearing. Truly clueless.

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