{"id":712991,"date":"2026-06-19T05:46:30","date_gmt":"2026-06-19T05:46:30","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/712991\/"},"modified":"2026-06-19T05:46:30","modified_gmt":"2026-06-19T05:46:30","slug":"why-single-payer-healthcare-in-ca-remains-elusive","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/712991\/","title":{"rendered":"Why single-payer healthcare in CA remains elusive"},"content":{"rendered":"

By Dan Walters<\/a>, CalMatters<\/p>\n

\t\t\t\t\""A\"
\n\t\t\t\tA patient waits for a doctor at Martin Luther King Jr. Community Hospital in Los Angeles on July 26, 2022. Photo by Pablo Unzueta for CalMatters<\/p>\n

This commentary was originally published by CalMatters<\/a>. Sign up<\/a> for their newsletters.<\/p>\n

Is there a pathway for California to create a universal healthcare system, one with benefits paid through\u00a0a \u201cunified financing system\u201d that merges federal and state funds with costs now borne by employers and \u2014 probably \u2014 a new layer of taxation?<\/p>\n

The answer appears to be that, while such a pathway may be possible, hacking it through the thicket of healthcare economics and politics would require dozens \u2014 or even hundreds \u2014 of difficult choices.<\/p>\n

That\u2019s the gist of a 181-page report<\/a> from a team of University of California researchers that was charged with defining the factors to be resolved before such a system could be implemented.<\/p>\n

On Wednesday the research team, organized by the UCLA Center for Health Policy Research, outlined the report\u2019s findings and fielded questions during a webinar. Its responses about the specifics of a unified system generally boiled down to maybe yes, maybe no.<\/p>\n

In other words, someone or some entity would have to plow through the seemingly countless variables catalogued in the report and decide which would be included and which would be excluded.<\/p>\n

Those variables start with the overall approach. Would it be a \u201csingle-payer\u201d system in which the state finances medical services for every Californian, similar to the systems in the United Kingdom and parts of Western Europe? Or would it be a hybrid that retains some aspects of the current system?<\/p>\n

Would the state pay the current private and public health care providers or set up its own proprietary network? Would payments be fee-for-service or encompass the managed care system that currently dominates health insurance?<\/p>\n

Would the federal government, which now pays roughly half of California\u2019s healthcare bills through Medicare, Medi-Cal and various programs for federal workers, be willing to give the state those many billions of dollars for a unified system? How would undocumented immigrants \u2014 now ineligible for federally financed services \u2014 be handled<\/a>?<\/p>\n

The report generally contends that a single-payer system would, by eliminating the paperwork and other aspects of the current system, be the most efficient from a cost\/benefit basis. However, it would probably be the most difficult version to create from a political standpoint.<\/p>\n

Single-payer would be a holy grail achievement for the political left, both in California<\/a> and nationwide. The current search for some form began eight years ago when Gavin Newsom<\/a>, then running for governor, declared \u201cI\u2019m tired of politicians saying they support single-payer but that it\u2019s too soon, too expensive or someone else\u2019s problem,\u201d thus pledging to pursue it.<\/p>\n

Once elected, however, Newsom drifted away, eventually calling single-payer \u201caspirational\u201d rather than a hard promise, and sought incremental extension of coverage through Medi-Cal and other programs.<\/p>\n

He did, however, sign legislation in 2019 creating a commission to study the issue, saying, \u201cAs our march toward universal coverage continues I am calling on the brightest minds \u2014 from public and private sectors \u2014 to serve in the Healthy California for All Commission to improve the health of our state.\u201d<\/p>\n

The commission\u2019s 2022 report<\/a> endorsed a \u201csystem of unified financing,\u201d but didn\u2019t specify a single-payer system. It led to the 2023 passage of Senate Bill 770<\/a> that, among other things, called for the UC study on alternatives that was released in April.<\/p>\n

In a sense, the issue has come full circle. When Newsom advanced the notion of a single-payer system in 2018, everyone knowledgeable about the state\u2019s massive, very expensive and multi-player system of healthcare also knew that fundamental change would be very complicated and very difficult.<\/a><\/p>\n

The UC report says the same thing, only in more detail. Newsom managed to avoid making those tough decisions and will soon depart, probably for a presidential campaign. Will the pursuit of a pathway continue? Or has it just been a theoretical exercise?<\/p>\n

This article was originally published on CalMatters<\/a> and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives<\/a> license.<\/p>\n","protected":false},"excerpt":{"rendered":"By Dan Walters, CalMatters A patient waits for a doctor at Martin Luther King Jr. Community Hospital in…\n","protected":false},"author":2,"featured_media":712992,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[3200,97,252,253,9042,17345],"class_list":["post-712991","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-commentary","tag-health","tag-health-care","tag-healthcare","tag-insurance","tag-university-of-california"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/712991","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=712991"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/712991\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/712992"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=712991"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=712991"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=712991"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}