The Single Payer Option Is the Responsible Option

Being able to obtain quality, timely, affordable healthcare is what responsible and effective nations ensure for all of their citizens. The right likes to level accusations of “entitlement” when the subject of single-payer, or government sponsored healthcare arises. It’s not a matter of entitlement. It’s time for the left to reframe this discussion the way it should have been framed from the beginning and fight for a healthy future for all Americans.

Passing single-payer reforms is a matter of taking responsibility for future health needs of everyday Americans and our aging population. Doing anything less is simply negligent, considering our rankings on national health scores and the outrageous overhead of our past system, our current system, and the Republican proposed alternatives.

It cannot be emphasized enough that the language used to frame this debate must change. Single payer is the only responsible alternative to our current system, and without a doubt, as has already been covered in Healthcare: Critical Action Needed and Healthcare: What Would a Working Alternative Look Like?, we are in great need of an alternative.

But We Can’t Afford Single-Payer!

Say what? At this point, this argument should be seen as the façade that it truly is. With US medical administration costs 2 ½ x those of other OECD countries, the real question everyone should be asking themselves is how can we NOT afford single payer? Our current path, which was already problematic well before the ACA was enacted, as established before, is becoming untenable.

The insurance companies have had no interest in restraining medical costs, because they make more money the more we spend. Dr. Gary Sobelson says that insurance companies “make their profitability based on how much they collect in revenue.” Because of this, keeping the insurance industry as part of our primary medical coverage system has put us at a distinct cost disadvantage. If we want to keep them involved, they should only be involved in the limited role of providing add on services for those who are willing to pay additional money for care above and beyond the basics. Doing so makes sure that they are providing measurable value for the payments they collect, rather than taking advantage of those whose basic needs are at stake, which is the situation we currently have.

According to Steffie Woolhandler, MD, MPH and David U. Himmelstein, MD, in their paper titled,  Single-Payer Reform: The Only Way to Fulfill the President’s Pledge of More Coverage, Better Benefits, and Lower Costs “single-payer reform could save approximately $504 billion annually on bureaucracy.” Princeton economist, Angus Deaton, concerned about the built-in opportunities for corruption and waste our current system has with all of its gaps and loopholes, says, “it will get this monster that we’ve created out of the economy and allow the rest of capitalism to flourish without the awful things that healthcare is doing to us.”

Woolhandler and Himmelstein wrote another paper, Liberal Benefits, Conservative Spending, where they argue, “National health insurance could solve the cost versus access conflict by slashing bureaucratic waste and reorienting the way we pay for health care,” and explain how the elimination of a very bureaucratic system in favor of bundled payments works to reduce overall healthcare costs. In the conservative argument for single-payer care, it is argued that because bureaucracy would be reduced and care would be emphasized, firms (and employees, of course) would be “spared the outrageous annual cost increases that have become commonplace in the large- and small-group markets.”

How Could Single-Payer Be Successfully Funded?

California right now is at the front of the single-payer debate. Michael Lighty, to begin with, the Director of Public Policy for National Nurses United and for the California Nurses Association, argues that “Californians will receive every federal healthcare dollar for which we are eligible, the question is in what form.”

In another piece, Lighty argues that, “Currently, 70 percent of healthcare expenses in California are paid by taxpayers.” Wait…say what? Taxpayers are already paying 70 percent of healthcare expenses in California? The vast majority of what is needed to pay for healthcare is already being covered by taxes already? He goes on to say that, “We estimated $37 billion can be saved by going to this Medicare-for-all-type system in California.”

In addition to these funds, some additional ways to secure the funding include a 15% payroll tax. According to Gerald Friedman, a University of Massachusetts economist, who has done the math, the original estimates make no mention of the savings that would be employed by switching to a single payer system, which he says is disappointing “because it assumes no savings from bulk purchasing of drugs and medical devices even though the rest of the world buys these at barely 70 percent what Americans pay, and the VA [Veterans Administration] buys drugs at 59 percent.” Based on what Californians are already paying right now for their medical, at a 15% payroll tax, many would find a significant costs savings, and they will find that “paying 15 percent of one’s income for health care is a very good deal.”

If California can successfully deliver on single-payer, it should give the rest of the nation the clear example it needs to get the job done.

The Real Question

The question shouldn’t be “How will we fund it?” Obviously, the details will have to be hammered out, but it is not the quagmire political opponents paint it to be. The real question is, “How do legislators find the political will to do what probably should have been done at least two decades ago?” Speaker Anthony Rendon has been standing between Californian’s and the single-payer system they want, and it’s pretty clear why, because “the healthcare industry has given the speaker, along with the insurance industry, over $700,000, and he’s the one who stopped progress on this bill.” When the process began in the Assembly, he “…decided to abort the process at the beginning of Assembly consideration of SB 562.” His action resulted in a “denial of democracy and is inconsistent with his claim that the bill needs work, because precisely the process that would have constituted that work was the one that he stopped.”

This question of where legislators find the political will actually has a ready-made answer. Not only that, since the election, and since the GOP has been threatening the ACA, people want to step up to the plate and act, so the time for us to act on this couldn’t be better.

Here’s what has to happen. Sacramento needs to hear us loud and clear, because, even though a lot of lobbyist money is standing between us and what we want, according to the University of Wisconsin Population Health Institute, “Decision makers find the political will to act when they feel the public’s demand for action. Your job is to make them feel that demand.” It’s as simple as that.

Californians need to make it crystal clear to lawmakers that we will stand for nothing less than a viable single-payer system for all California residents.

Speaker Rendon needs to hear from Californians and their own representatives who are invested in a healthier California for all so he realizes that it’s no longer politically expedient to stand in the way of what is best for California.

Ways to Get Involved

There are a few main organizations that can help you get involved in pushing for single-payer in the State of California right now.

Both of the following pages offer links for events to RSVP for, and participate in:

Join the Healthy California Email List.

Healthy California has a Facebook Page.

Nationally, the Physicians for a National Health Program supports the California effort for single payer, and gets behind other state and national single-payer efforts across the country.

And National Nurses United has been covering single-payer reform in California for quite some time.

If you would like to see additional ways to get involved added to this list, please use the contact form on this site.


The reality is that single-payer is the responsible path towards a healthier future for all Americans. We already clearly pay a sizable amount of the money required to provide care to California’s population, and the remaining money needed to cover Californian’s completely should not be hard to carve out, as Californians already spend a fair amount in premiums and out of pocket every year. As the largest state economy in the nation, pushing single payer healthcare reform gives us the opportunity to set the standard for the rest of the country.

The only thing standing between us and a single-payer system is a matter of political will, and that is something every single Californian has the power to do something about. There are organizations who have already been active in working towards this shift and all we need to do is participate in the process by attending events supporting single-payer, contacting our state representatives, contacting the Speaker and Governor Brown, and asking the organizations above if there are any additional ways we can help move this policy change forward. All we really have to do is act, and act today.


Additional Resources (working list):

Fighting For Our Lives: The Movement For Medicare For All

Meet the Opponents

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