Universal healthcare legislation introduced in California?

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“This bill is what’s called a spot bill, which means that it states our intention to work toward single-payer health care for all Californians. The California Nurses Association will work with Assembly-member Ash Kalra to introduce full single-payer legislation in 2024.”

by Barry Hermanson

Two years ago, Assembly Bill 1400 was introduced on the last day to introduce legislation in theCalifornia legislature. CalCare failed to get out of the Assembly and move to the Senate in 2021 and 2022.

At the time, Democrats held a super majority in the 80-member Assembly and couldn’t find 41votes. This year, AB 1690, the new version of CalCare was also introduced on the last day, Feb.17th. 

A California Nurses Association email announced: “This bill is what’s called a spot bill, whichmeans that it states our intention to work toward single-payer health care for all Californians. TheCalifornia Nurses Association will work with Assembly-member Ash Kalra to introduce full single-payer legislation in 2024.”

Unlike the detail provided in AB 1400, the entire text of AB 1690 is one sentence. “It is the intent of the Legislature to guarantee accessible, affordable, equitable and high-quality health care for allCalifornians through a comprehensive universal single-payer health care program that benefits every resident of the state.”

The California Nurses Association is organizing a statewide action the last weekend of March to“visibly demonstrate the power of our movement to the legislature.” 

Universal healthcare advocates have been doing this for more than twenty years. Republican Governor Arnold Schwarzenegger vetoed bills both times Democrats passed universal healthcare legislation under his administration. Since then, with Democratic governors Brown and Newsom, legislation has failed to advance.

This year, it feels like the introduction of AB 1690 is a major step backwards. In 2021, AB1400 wasintroduced by Assemblyman Kalra and two of his colleagues. Four Assembly members and three Senators were Principal Coauthors. In addition, six Assembly members and five Senators were Coauthors. This year, only Kalra’s name is on the legislation.

“The average amount spent on health per person in comparable countries ($6,125) is less than half of what the U.S. spends per person.” 

Why is there no debate in Sacramento in 2023? The answer could be that most legislators takecampaign contributions from opponents of universal health care. Billions in profits could be jeopardized. “As a share of the nation’s Gross Domestic Product, health spending accounted for 18.3%. $4.3 trillion or $12,914 per person.” 

“The average amount spent on health per person in comparable countries ($6,125) is less than half of what the U.S. spends per person.”  

Even though much less is spent per person, people are healthier and live longer lives than in those the U.S.

Will single-payer legislation be introduced in California in 2024? I doubt it. Universal health care would become a central issue in the presidential primaries which begin early in the year. 

If politicians in California are not ready to take on this debate in 2023, expecting a national debate next year seems absurd. Any candidate for president in 2024 advocating for fundamental change will face enormous opposition spending.

Universal healthcare advocates have been visibly demonstrating the power of our movement to the legislature for a long time. We have participated in rallies, marches, phone banks, letter writing, legislative visits, candidate and constituent education forums and much more. 

This work has, no doubt, resulted in many public opinion polls showing strong support. But, we have not succeeded in overcoming the power of campaign contributions from our opponents to influence legislators.

Continuing to do the same work as we have in the past might fit the definition of insanity. What can we do differently? 

In California, initiatives can be brought before voters. Even if legislators passed universal healthcare legislation, voters will need to weigh in. To win, a campaign to identify supportive voters will be necessary. 

Continuing to do the same work as we have in the past might fit the definition of insanity – what can we do differently?

Why not begin this work now? Legislators need to see more than polls. The power of money to influence their votes will be reduced as the number of identified constituent supporters grows. This strategy can be tested in individual Assembly or Senate districts to create new legislative advocates. Traditional efforts to identify voters have been expensive and labor intensive, often involving a lot of door to door work. 

Because of strong polling, however, it may be possible to develop an on-line database where voters can register support for universal health care in California and do so with more modest resources. During the next few months, I will be working to develop a voter identification campaign. If you would like to help, please contact me.

At the end of each of my columns, I identify myself as a member of the San Francisco Green Party. Every member of the Green Party is publicly identified as a supporter of single-payer universal health care by their political party registration. Polls show that most registered Democrats and about half of Republicans also are supporters. Greens prioritize people and the health of the planet over profit.

Unfortunately, Democratic and Republican legislative leaders do not. In addition to participating in the voter identification campaign described above, I hope you will consider registering to vote with the Green Party to publicly show your support for single-payer universal health care.

Barry Hermanson is a member of the San Francisco Green Party and a former small business owner. Contact him at Barry@Hermansons.com or 415-255-9494.