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Not All Agree Single Payer Health Care is Cure for Ailing System

The governor and other state lawmakers say reforming the state's troubled health care system is a top priority this year. One of the proposals they're looking at would create a single payer, universal

Not All Agree Single Payer Health Care is Cure for Ailing System

The governor and other state lawmakers say reforming the state's troubled health care system is a top priority this year. One of the proposals they're looking at would create a single payer, universal health care system in California. KPBS Health Reporter Kenny Goldberg has the story.

When it comes to expressing their views about healthcare reform, members of the California Nurses Association aren't shy about it.

On a recent weekday afternoon in Sacramento, more than 1,000 nurses held a rally on the steps of the Capitol. They've come to support a single payer, universal health care bill making its way through the state legislature. Nurse Alice Colacino works at USC Norris Cancer Center . She says there are just too many inequities in the current healthcare system. 

Colacino: I think in order for things to change, we need to have a single payer initiative, where it's basically funded the same way that Medicare or Medicaid is, where it's a tax the employers and employees pay, it's put into a general fund. Everyone is guaranteed the same level of care.

The single payer bill would create a new state agency to run one health care plan for all Californians. Under the proposal, people could choose their own doctors and hospitals, just like they do now. The plan would cover all acute care needs, and preventive services including cancer screenings.

Sounds pretty good. But Governor Schwarzenegger doesn't care for it.

Schwarzenegger: We don't believe that government ultimately should run health care.

The governor says a state-run single payer system would be a total flop. In fact, he says California has already tried it in the state prison system.

Schwarzenegger: A government run health care system for 1$72,000 prisoners doesn't work, a federal judge had to step in because it was a disaster. Why would we have the government run our health care system for 37 million people, when they cannot even do it for 170,000 inmates?

Dr. Joseph Scherger: It's nonsense, and first of all, the comparison is crazy.

Dr. Joseph Scherger is a clinical professor of family medicine at UCSD. He says the governor's opposition to the single payer idea doesn't make sense.

Scherger: I mean, we have a single payer highway system. I mean, is he against Cal Trans, and should we privatize all highways and have toll roads all over the place?

Scherger belongs to a single payer advocacy group called Physicians for a National Health Program . He says the current healthcare system wastes hundreds of billions of dollars a year on insurance company profit and overhead. Scherger argues a single payer model would be much more efficient. And we wouldn't have to reinvent the wheel -- just expand the Medicare program.

Scherger: Medicare has only a 5 percent or less administrative fee. I mean, it's not perfect and it can be improved, but it's a model for how to give needed health care to people. And we could allow for private insurance for people who want more than that. I mean, Medicare supplements are a good example.

Victor Fuchs is a professor emeritus in economics at Stanford University. He agrees a single payer system would save money on administrative costs. But he says that's not the biggest amount of waste in our current system.

Fuchs: The biggest amount is the fact that our health care system is not run very efficiently from the point of view of getting the maximum amount of benefit from what is spent.

Fuchs says we need a new system of financing health care, and a way to make sure doctors and hospitals provide more cost effective care.

Governor Schwarzenegger says he has a plan that would extend coverage to everyone and save money at the same time. He says a single payer system is not the way to go.

Schwarzenegger: We have seen it all over the world, this government, you know, programs, don't work. People in places have to go and wait for a month to get surgery and to get medical attention, I mean we have a plan and ours will work. 

The state legislature approved a single payer bill last year, but the governor vetoed it. There's no reason to assume he'd do anything differently this year. Kenny Goldberg, KPBS News.