As a Californian, some of the decisions of our state legislature seem ridiculous. After all, this is a state that approved a $64 billion high speed rail project that has been delayed numerous times. It is the state that passed a gas tax increase in the name of repairing roads when the last few tax increases couldn't do the job. It is the state that screwed over farmers by pursuing policies that prolonged the drought. Overall, California’s state government makes many questionable decisions. Nevertheless, the recent passage of a bill creating a statewide single-payer healthcare system is questionable even by California’s usual standards.
One could write an entire article about the general issues with single-payer health-care, but for the sake of brevity, I will focus only a paragraph to single-payer health-care’s general flaws before diving into the problems with the California proposal in particular. For one thing, single-payer healthcare lacks a market-based price system, which is essential to conveying the value of services and goods. Additionally, there are the issues of not being able to treat everyone, making people suffer from longer wait times. In Canada’s much-praised universal system, wait times for healthcare recently hit 20 weeks, a length that makes getting critical care difficult at best. In Britain, the NHS faces similar problems, with many patients not getting treatment for over 18 weeks after being referred. Overall, even in some of the most praised versions of single-payer healthcare, there are critical problems.
Even if one does not find the above critiques to be sufficient reasons to oppose single-payer healthcare, there are enough issues in this particular proposal to doubt its merits. For one, there is the budgeting needed for the system. It is believed the proposal would cost $400 billion and was not passed with a plan to pay for it ready. For comparison, in 2015, California's entire state budget was $252 billion. This healthcare plan alone would exceed recent state budgets. Redirecting the entire state budget to this healthcare plan would still leave a roughly $100 billion deficit.
Coming up with a way to pay for this plan is extremely difficult. Raising taxes to pay for this plan is a nonstarter. California's taxes have driven approximately 9,000 businesses from the state. These prohibitively higher taxes also intimidate new businesses from even being started, harming the state’s economy. Not only are businesses fleeing these high taxes, but these taxes are also driving other residents out of the state. Any tax increase to pay for this healthcare plan would only exacerbate these problems. Clearly, that is an option that shouldn’t even be considered. Going into debt is also not an option. Theoretically speaking, California’s constitution requires a balanced budget. Even when this requirement is not met, passing the burden on to future residents is not a good policy. Putting our children and grandchildren into debt to pay for this program would put the long-term health of California’s economy at risk.
Overall, the cost alone is sufficient reason to reject the merits of a statewide single-payer healthcare system. Coupled with the general issues with single-payer healthcare, this proposal should easily have been rejected. Unfortunately, this legislation has already passed the State Senate. It still faces obstacles - it must pass the state assembly and Governor Brown hasn’t yet said if he would sign this bill into law. However, there is a chance this proposal, however poorly considered, could become law. That would be bad for all of our state’s residents.
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