The barrier to single payer isn’t cost, it’s politics

Members of the California Nurses Association cheer speakers during a rally supporting Senate Bill 562 on the west steps of the state Capitol on May 19.
Members of the California Nurses Association cheer speakers during a rally supporting Senate Bill 562 on the west steps of the state Capitol on May 19.

With Covered California announcing this week that health insurance premiums will jump an average of 12.5 percent next year, and possibly far more depending on actions in Washington, it’s worth repeating that a real cure for Californians, Senate Bill 562, is still achievable this year.

Under SB 562, a Medicare-for-all bill, not only would every Californian be guaranteed health coverage, but all premiums, as well as deductibles and copays, would be eliminated.

That would be a huge relief to the 15 million Californians who have no health coverage or struggle to pay medical bills and insurance premiums, even with the Affordable Care Act still in place.

They were left out of the SB 562 debate by many in Sacramento and the media. But nurses don’t have the luxury or inclination to forget the people abandoned by a callous health care industry that profits from suffering and pain. We see them every day.

People such as the 46-year-old Los Angeles woman with stage 4 breast cancer who told us her cancer returned even though she did everything right with her treatment, diet, exercise and other lifestyle choices. Others have told us that with premiums and other costs continuing to rise, they’ve exhausted their savings with no money left for essential medical or dental care.

When Speaker Anthony Rendon arbitrarily prevented the Assembly from holding hearings, or making amendments to SB 562, to a bill he says is “inadequate,” who was speaking for these Californians?

Isn’t it legislators’ job to hold hearings and amend bills they say need changes? That’s why the California Nurses Association is pressing Rendon to free the bill and calling on all Assembly members to announce their support for the bill and urge Rendon to let the legislative process move forward this year.

Who is speaking for patients when SB 562 opponents conjure up barriers as incontrovertible facts?

Take the assertion that SB 562 is impossible with Proposition 98’s budget carve-out for education. A single-payer system can be crafted so that it’s not part of the state budget, says former state Sen. Sheila Kuehl, who authored two single-payer bills.

Or consider the argument that the Trump administration would never approve a federal waiver to use federal revenue. Section 1332 of the ACA requires the Department of Health and Human Services to grant a waiver, as it did for Hawaii, for state innovations that “provide for an alternative means” to meet the minimum standards of Obamacare

Or look at claims that SB 562 would cost $400 billion in new spending. In fact, most of that is what is already spent on health care. And a study led by economist Robert Pollin says that SB 562 would cut tens of billions from what the state spends now.

Revenue to achieve a truly universal system could be raised with two fair taxes with exemptions for low-income residents and small businesses. Nearly every California household and business would spend less than they do now on private insurance.

The real barrier to a more humane system is not cost, Prop. 98 or a federal waiver. It’s political will and public priorities.

Nurses will never stop campaigning for transformative reform. As Nelson Mandela famously reminded us, “It always seems impossible until it is done.”

Deborah Burger, a registered nurse in Sonoma County, is co-president of the California Nurses Association. She can be contacted at