California Reaches a Healthcare Precipice:
The Post-Incrementalist Case for the Leap to Medicare-for-All in the Golden State in 2018

Ron Birnbaum. February 6, 2018. Medium.

Excerpts only. Read complete article here. 

“Everybody in, nobody out” This cry from the now ubiquitous healthcare activists encapsulates both the moral case and at many levels the economic and practical cases for Medicare-for-All in California. Exception: time to put out the private sector health insurers, who like lawn darts and cocaine have proven too toxic to humanity to continue on among us. While rearguard actions and defense characterize the best Democrats can do in Washington in 2018, the possibilities and therefore the stakes are bigger in California. The Affordable Care Act did in fact improve our system, most significantly by reducing the number of persons without insurance, and California has benefited from its full-throated embrace in ways demonstrable when compared with states that have not. But savage problems persist, and the bloodthirst that licenses disregard for the needs of human beings in the name of spiting the Obama legacy has driven Republicans’ various failed and now partly successful attempts to gut the Affordable Care Act.

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What We May See in the Way of Incremental Reforms and Why Turning to Them are Failures to Lead
The answer is Medicare-for-All, and the Healthy California Act SB-562 is the vehicle at hand for that in the California legislature. Does it need some legislative work? Yes, sure. But that is something we should expect from our leaders in Sacramento, and specifically the leadership in the Legislature. People interpret variably Speaker Anthony Rendon’s blocking of the bill by holding it in the Assembly Rules Committee. Some see the campaign money he has taken from insurance and pharmaceutical interests as determinative; he owes too much to the people who bankroll him to work against their interests for the larger social good. A more sympathetic view is that he has legitimate problems with the bill, but that just begs the question, “Well, what are you doing to marshal the resources and pass single payer in California? You head the Democratic supermajority in the Assembly, so lead by legislating.”

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With Medicare-for-All languishing in the Assembly Rules Committee, and a public crying for relief from a failed a system, what might we see from legislators who want to show constituents they are “doing something”? The answer is “incremental reform.”

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I am a post-incrementalist! Our current system is an unstable edifice to build on, both because the President and Republican allies are trying to destabilize it, but also because the central flaw of our system — misdirection of enormous resources from care of humans to the coffers of insurers, pharmaceutical companies, their executives, their obstructive bureaucracies, and their shareholders — is the rot at the foundation. It is why we spend enormously — at 18% of GDP in the country and 14% in California — and yet still have millions of uninsured and underinsured and people and businesses crushed under the weight of costs.

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