What happened to California single payer?

From my friend Nicole Belle on Facebook:

I feel a bit of a rant coming on. Bear with me.

Before I begin, I must provide my caveats: I am a full supporter and big believer that the ONLY answer to healthcare in this country is to migrate to a single payer system. I am an unapologetic liberal and not a neo-liberal shill (and I’m willing to bet money you couldn’t define that anyway) I am not paid by Big Pharma, any insurance agency, special interest group or George Soros. If these are your retorts to what I’m about to write, just move along, this is grown up time and I don’t have time or energy to deal with tantrums.
That said….

I need liberals to take a deep breath and calm down about single payer in California.

It is disappointing to know that AB #562–the “single payer bill” in California has been shelved. It has to be said: this may not be a permanent situation.
HOWEVER, California Assembly Speaker Anthony Rendon decided that the bill–as written–was “fatally flawed” and has decided to not bring it out of the rules committee. It should be mentioned that Rendon is on record as being supportive of single payer. He’s said that he thought California should be a leader for the rest of the country.

http://www.latimes.com/…/la-pol-ca-essential-politics-updat…

But here’s where the rubber hits the road. There is a deep and fundamental difference between supporting a concept and actually being responsible for putting together the infrastructure to make a workable program. I fully support the concept of ending racism and sexism in our time. How to actually accomplish that is where things get a little fuzzy.

Moving a state as populous as California to single payer requires the coordination of a fuckton of moving parts. And unfortunately, AB #562 didn’t give specifics on how to get that accomplished. I personally talked to some of the activists on how they thought it would work in terms of delivering the health care. They responded by talking about taxes. No, no, no. I grasp that we’re going to pay higher taxes (although I thought some were fairly flippant about that. Right now, my husband and I pay our 18 year old daughter’s insurance through our private policy–under a single payer plan, that would be taken out of her paycheck in taxes, effectively leaving her little to no discretionary income. How many struggling minimum wage workers in this state would be in the same boat?), and honestly, I’m fine with paying higher taxes because this is a program I think should be done for the greater good.

But I’m talking about actually getting health care. Is it an expansion of MediCal to everyone? Does that mean that doctors in the state HAVE to accept those capitated rates? (A lot of doctors don’t accept MediCal patients). What’s the policy for experimental procedures? What’s the policy for support procedures (physical therapy, acupuncture, etc.)? What’s the maximum allowable time for health checks (presumably urgent care remains same day, but is it acceptable to have a three month wait for a physical?)? What about hospitalization, hospice, palliative care? Does it also include mental health and dental services? What’s the prescription reimbursement rate? What has been negotiated with the existing health insurance industry in the state to make sure that we’re not creating an economic crisis by putting people out of work? Are we going to adopt the basics of MediCal or are we going to have a more robust system like private insurances/ACA?

Who makes these decisions? Who continues to manage the program? Who sets up this infrastructure? Who handles billing and payment? I don’t know specifically what the fatal flaws are in this bill, but I would think that smart liberals actually dedicated to bringing single payer to California would want to know what they could do to fix it rather than stomping their feet and throwing accusations of corruption around.

These things take a lot of thinking and planning to make happen. The answer is not “Well, every other country does this, so why don’t you want it? Are you paid off by Big Pharma, you neo-liberal shill????” Every country does it differently. We need to figure it out.

And that doesn’t even take into account the current political climate. The GOP appears to be specifically punishing blue states in their awful Trumpcare plans (http://washingtonjournal.com/…/republicans-included-sneaky…/). This bill is ALREADY proposing a program that is twice the state’s budget already (yes, you read that right: https://www.vox.com/…/california-single-payer-health-care-e…).

What happens if California starts getting less federal payments as punishment? What programs start getting hit then? How will that hurt Californians, especially the most vulnerable of us?

Again, I WANT single payer.

But I want a program that will make sense and will work. Last November we had a proposition that was supposed to lower our pharma costs. Liberals touted that proposition, Bernie did ads for it. But I read the language of the bill and asked other health care experts about it as well. It was written so poorly that it actually would have ended up costing us MORE money, not less. Thankfully, the proposition failed here. Maybe, just maybe, that’s the same problem with AB #562. I honestly don’t know, but the material point to all the liberal blogs screaming “corruption” is THEY DON’T EITHER.

Full credit for wanting to show that single payer should be the law of the land. But now, rather than alienating potential allies by assuming bad faith, why don’t we find out WHY the bill has been shelved and how it can be addressed?