Not so long ago Democrats would run for cover whenever a colleague proposed a government-run, single-payer health care system. Today, they scramble to out-single-payer other Democrats, even at the state level.
Under a single-payer system, the government pays most if not all health care bills for virtually every resident and taxpayers pay higher taxes to finance it.
While most of the single-payer legislative efforts have been at the federal level – such as Sen. Bernie Sanders' "Medicare for All" proposal – some left-leaning states are jumping on the bandwagon.
Vermont became the first state to pass such legislation in 2011. Gov. Peter Shumlin proudly boasted at the time that it would cover all 620,000 Vermonters. But the governor abandoned the effort claiming that the needed tax increases were too large.
And then there's California.
California Healthline reports that donations are pouring into the governor's race, where both Gavin Newsom, California's Democratic lieutenant governor, and John Chiang, the state treasurer, support the concept of single-payer, which would offer universal coverage to Californians, likely at a "significant cost to the state."
"Likely"?
The Los Angeles Times pointed out last year that "Single-payer has a long, troubled history in California. Bills made it through the Legislature in 2006 and 2008 only to be vetoed by then-Gov. Arnold Schwarzenegger."
And with good reason.
A 2008 report from California's Legislative Analyst's Office found that even with a tax of 4 percent on employees and 7 percent on business payrolls the state would still have come up about $40 billion short the first full year.
This from the same state that in 2009, only one year later, handed out nearly 29,000 IOUs worth $53.3 million because of a $26 billion budget deficit.
But state-based universal coverage isn't just financially impractical, it's virtually impossible – because federal law trumps (pun intended) state law.
There are nearly 57 million Americans on Medicare, which is a federal program. States have no say in it.
So a state might offer government-run coverage to its seniors and disabled, but it can't change or take away their Medicare. And any politician who tried would likely be unemployed after the next election.
About 73 million Americans are on Medicaid, the federal-state health insurance program for the poor. While states have some say over Medicaid, the feds set the parameters and provide most of the money.
A state might petition the federal government for a block grant of its Medicaid funding to help subsidize its single-payer system, but don't count on them getting it.
Republicans have been pushing the Medicaid block-grant idea for years, and Democrats have consistently blocked it.
And then there's employer-based coverage. About half of the 160 million workers with employer coverage are in "self-insured plans" – where the company pays their employees' claims rather than health insurers. Those plans are governed by federal law.
States have some ability to micromanage employer plans that depend on health insurers to pay the claims, but not self-insured plans.
States certainly could tax employers and individuals to pay for a single-payer system, as the last California plan did. And they could allow – or force – individuals with employer coverage to join the government-run plan.
But how many employees of major California-based companies such as Apple, Google, eBay and Hewlett Packard would be willing to trade their excellent employer-based insurance for under-funded coverage managed by politicians?
And why would any politician even try to make the switcheroo, since neither employer-provided coverage nor Medicare cost the state a dime?
Thus the good news is that state-level Democrats can rattle the single-payer saber in the hope of attracting progressive voters, but they can't do much about it. The bad news is that Democrats in Washington can.
The above piece also appeared in the following publications:
KEENE (NH) SENTINEL, JUNE 11, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster” by Merrill Matthews (9,647)
ADRIAN (MI) DAILY TELEGRAM, JUNE 10, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster” by Merrill Matthews (21,327)
ARIZONA DAILY STAR / TUCSON, JUNE 11, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster” by Merrill Matthews (96,682)
BEND (OR) BULLETIN, JUNE 10, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (31,796)
DANBURY (CT) NEWS-TIMES JUNE 10, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (18,891)
CANADA FREE PRESS / TORONTO / CANADA’S MOST POPULAR OPINION WEBSITE WITH MORE THAN 911,000 DAILY VIEWERS, JUNE 9, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews
RUNNELS COUNTY REGISTER / BALLINGER (TX) JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (4,114)
ANNA MELISSA TRIBUNE / VAN ALSTYNE (TX) HERALD JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (1,368)
FALL RIVER (MA) HERALD NEWS, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (14,979)
NAPA VALLEY (CA) REGISTER, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (13,794)
KEEP HEALTHCARE.ORG, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews
KONSERVATIVE KARTEL.COM, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews
COLUMBIA (SC) THE STATE, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (70,980)
VAN ALSTYNE (TX) DAILY LEADER, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews, with writer’s photo
EDINBURG (TX) DAILY REVIEW, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews, with writer’s photo (11,657)
ELKTON (MD) CECIL WHIG, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (13,320)
SHERMAN (TX) HERALD DEMOCRAT, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (20,278) with writer’s photo
BRISTOL (VA) HERALD COURIER, JUNE 8, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (24,259)
HAMODIA INTERNATIONAL DAILY NEWSPAPER OF TORAH JEWRY / BROOKLYN, NY, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (110,789)
ORLANDO (FL) SENTINEL, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (173,576)
SUN-SENTINEL / FORT LAUDERDALE, FL, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (147,860)
ROANOKE (VA) TIMES, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews, with writer’s photo (78,663)
BOZEMAN (MT) DAILY CHRONICLE, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (17,537)
SPRINGFIELD (IL) STATE JOURNAL-REGISTER, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (44,772) with writer’s photo
CHICAGO TRIBUNE / LIFESTYLE SECTION, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (414,590)
BALTIMORE SUN / LIFESTYLE SECTION, June 7 2018,Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (133,169)
NEWPORT NEWS (VA) DAILY PRESS, June 7 2018,Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews 57,612)
SACRAMENTO BEE, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (122,600)
BELLINGHAM (WA) HERALD, June 7 2018,Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (23,933)
KENNEWICK (WA) TRI-CITY HERALD, June 7 2018,Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (30,985)
TRIBUNE CONTENT NEWSWIRE, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews (9,356)
ARCA MAX, JUNE 7, 2018, Op-Ed “Con: Single payer healthcare won’t pass muster in California or other states” by Merrill Matthews