California’s Single-Payer Health Care Plan Would Be Costly and Risky

MedizinSingle-payer health care is e a major issue in California’s 2018 gubernatorial election. Democratic candidate Gavin Newsom has strongly endorsed the idea, while Republican candidate John Cox is opposed. Last year, a single-payer bill, SB 562: The Healthy California Act, passed the state Senate but was placed on hold in the Assembly.

SB 562 would replace the current health care system with a state program under which all provider claims are paid centrally with no network restrictions, deductibles, co-pays, or other limitations. One governing body would replace the current array of public and private insurers. Medicare, Medi-Cal, and the Children’s Health Insurance Program (CHIP) would be integrated into the new system.

Proponents of single-payer primarily tout its ability to move the state towards universal coverage. However, California is already fairly close to achieving universal coverage. The June 2017 CDC report states that only 6.8 percent of Californians are uninsured. The other 93.2 percent already have private insurance, Medi-Cal, or gained insurance through Covered California during the Affordable Care Act (ACA) expansion.

Creating a single-payer health care system would be enormously costly, time-consuming, and difficult from a political and implementation standpoint. If achieving universal coverage is the primary goal, existing insurance schemes and government programs could be expanded to cover the uninsured instead. If Medi-Cal coverage is considered insufficient, it could be enhanced without impacting other categories of insurance.

A major argument from proponents of single-payer is the claim that it saves money by eliminating profits and administrative overhead — money that is going to insurance providers. Relative to all health care costs, these amounts are quite small. Most California residents already have coverage either through the government (Medi-Cal or Medicare) or a non-profit provider (Kaiser Permanente or Blue Shield), so profits only enter into the equation for a minority of Californians. Second, SB 562 would remove incentives to control costs, eliminating managed care. As a result, provider charges would probably increase substantially, overwhelming any savings from the elimination of middlemen.

Kaiser Permanente, the nation’s largest non-profit health plan and the insurer for many Californians, is known for its high quality of care and cost-conscious decision-making. A single-payer system would eliminate managed care organizations, and with them, the years of efficiency gains made to eliminate wasteful spending and improve quality. A statement by Kaiser’s CEO last year emphasized the difference between universal coverage and single-payer, mentioning his hesitations with single payer’s outdated fee-for-service model.

Perhaps the most daunting challenge of a single-payer system is the price tag. Analyses estimate that implementing a single-payer system would cost California between $330 billion and $400 billion per year, and there are reasons to believe that these estimates are too low. To put the potential costs in perspective, the entire California state budget for 2018-2019 is $201.4 billion. SB 562 does not provide details about how funds would be raised to pay for single-payer.

Furthermore, SB 562 has no mention of cost control measures, while explicitly saying there will be no co-pays, deductibles, or premiums. It plans to cover all medically necessary care, including medical, vision, dental, hearing, and reproductive services. Other services like chiropractic care and acupuncture would also be fully covered under the new program.

Many other countries have universal health care coverage and better health outcomes than the United States, an argument frequently used in favor of single-payer. However, many of these countries utilize free-market mechanisms that promote cost-conscious decision-making. These include price transparency, fewer regulations, consumer choice, and cost-sharing to prevent overuse of services.

Aside from the fundamental problems aforementioned, there are considerable political and legal roadblocks associated with implementing a single-payer system in California. Assuming that tax increases would be a necessity for funding purposes, a key obstacle would be gaining the two-thirds vote requirement for passing any such increases in the state legislature. Other obstacles include Proposition 4 of 1979, referred to as the Gann Limit, which limits state and local appropriations. Implementation of a taxpayer-funded single-payer system would necessitate repealing the Gann Limit or exempting the new taxes from the limit. Proposition 98, passed in 1988, requires that a certain amount of state tax revenues be diverted toward education funding and taxes for a single-payer system would fall into this category. So, once again, voters would have to approve exempting these new taxes from Prop. 98.

Proponents of the single-payer system believe that the new taxes needed to fund it could be addressed in legislation without requiring voter approval. The California Budget & Policy Center sees this as “very unlikely,” since it would require amending the state Constitution. When it comes to Proposition 98, the likelihood of exempting new taxes is less clear, since it depends on differences between the General Fund and Special Fund, potentially opening the door to a lawsuit.

Much uncertainty exists about the possibility of rolling federal funding into the California Health Fund (a new fund from which the state government would pay all medical expenses). The federal government funds Medicare and most of Medi-Cal, setting or at least influencing eligibility rules. This creates a hurdle to covering undocumented immigrants; federal funds are currently not allowed to finance any of the social services provided to this population.

The combination of the political and legal complications, SB 562’s enormous price tag, and the lack of cost-control measures and long-term funding uncertainties need to be carefully considered by Californians. Vermont tried to implement a single-payer health care system in 2014 but ultimately abandoned it following a myriad of challenges. Vermont had a population of 625,000 residents at the time. California’s is home to nearly 40 million people. Increasing access to health care is a laudable goal, but changes to the system should focus on improving health care outcomes for patients and  improving the quality and affordability of care. Increasing the state government’s role in health care is unlikely to deliver those results.

This article was originally published by Reason.com

CSU Long Beach Mascot Prospector Pete Gets the Boot

Prospector PeteCal State Long Beach is sending Prospector Pete packing.

The towering bronze statue that sits in the plaza outside the liberal arts building soon will be relocated to a less prominent place on campus as the university officially moves to retire the mascot that some say represents the state’s history of racism and genocide against Native Americans.

The university’s announcement Thursday comes on the heels of a decades-long debate over the suitability of the “49ers” image, which pays homage to the state’s gold rush, on a college campus that has increasingly welcomed a more culturally diverse student population in recent years.

“As our diversity grew and more voices were heard, we came to know that the 1849 California gold rush was a time in history when the indigenous peoples of California endured subjugation, violence and threats of genocide,” President Jane Close Conoley said in a statement. “Today, the spirit of inclusivity is reflected in our students, faculty, staff, alumni and community. Today’s Beach is not connected to that era.”

The Prospector Pete statue, formally named “The Forty-Niner Man,” evolved from the creation of the campus in 1949 and founding President Pete Peterson’s reference to having “struck the gold of education” by establishing the college. However, students see it largely as a commemoration of prospectors and their participation in an uglier side of the state’s history. …

Click here to read the full article from the Los Angeles Times

California Restaurants Banned from Providing Plastic Straws or Kid’s Meal Sodas

StrawsGov. Brown signed 41 bills into law on Thursday including banning restaurants from automatically distributing plastic straws or advertising kid’s meals with a soda.

The California Constitution requires that September 30 is the last day for the Governor to sign or veto bills passed by the Legislature before September 1. Governor Brown on September 20 signed 41 bills and vetoed 6.

Brown signed 40 of the 45 bills authored by a Democrat and 1 of the 2 bills authored by a Republican. The environment and education were the two biggest focus areas of the legislative 2018 legislative session with Brown signing 9 education bills and vetoed 4; while signing 10 bills and vetoing 0 associated with the environment.

Brown justified signing Assembly Bill 1884, prohibiting dine-in restaurants from automatically providing plastic straws with meals, with a statement that plastic is now a danger that “pervades every aspect of modern life” and its “single-use convenience has led to disastrous consequences” for society that must eventually be eliminated.

The governor stated that with the annual global production of plastic having reached 448 million tons by 2015, plastic in the world’s oceans now kills millions of marine mammals each year. He added that microplastics in tap water and plastic straws, bottles, packaging, and bags “are choking our planet.”

The impact of the bill will be limited because it does not apply to fast food, coffee shops and other take-out stores that are the biggest distributors of plastic items. Customers can still get a straw at dine-in eateries but will have to independently request one.

Brown also signed Senate Bill 1192 that amends the California Retail Food Code to requires all dine-in and fast food chains to offer milk; a non-dairy milk alternative; or sparkling, still or flavored water as a default or advertised beverage for a child’s packaged meal. The bill does not prohibit a restaurant from selling, or a customer’s ability to purchase, an alternative beverage if the purchaser requests one.

Both AB-1884 and SB-1192 will be effective on January 1.

The most significant surprise on Thursday was Brown’s pocket veto of Senate Bill 1424 that would have directed the California Attorney General Xavier Becerra to establish an advisory group to study the supposed “problem of the spread of false information through Internet-based social media.

Brown called SB-1424 called the “creation of a statutory advisory committee to examine this issue not necessary,” given the numerous studies by academic and policy groups.

This article was originally published by Breitbart.com/California

Gov. Jerry Brown blocks later school start time mandate

shocked-kid-apGov. Jerry Brown vetoed a bill Thursday requiring that California middle and high schools start no earlier than 8:30 a.m., saying the decision of when to start classes should be up to schools not the state.

Supporters of the bill cited research that says delaying school start times could result in better grades, attendance and graduation rates.

A study by the American Academy of Pediatrics said insufficient sleep for teens was “an important public health issue that significantly affects the health and safety” of adolescents.

State Assemblyman Anthony Portantino, who carried SB328, cited that study and one by the Centers for Disease Control and Prevention that both suggested schools start at 8:30 a.m. or later to help students get the optimal amount of sleep of at least eight hours a night. …

Click here to read the full article from Fox News

Let’s Avoid a “High Speed Rail” Situation in Space

Photo courtesy Steve Rhodes, flickr

Photo courtesy Steve Rhodes, flickr

Putting aside questions of effectiveness and even validity of the satellite project proposed by Gov. Jerry Brown at his Global Climate Action Summit, we should be concerned that the satellite could emulate the high-speed rail in that the costs will not be covered as promised and that taxpayers will end up holding the bag.

The release from the governor’s office said initial funding “has been provided by Dee and Richard Lawrence and OIF, as well as The Jeremy and Hannelore Grantham Environmental Trust.” The release adds that, “Additional scientific, business and philanthropic partners are expected to join this initiative…”

Then there’s this: “Planet (Labs) will manage the mission operations and collaborate with the State of California and others on funding this groundbreaking effort.”

Clearly, the state–that is the taxpayers–are expected to chip in for the satellite project. More is expected from outside sources such as business and others. But let’s not forget the promise of the high-speed rail: That it would be funded by the state, federal and private interests. Yet, no private money has come forward.

Whether the state should even sponsor such an endeavor is not the issue here. The point to be considered is that given the situation with the rail, it would be best to have that money in the bank before setting off on this project; before the taxpayers are involved to a greater extent than desired.

Will California embark on the satellite project on the hope that money will come from private concerns? As with the high-speed rail, will we see a General Obligation bond to help support it?

Remember, the idea is not for one satellite but multiple satellites. No price tag was associated with the project so we can’t compare its costs to that of the rail project. But, who really knows the high-speed rail cost. It’s forever changing. Is that the future of the California satellite venture?

If, in fact, taxpayer money is involved it should also come from taxpayers beyond California’s borders. The satellite monitoring will be world-wide and at a minimum the United States Climate Alliance made up of 17 states that are involved in the alliance should contribute because they would benefit from any information the satellites collect.

On another level, you do have to hand it to a clever Jerry Brown for turning around the “Governor Moonbeam” moniker once given to him by Chicago Tribune columnist, Mike Royko, when Brown proposed California launch a satellite for a different purpose 40-plus years ago.

While Royko declared the moniker “null, void and deceased” 15 years after appending it to Brown, the governor has come to embrace the nickname. With his latest satellite pronouncement, he turned a mocking handle into a mark of enlightenment. And to do so at the end of his term completes the circle of his time as California’s governor.

But part of Royko’s complaint was the issue of cost and that nagging question of cost still exists. It is currently spoiling Brown’s signature issue, the high-speed rail. If the satellite proposal follows a similar path, it would undercut the now prized Gov. Moonbeam appellation.

This article was originally published by Fox and Hounds Daily

Court Says California Cities Must Let Homeless Sleep On Streets

homelessA ruling this month by the 9th U.S. Circuit Court of Appeals which holds it is unconstitutional to ban homeless people from sleeping on the streets is likely to complicate the attempts to crack down on homelessness problems by local governments in California.

While the ruling involved a 2009 law adopted by Boise, Idaho, it is binding on California, which is one of the states under the 9th appellate court, which is based in San Francisco.

“[J]ust as the state may not criminalize the state of being ‘homeless in public places,’ the state may not ‘criminalize conduct that is an unavoidable consequence of being homeless — namely sitting, lying, or sleeping on the streets,’” Judge Marsha Berzon wrote for a three-judge panel.

The finding that the law is a cruel and unusual punishment under the Eighth Amendment was welcomed by activists who have long argued that such restrictions make being poor a crime.

Maria Foscarinis, executive director of the National Law Center on Homelessness & Poverty, told the Idaho Statesman that “criminally punishing homeless people for sleeping on the street when they have nowhere else to go is inhumane, and we applaud the court for holding that it is also unconstitutional.” Her group provided an attorney to the handful of Boise homeless men and women who sued over the city’s law.

If Boise does not appeal the ruling, the 9th Circuit will have expanded on the protections for the homeless that it created in 2007. The appellate panel ruled then that Los Angeles could not ban people from sleeping outside when shelters were full.

Legality of living in cars is next battleground

Meanwhile, the next fight over homeless rights in California has already emerged. It involves regulations in many cities that have the de facto effect of banning people from sleeping in their vehicles, even if the practice is not specifically singled out.

In Los Angeles, for example, a city ordinance that bans overnight parking in residential areas and a growing number of such restrictions in commercial areas have made it increasingly difficult for vehicle dwellers to find anywhere to sleep. This has made life difficult for the estimated 15,000 people who live in their cars, trucks or recreational vehicles in the city. The policy prompted sharp criticism from some quarters this spring over a perception that City Hall was insufficiently sympathetic to those without shelter.

City officials in San Diego and Santa Barbara are going in the opposite direction, starting trial programs in which car dwellers are allowed to use a handful of designated parking lots overnight – so long as they meet a handful of rules meant to preserve public safety and to minimize littering and public defecation and urination.

But San Diego may have to expand its program or develop other new policies as well. Last month, federal Judge Anthony Battaglia issued an injunction banning the city from ticketing people for living in their vehicles.

Unlike in the other high-profile federal cases involving city laws and homelessness, Battaglia’s argument wasn’t based on the idea that penalties which appeared to single out the homeless were cruel and unusual.

Instead, he concluded that “plaintiffs have shown a likelihood of success on the merits of their claim that the ordinance is vague because it fails to alert the public what behavior is lawful and what behavior is prohibited.” He noted that some people were given tickets merely for reading books in their cars.

The injunction is not permanent, but Battaglia indicated he is likely to make it so in coming months.

This article was originally published by CalWatchdog.com

Oakland City Council Passes ‘Abolish ICE’ Resolution

OaklandOakland’s city council unanimously approved a resolution on Monday evening calling on Congress to abolish Immigration and Customs Enforcement (ICE).

Oakland Mayor Libby Schaaf made headlines months before Democratic-Socialist Alexandria Ocasio-Cortez (D) upset longtime Rep. Joe Crowley (D-NY) in a primary earlier this year when Schaaf alerted illegal immigrants in the Bay Area of impending ICE raids. Schaaf also signed a letter calling for ICE to be abolished.

Councilmember Rebecca Kaplan, who authored the resolution, told the East Bay Citizenthat “ICE’s actions have had ramifications in our own backyard.”

“ICE came into West Oakland and tore apart a family while falsely slandering them–claiming it was a criminal case–when they were filing a civil deportation action and no criminal charges,” she reportedly said. “We’ve now experienced enough of ICE telling lies, ripping apart families, and leaving guns loose where they get into the hands of murderers and spreading racism.” …

Click here to read the full article from Breitbart.com/California

Making the DMV Audit a Reality

dmv

Motorists across the state have had to wait in hours-long lines at the Department of Motor Vehicles (DMV) to register their vehicle or license renewal. Some have spent an entire day waiting in line. Upset drivers have flooded my office with calls and emails.

To make matters worse, DMV personnel mangled 23,000 voter registrations. How did this happen?

In 2015, Democrats passed the Motor Voter Law, directing the DMV to automatically register new voters, unless they choose to opt out. State Senate Republicans warned that this would be problematic. At the time, my colleagues and I expressed our concerns of adding to an already overburdened workload at the DMV. Furthermore, the DMV is the wrong venue to register new voters since this is not the agency’s area of expertise.

Three years later, we learn that tens of thousands of Californians have been registered to vote even though they did not want to be registered. The DMV also made “mistakes” that assigned some voters a different political party preference than the one they chose. We sincerely hope this was not a case of voter fraud.

Once again, the DMV is the state agency that just can’t get it right. It already has been criticized by the public for long wait times, which it blames on an antiquated computer system and the federal REAL ID law – passed in 2005 and set to be implemented by 2020.

Before the legislative session concluded in August, a group of Assembly Republicans called for an audit of the DMV. At the Joint Committee on Legislative Audit hearing, DMV Director Jean Shiomoto apologized for the long wait times, asked for more money and reassured lawmakers that the problem would be corrected by the end of the year. The request for an audit failed after some Democrats did not vote for it.

The public has lost confidence in the DMV.

It has mishandled its core mission, along with a long list of problems including the erroneous registration of voter affidavits. Something needs to be done to regain that trust. The best way to do so is for the DMV to undergo a nonpartisan audit, which would reveal the extent of its problems and suggest recommendations for fixing them.

Enough excuses. Let’s audit the DMV now.

California State Senate.

This article was originally published by Fox and Hounds Daily

Las Vegas to L.A. rail line gets new backer

Las Vegas railThere might be hope again for high-speed rail between Las Vegas and Southern California.

Brightline, which already operates passenger rail service in Florida, has agreed to acquire XpressWest.

The federally approved project includes 38 acres of land adjacent to the Las Vegas Strip.

If approved, the light rail would transport passengers between Las Vegas and Victorville, California, in a little under two hours.

There has been talk of a high-speed rail for several years. The XpressWest project was once expected to break ground in 2012. Brightline says that construction is expected to begin next year.

The company has already launched a passenger service in Florida, running between Miami and West Palm Beach. …

Click here to read the full article from ABC13 News

Jerry Brown Signs Law Legalizing Street Food in California

Street FoodCalifornia Gov. Jerry Brown has signed a bill to make it easier for sidewalk vendors to operate legally in the state.

It’s one of dozens of bills Brown announced signing Monday, including measures to help voters ensure their mail ballots are counted and standardize balcony inspections.

The new sidewalk vending law will let cities and counties create permit programs for vendors and limits when they can be criminally prosecuted.

“We can start seeing sidewalk vendors for who they are – women and seniors, single parents, and micro-business owners taking that first step to starting their own business,” said Sen. Ricardo Lara, the Bell Gardens Democrat who authored the bill, SB946. “Gov. Brown’s signature validates that thousands of sidewalk vendors are an important part of our economy.”

Sidewalk vendors, who typically sell food or other goods, can be required to hold business licenses and pay taxes under the law. Cities and counties can also establish health and safety policies for vendors. …

Click here to read the full story from ABC7