The debate on SB840 in Senate Health Committee went smoothly, with only two questions from the Committee. But this is because the committee has heard this bill before in different incarnations. It’s instructive to see how the debates have gone previously.
Here are the reports from previous committee hearings on single-payer:
April 2003 when then-SB921 passed Senate Insurance Committee.
What they said then….
Opponents included the CA Association of Health Plans, which criticized the bill because it “promises too much,” that the stated administrative savings “defies belief,” and that the bill would replace “private competition in favor of a monopoly.” The CA Healthcare Association, representing hospitals, stated that the “risks associated with abandoning” the current system are not worth it. The CA Chamber of Commerce, and other employer and business groups, complained about the envisioned taxes. (Supporters restated that revenues raised would serve to replace the current expense of health premiums, deductibles, and other expenses.) The CA Association of Physician Groups stated that “a government-run system in not acceptable.” Some health underwriters from around the state turned out, wearing buttons against SB921.
Dozens of organizations came forward to declare their support, as Senator Kuehl joked, half in fun and full in earnest, “I apologize that there are over 500 organizations in support of this bill.” When closing on the bill, she again stated how she had “never seen anything” like the support SB921 has, and simply said that this the bill “is in the interest of California.”
OPPOSITION TESTIMONY: Opposition witnesses used several arguments. The Chamber of Commerce representative stated “we do not support the concept of universal health coverage.” The Chamber stated their belief that the bill would entail “significant costs” beyond what Californians currently spend, but did not produce research to back up that argument. She referred to the recent Oregon ballot initiatives for a single-payer plan, where 79% of the state voted no. She claimed that SB 921 does “nothing to address the underlying cost of health care.”
A representative of health plans challenged the belief that “in order to get to universal coverage, you must junk the concept of private competition.” He argued that we all rely on vital services, such as “food, clothing, and housing,” which are “delivered best by a private, competitive approach.” Finally, he cited that this was a “danger” in thinking there were “easy options” to the health care crisis, and that instead, there are “very difficult tradeoffs.”
Other business associations railed against “government-run health care,” and instead argued for health savings accounts and association health plans. Representations of manufacturers pointed out that the bill removes employers from the “control and cost of utilization of health care,” and the employer would be stuck with “whatever bill that the state sent them.” Health underwriters noted that the United States spends more than most countries with single-payer systems, and “what services will be rationed to reduce our costs?”
The opposition was led by the Chamber of Commerce, which “rejected the premise that it is best to have government-run health care.” The representative disparaged the ability of “elected officials” and a “huge bureaucracy” to run a health care system, and he feared that they would be “pressured to shift the cost away from individuals and onto those that don’t vote, such as businesses.” He also said that of his time around the Capitol, “I can’t think of an instance of scaling back benefits, particularly in this area,” citing that this would be a problem with controlling costs. (Kuehl rebutted later, citing worker’s comp changes made recently.) A lobbyist for life and health insurance companies said they “disagree on the premise that the government can do a better job than the private sector.” Other opposition came from insurers, optometrists, chiropracters, and other providers.
Senator Wes Chesbro (D) asked the Chamber what he thought of the current health system, and the Chamber lobbyist stated “we are willing to concede, given that there are 6.7 million uninsured, that the market is not operating at an optimal level, or close to opitmal,” but he thought a single-payer system would provide “a different set of problems.” Senator Chesbro followed up that if employers that provide coverage are paying for those that don’t, and to remedy this, that they can choose between requiring employers to provide coverage, or having the government do it.
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Opponents included Senator Dave Cox (R-Fair Oaks), who said that SB840 would lead to rationing. He knows that people from other countries come here to get care, such as MRIs and other advanced technology, that they cannot get in their own country. He asked, why is this such a problem if 80% of Californians have health insurance? Senator George Runner (R-Lancaster) asked why we were moving this bill forward if it was not fully worked out. He said he was sympathetic to the problem of the uninsured, but did not regard SB840 as the solution.