The two leading Democrats for California governor on Sunday split over how to achieve universal health care, with Lt. Gov. Gavin Newsom defending his support for a government-run, single-payer system and former Los Angeles Mayor Antonio Villaraigosa dismissing as “pie in the sky” plans that don’t include viable financing methods.
At a union-sponsored health care forum, Villaraigosa credited the Assembly speaker for sidetracking a universal health bill, Senate Bill 562, in Sacramento, because it didn’t include a funding mechanism. He supports the concept, but argued the state’s immediate focus should be on protecting the 5 million people who could lose their coverage if Republicans and President Donald Trump succeed in repealing Obamacare.
“As governor, you gotta make the tough choices, you can’t just say ‘I want pie in the sky,’ because that doesn’t put food on people’s tables,” he said, advocating for a public option that allows people to buy into the existing Medi-Cal program.
“What I’ll never do is sell you snake oil,” added Villaraigosa. “The fact of the matter is we don’t have a plan yet.”
Newsom, a proponent of advancing the bill, cast the issue as one of leadership and commitment. He contended there is considerable “mythology” about the $400 billion annual price tag of enacting the system because the state currently spends about $368 billion a year on health care in California, nearly two-thirds of it borne by taxpayers.
“A single-payer system drives down the cost of health care; drives down the cost of prescription drugs through economies of scale; and provides more effective, efficient and universal access for those that are uninsured,” Newsom said, pointing to double-digit increases in Obamacare here. He said the financing will be worked out as the legislative process moves forward.
“It’s a question of leadership,” he added. “This is what they said about Social Security and Medicare: ‘You can’t do it ...’ I’m not going to wait around for the debate to unfold in Washington, D.C. Sure, I support Medicare for all, but you got to shape the debate in California.”
The exchange between Newsom and Villaraigosa came at the forum hosted by the National Union of Healthcare Workers, which also included Democrats Delaine Eastin, a former state school’s chief, and Treasurer John Chiang.
Chiang largely sidestepped the debate over universal care, offering that the state should take an incremental approach to health care. He wants to see more “effectiveness and efficiency” in the current system.
“We have to figure out how to scale-up, the time frame we’re going to scale-up,” he said, adding, “We don’t have to go all in to provide all the services all at once. Let’s make sure that what we are implementing we can scale-up appropriately.”
Eastin, like Newsom, believes single-payer would cost “slightly more” now but far less in the long run.
“The fact of the matter is people are dying in California because we do not have affordable health care coverage for everybody,” she said, calling the solution “realistic,” and saying it could be paid for with a gross receipts tax and a partial income tax increase.
She added: “There’s nothing California can’t do if we put our minds to it.”
The single-payer measure, driven largely by the California Nurses Association, has divided Democrats and is emerging as a litmus test for 2018. Newsom, endorsed by the nurses’ union, has never trailed in public polls and fundraising, while Villaraigosa has been the second-place Democrat.
The Republicans in the race, John Cox and Travis Allen, did not attend the forum, though the host National Union of Healthcare Workers, representing 14,000 workers in California, said they were invited. After Sunday’s forum, the union voted to endorse Newsom. Eastin was runner-up.