We looked high and low for an article that exposed the poison pill buried in Section 100610 of AB 1400, a single-payer measure recently proposed and withdrawn in the California State Assembly, but found none. That’s worrisome. Typical single-payer systems are not governed by boards dominated by providers as called for by Section 100610, which would put the fox in charge of the henhouse. California already has a fox/henhouse problem on its public pension fund boards, which since Proposition 162 passed in 1992 must give precedence to beneficiaries, thereby delegating residents and taxpayers to subordinate roles. That’s how, eg, CalPERS’s board employed biased actuarial assumptions in 1999 to justify a retroactive pension increase the cost of which is still crushing services and taxpayers today.
Section 100610 wasn’t the only miss. Some journalists incorrectly credited single-payer as uniquely capable of providing universal coverage, exposing a stunning lack of knowledge about the multi-payer universal coverage systems that dominate Continental Europe. We know it’s not easy (AB 1400 is 67 pages; Zeke Emanuel’s excellent comparison of health systems is 464 pages) but next time we hope journalists do a deeper dive on an important public issue.
