Many Americans have begun to question why, in the wealthiest nation on earth, we cannot implement a healthcare system that works better for everyone. And while change may be a long time coming to the American populace as a whole, the state of California appears to be testing things out by implementing their own universal system to cover the citizens of their state.
California State Assembly Bill 1810, “establishes the intent of the Legislature to provide coverage and access through a unified financing system for all Californians, to control health care and administrative costs, to ensure high-quality health care, to limit out-of-pocket costs, to train and employ an adequate health care workforce, and to ensure all Californians have timely access to medical care.”
The bill passed as a trailer bill to the 2018-19 California state budget. The bill establishes a council consisting of five members to develop a way to implement a universal healthcare system in California by the year 2021. Three members of the council will be appointed by the governor, the other two by the legislature.
Current estimates project that approximately $100 billion in new taxes will need to be raised to pay for the measure, but proponents remain confident that the plan will save money overall. Proponents also argue that a universal system will alleviate the burden on small business owners to provide employees with benefits they may not be able to afford.
California already has a strong healthcare market, with citizens in all areas of the state able to select from at least three care plans. This stands in stark contrast to many other states where there is only one provider in the market, leading to increased costs. Given this fact, the switch to a universal care system may have consequences yet unforeseen by the writers of the bill or even members of the five-member Council on Health Care Delivery Systems.
California already draws an enormous number of immigrants from other states. And, due to the lack of consistency in access to healthcare across the United States, those who find health insurance impossible to afford in their state may decide that the risk in making a move across state lines is worth it. Due to its appeal, California already has some of the highest costs of living in the nation, especially in terms of housing costs. A large influx of even more immigrants from other states could exacerbate California’s existing housing crisis.
Similar rises in housing costs have occurred in other areas, as seen when cannabis was legalized for recreational use by Colorado and Washington. Seemingly overnight, Denver became the most expensive landlocked city in the US, and housing costs in the Seattle area similarly skyrocketed. Everyone wanted to move for the opportunity, but the sudden overwhelming demand for housing drove prices out of reach for a good number of people.
Proponents of the universal plan, however, argue that increased population will only grow the tax base, and thus, lower the financial burden on individuals. They also argue that by relieving individuals and small businesses from the cost of health insurance, more money will be available in just about every family’s budget for things such as housing. In addition, proponents argue the move will spur business growth and expansion, further growing the economy.
In the end, as the trailer bill which created, at least on paper, a universal healthcare system for Californians, left much undetermined in how the plan would be implemented, the devil truly will come down to the details. It will be impossible to please everyone with the measure; however, if administered properly, the result could very well be fewer sick Californians, as well as money saved.
In addition, the success of the plan will rely upon current federal funding for things such as the Veterans Administration, so changes to state funding from the federal level may also play a determining role in the success of the plan.
We know from the example of other nations that have implemented a universal system of care that it is possible to both save on administrative overhead and provide a great level of care. Whether or not California’s venture into universal healthcare will succeed in the US remains to be seen. If it is a success, that success could then translate into a model the rest of the US can follow.