Californians like to think of ourselves as the center of resistance to the Trump regime. But when it comes to health care, we have folded our tents without even putting up a fight. It happened last Friday at 5 pm, when California Assembly Leader Anthony Rendon announced he would not bring a single-payer health care plan up for a vote this year.
When it comes to climate change or marijuana, California is ready to buck the federal government and forge our own path. But when it comes to health care, the attitude seems to be that we’ll sit quietly and wait for Senator McConnell to handle things before we act.
Rendon raised legitimate concerns about the current legislation, which is missing some key details and a funding plan. But rather than working to improve the bill, Rendon just kicked the can down the road and said that maybe he’ll take it up next year. This short circuits the legislative process of committee hearings that should have taken place in the Assembly this year.
Allowing the bill to work its way through the Assembly would have fostered a public debate about whether it is cheaper to have one government entity pay for health insurance (such as the Medicare system), or to have private firms profiteering in a broken marketplace where consumers are forced to buy products they have little information about or control over.
If the bill was not improved sufficiently to meet Rendon’s concerns by the end of the committee process, he could have simply voted against it. If the bill passed the legislature and Governor Brown felt it was unworkable, he could have vetoed it. Those decisions could then be debated in the upcoming election campaigns. One gets the sense that this public discourse is precisely what Rendon is trying to avoid.
Insurance companies, health care providers, pharmaceutical firms, and hospitals are among the biggest contributors to California campaigns. The California Medical Association, which has given California politicos nearly $20 million over the past two decades, has declined to push the bill as has California Blue shield, another huge donor. If Rendon allowed a vote on single-payer in the California Assembly, it would force his members to choose between the concerns of these big donors and the concerns of California voters. He spared them from making the choice.
It’s likely that even after a process of amendments and improvements in the Assembly, a single-payer health care bill would have flaws. No bill is perfect. The Affordable Care Act required dozens of tweaks and changes as it was implemented by President Obama and it is now jeopardized by Trump’s unwillingness to keep making repairs. It is the job of a functional executive branch to implement legislation and we should not expect that every bill passed will include every detail – otherwise we have no flexibility to make fixes as we see how policy plays out in real life. There are also risks in doing nothing, yet Rendon seems willing to accept those known perils in favor of the unknown challenges we would face in moving to a different system.
While it remains unclear what Congress will do at the federal level, simply sitting on our hands and leaving our fate in the control of Mitch McConnell and Paul Ryan is not what you would call leadership. California could pass a bill that is conditional upon the federal government rerouting current funds into our new program, or like marijuana or sanctuary cities decide the issue is important enough for us to go it alone in defiance of federal policies.
Those who have concerns about current proposals have an obligation to offer a better alternative, not just shut down the debate. Punting on first down while blaming others may be a move worthy of Donald Trump, but it’s not leadership and not what Californians are looking for in our elected officials.