Featuring Michael Lighty, founding fellow of the Sanders Institute and former healthcare constituency director for Bernie 2020:
Did Gov. Gavin Newsom change his mind on single payer? Is the Healthy California for All Commission meeting its mandate? Where are the major California healthcare foundations when it comes to reform? Michael Lighty and host Brenda Gazzar discuss the principal players in California’s struggle for health equity and Medicare for All.
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Photo of California Gov. Gavin Newsom by: Gage Skidmore
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California’s Healthcare Reform: The Players, Policy & Politics
—– TRANSCRIPT —–
Opening MUSIC – “Talk Back” 10 seconds, fade down
Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host Brenda Gazzar. Today, we’ll talk about what it will take to win Medicare for All in California.
Michael Lighty has organized, advocated and developed policy for single-payer, Medicare for All nationally and in California for nearly 29 years. He’s a founding Fellow of the Sanders Institute. Most recently, he was the healthcare constituency director for Bernie 2020.
Welcome to Code WACK!, Michael.
Lighty: Thank you Brenda. It’s great to be here.
Q: Thank you. So what do you think California’s best shot is for getting Medicare for All? Would it be a bill in the state legislature or maybe a ballot measure?
Lighty: I think it is a three-part approach. I think it takes an administration — the governor’s office — to make the request to the federal government for the waivers and funding that are necessary to implement single payer in California. I think it takes legislative support and I think it takes a grassroots movement that could win a ballot initiative. So those, it really is a three-part approach.
Q: Got it. Why do you think California Gov. Gavin Newsom walked back his support for Medicare for All?
Lighty: Well, I don’t think he walked back it as much as he has put forward this process that is designed to achieve greater consensus. If we just have the current supporters of Medicare for All engaged, right, the current supporters of single-payer in California, I think it’s fair to say that’s not sufficient. And so the question becomes what method do we use to generate the broader support?
I don’t think necessarily the folks on the Healthy California (for All) Commission reflect the mandate that I believe it was given to establish single-payer financing, and so there is obviously controversy about whether that’s a good vehicle or not. The fact is it is the current vehicle. I think the governor ultimately is the one who needs to direct the result and I think the legislative leadership has got to step up and if we’re going to throw billions more public money into health care, and it’s just going to go to the for-profit players or the nonprofit players who act like for-profits and siphon out the monies for their own administration or profits or other high executive salaries, then we’re wasting that public money.
And what we need to do is say ‘no, there is a condition, we’re going to move to public financing, we’re going to identify the obstacles to single-payer financing and we’re going to overcome them.’ That’s what the commission needs to do. If it does that I think that’s a fulfillment of the governor’s mandate and the mandate he got from the voters. If they don’t, then it’s on us.
Q: Got it. Do you have a sense so far of what the outcome of the Healthy California for All Commission hearings will be?
Lighty: I don’t. I certainly know that single-payer advocates are a very strong presence. We’ve got commissioners who are very supportive and recognize that we shouldn’t be just reinventing the wheel and doing another survey of what health care’s like in California and ‘oh, let’s address all the stuff we already know.’ We had a presentation, the commission had a presentation that we saw on healthcare disparities and inequality, and you simply cannot make the case that a system of private insurance is going to solve those inequities. It’s not going to happen.
You’re not going to create…Where are you going to get the money for an expanded public health program if you don’t save the money by going to single payer? So there has to be a recognition of reality, particularly of the policy reality, and that will help us then change the political reality.
Q: You’ve previously mentioned health foundations. Do you know where the major healthcare foundations in California stand on the issue of healthcare reform, and what role would you like them to play in the fight for state-based single payer?
Lighty: I think neglect is where they stand. (laughter) You know, if I were a foundation that had spent a billion dollars in the last 10 years on ‘Healthy Communities,’ and then saw the results of the COVID pandemic on those same communities, I would wonder what I had spent that money on. And the fact is, these foundations were set up to address health care for all Californians. And they have done two papers since the 90s on single payer — not even full reports, not studies, they’ve done two, two brief reports on single payer and they have devoted over a billion dollars on some of these other projects, tens of millions of dollars promoting private insurance and the ACA (Affordable Care Act) reforms directly, and what do we have to show for it?
Is health care more affordable? Are there still gaps in coverage? Have people lost coverage because we relied on an employment-based system? Are subsidies for the purchase of private insurance through Covered California working? Right?
Do we have high deductibles? Yes, we do. Are business costs for health care still going up? Yes, they are. So, you have to ask yourself, okay, guys, you’ve got $4 billion dollars in an endowment, why don’t you spend a chunk of that and actually guarantee health care for all Californians, which is what you’re supposed to do. So I am quite critical of the healthcare foundations, I think they are bought and sold by the healthcare industry and they’re not actually addressing the needs of Californians.
Thanks so much, Michael.
Find more Code WACK! episodes at ProgressiveVoices.com and on the PV app. You can also listen at heal-ca.org. This podcast is powered by HEAL California, uplifting the voices of those fighting for healthcare reform around the country. I’m Brenda Gazzar.
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