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The CA Single Payer Non-Plan is Not a Valid Litmus Test


People like RoseAnn “Trump will bring us single payer” De Moro and, natch, David Sirota are trying to run a con conflating a refusal to support a particular single-payer “plan” being floated in California with opposition to universal health care in principle. The rather obvious flaw in the scam is that the California proposal is a joke. Drum explains why, but these are the two most obvious reasons:

Prop 98. Like it or not, California has a school funding law put in place years ago by Proposition 98. It’s insanely complicated, but basically requires that 40 percent of the state budget go to K-12 schools. Using round numbers, if the state budget is $100 billion, school spending has to be at least $40 billion. If state spending goes up to $300 billion, school spending has to be at least $120 billion. Aside from being ridiculous, it also leaves only $120 billion for the health care bill. Oops.

As far as I know, there is no tricky way to get around this. It would have to be dealt with by a ballot initiative. That’s obviously not going to happen in this legislative session.

Waivers. This is the issue nobody pays attention to, but is probably the most important of all. To implement single-payer, California would need $200 billion in new funding plus $200 billion in federal money that currently goes to Medicare, Medicaid, veterans health care, and so forth. Without federal waivers to give California access to that money, the plan can’t go anywhere. As Duke University researcher David Anderson puts it, “If there aren’t waivers, this plan is vaporware.” What do you think are the odds that the Trump administration will grant all those waivers? Zero is a pretty good guess.

Along the same lines, Michael Hiltzik points out that self-funded health care plans are governed exclusively by federal law. That means California would need an exemption from the law. What do you think are the odds that a Republican Congress will grant that exemption? Zero again?

Really, the waiver point is in itself the ballgame. There’s no way of making single payer work without getting federal health care money and the requisite legal waivers, and anyone who thinks that Trump, Ryan and McConnell would work with California to implement single payer would put their life savings into a degree from Trump University. And the waiver problem not only makes this plan vaporware as until 2021 at the earliest, it also makes it unworkable as a model period, unless you think Republicans will never win another presidential election again. As Drum says, universal health care — whether single-payer or another variant — is going to have to be implemented federally, not on states that have to have annually balanced budgets and depend on federal spending.

As with people who insist on “single payer” per se as opposed to “one of the many European models of universal health care, most of which are more plausibly attained in the American system” being the ultimate goal but even more so, trying to make supporting the farcical California proposal is a litmus test for Real Leftism has nothing to do with universal healthcare. The point is finding another reason to say “the Democrat Party sucks.” That’s it. As Dayen says, the people pushing this as a viable single-payer plan are quite simply lying to their supporters.

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