{"id":2849,"date":"2026-06-23T10:39:47","date_gmt":"2026-06-23T10:39:47","guid":{"rendered":"https:\/\/nextcitydigest.com\/?p=2849"},"modified":"2026-06-23T10:39:47","modified_gmt":"2026-06-23T10:39:47","slug":"walters-single-payer-health-care-in-california-is-possible-an-economic-and-political-thicket-stands-in-way","status":"publish","type":"post","link":"https:\/\/nextcitydigest.com\/?p=2849","title":{"rendered":"Walters: Single-payer health care in California is possible. An economic and political thicket stands in way."},"content":{"rendered":"
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Is there a pathway for California to create a universal health care system, one with benefits paid through a \u201cunified financing system\u201d that merges federal and state funds with costs now borne by employers and \u2014 probably \u2014 a new layer of taxation?<\/p>\n

Read more Horoscopes June 23, 2026: Melissa Rauch, be precise to eliminate confusion<\/a><\/p>\n

The answer appears to be that, while such a pathway may be possible, hacking it through the thicket of health care economics and politics would require dozens \u2014 or even hundreds \u2014 of difficult choices.<\/p>\n

That\u2019s the gist of a\u00a0181-page report\u00a0from a team of University of California researchers that was charged with defining the factors to be resolved before such a system could be implemented.<\/p>\n

On June 17, the research team, organized by the UCLA Center for Health Policy Research, outlined the report\u2019s findings and fielded questions during a webinar. Its responses about the specifics of a unified system generally boiled down to maybe yes, maybe no.<\/p>\n

In other words, someone or some entity would have to plow through the seemingly countless variables catalogued in the report and decide which would be included and which would be excluded.<\/p>\n

Those variables start with the overall approach. Would it be a \u201csingle-payer\u201d system in which the state finances medical services for every Californian, similar to the systems in the United Kingdom and parts of Western Europe? Or would it be a hybrid that retains some aspects of the current system?<\/p>\n

Would the state pay the current private and public health care providers or set up its own proprietary network? Would payments be fee-for-service or encompass the managed care system that currently dominates health insurance?<\/p>\n

Would the federal government, which now pays roughly half of California\u2019s health care bills through Medicare, Medi-Cal and various programs for federal workers, be willing to give the state those many billions of dollars for a unified system? How would undocumented immigrants \u2014 now ineligible for federally financed services \u2014 be handled?<\/p>\n

Read more Asking Eric: I haven\u2019t gone back to the restaurant because I\u2019m confused about what happened<\/a><\/p>\n

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The report generally contends that a single-payer system would, by eliminating the paperwork and other aspects of the current system, be the most efficient from a cost\/benefit basis. However, it would probably be the most difficult version to create from a political standpoint.<\/p>\n

Single-payer would be a holy grail achievement for the political left,\u00a0both in California\u00a0and nationwide. The current search for some form began eight years ago when\u00a0Gavin Newsom, then running for governor, declared \u201cI\u2019m tired of politicians saying they support single-payer but that it\u2019s too soon, too expensive or someone else\u2019s problem,\u201d thus pledging to pursue it.<\/p>\n

Once elected, however, Newsom drifted away, eventually calling single-payer \u201caspirational\u201d rather than a hard promise, and sought incremental extension of coverage through Medi-Cal and other programs.<\/p>\n

He did, however, sign legislation in 2019 creating a commission to study the issue, saying, \u201cAs our march toward universal coverage continues I am calling on the brightest minds \u2014 from public and private sectors \u2014 to serve in the Healthy California for All Commission to improve the health of our state.\u201d<\/p>\n

\n<\/div>\n

The\u00a0commission\u2019s 2022 report\u00a0endorsed a \u201csystem of unified financing,\u201d but didn\u2019t specify a single-payer system. It led to the 2023 passage of\u00a0Senate Bill 770\u00a0that, among other things, called for the UC study on alternatives that was released in April.<\/p>\n

In a sense, the issue has come full circle. When Newsom advanced the notion of a single-payer system in 2018, everyone knowledgeable about the state\u2019s massive, very expensive and multi-player system of health care also knew that fundamental change would be very complicated and very difficult.<\/p>\n

The UC report says the same thing, only in more detail. Newsom managed to avoid making those tough decisions and will soon depart, probably for a presidential campaign. Will the pursuit of a pathway continue? Or has it just been a theoretical exercise?<\/p>\n

Read more Harriette Cole: I made the mistake of asking if I could date his sister<\/a><\/p>\n

Dan Walters is a CalMatters columnist.<\/em><\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

A new report examines if a single insurer funding model can succeed, noting immense structural and bureaucratic hurdles ahead<\/p>\n","protected":false},"author":1,"featured_media":2848,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-2849","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-opinion"],"yoast_head":"\nWalters: Single-payer health care in California is possible. 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