Elwell: Guaranteed health care is within our grasp
Dr. Mark Penner, an emergency room physician at O'Connor Hospital in San Jose, Calif., wears a black cat pin that he said he brought for good luck on the first day of vaccinations on Dec. 17, 2020. (San Jose Spotlight/Vicente Vera, Pool.)

    The COVID pandemic has put in sharp relief the weaknesses, inequities and complexities of our patchwork system of health care. Our nation’s for-profit private insurance model has garnered billions in windfall profits for insurance companies while patients and small health care providers suffer.

    Twenty-eight million people were uninsured in the U.S. in 2020. Another 31 million were underinsured and if they have a serious illness may end up in bankruptcy. Point of service charges such as co-pays and deductibles discourage many from accessing the care they need. In addition, the existence of thousands of public and private insurance providers and regulators has resulted in extraordinarily complex access to health care, and prevents many from using whatever coverage they may have or for which they qualify.

    The California Legislature has a historic opportunity to right these wrongs in California by passing CalCare AB 1400, the Guaranteed Health Care for All Act, co-authored by our own South Bay Assemblymembers Ash Kalra and Alex Lee, along with Miguel Santiago of Los Angeles.

    AB 1400 would:

    • Establish guaranteed universal health care for all California residents: Everybody In, Nobody Out
    • Provide comprehensive health care, including all primary care, hospital and outpatient services, dental, vision, audiology, maternity and newborn care, women’s reproductive services, mental health, prescription drugs, long-term care and more
    • Eliminate point-of-service costs like deductibles, co-pays and other out-of-pocket expenses
    • Ensure genuine choice of any doctor, hospital, clinic or other provider a patient chooses, without the restrictions imposed by private insurers
    • Make your health care not dependent on your employment

    Health care justice

    The ever-rising cost of health care and its discriminatory characteristics contribute to the growing national chasm of health and wealth inequality.  The COVID pandemic has exacerbated and laid bare inequities based on race, ethnicity, socioeconomic status and more. Nationwide, 55% of the uninsured are people of color.

    Immigrants are essential workers that contribute their labor to the system but are often not able to access the benefits. Undocumented immigrants, 10% of San Jose residents, are not eligible for the Affordable Care Act under federal law. Even in California, adult undocumented immigrants ages 26-50 are not eligible for Medi-Cal.

    Medi-Cal itself, while an important lifeline for low-income people, leaves a lot to be desired. Among other issues, many health care providers will not accept Medi-Cal because of the low reimbursement rates, resulting in long waits and delayed care. Community clinics and health care systems that serve mainly Medi-Cal patients are perpetually teetering on financial disaster.  The current Medicare system does not cover dental, hearing, prescription eyeglasses or long-term-care.

    Insurance premiums are so expensive that people who don’t qualify for Medi-Cal but still have low incomes, especially young people, would rather pay the state fine for not having insurance than face the premiums, deductibles and co-pays for Covered California. More and more people are turning to crowdfunding to pay medical bills.

    AB 1400 would remove these structural inequities and provide equal, quality and fully comprehensive coverage.

    Savings for people, government and employers

    Almost everyone would be paying less for comprehensive care with AB 1400, a single payer system, as it would eliminate all premiums, deductibles and copays.

    The never-ending rising costs of employee health care add challenges to our already strapped San Jose city budget, costing more than $102,000,000 per year, in addition to the cost of programs to deal with the human cost to San Jose residents of poor health, increased poverty and bankruptcy. Our small businesses, which keep our communities thriving but have suffered so much during the pandemic, struggle to provide health care for their employees. AB 1400 would reduce health care costs to most employers .

    Numerous studies, both conservative and progressive, have estimated that the U.S. would save from $2 trillion to $5 trillion over 10 years, compared to what our country is projected to spend under the current system, due to massive savings in administrative costs, lower prescription drug prices and improved efficiency through a uniform payment system – without the waste from billing, marketing and profit-taking of private insurance companies.

    The future is in our hands

    AB 1400 will be re-introduced to the California Assembly in Jan. 2022 and has only one month to make it through the Assembly. Passage of this legislation can’t be taken for granted, due to rampant misinformation spread by private health insurance companies, Big Pharma and others who profit from the status quo, as well as the politicians that receive money from them. It is important to inoculate the public against their gross deception by spreading the truth about single-payer.

    It is very important to contact South Bay legislators who have not come out in support of AB 1400 and urge them to commit to voting for it –- specifically Marc Berman of District 24 and Evan Low of District 28.

    The San Jose City Council will be taking up a memo of support for AB 1400 introduced by Councilmember Magdalena Carrasco. Following a hearing in the San Jose Rules and Open Government committee on Oct. 13, it will come up for a vote in the full City Council on Oct. 26. This support from the third largest city in California would be an important step, joining Los Angeles, San Francisco, Oakland and more.

    Readers are encouraged to contact their San Jose councilmember to get them to vote in favor.

    You can write letters to the editor highlighting the rationality and benefits from AB 1400. You can also join the movement by contacting the Santa Clara County Single Payer Health Care Coalition at [email protected] or on Facebook at https://www.facebook.com/SCCSinglePayer/.

    Peggy Elwell is a member of the Santa Clara County Single Payer Health Care Coalition.

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