When will all Americans participate in the Medicare (single-payer) system that, despite the efforts of neo-conservatives, has managed to serve the health needs of seniors for more than 40 years? Will our struggling economy be the impetus for reform, or will it take a public-health disaster to force our legislators to adopt a system of quality, accessible health care for all?

The inflation of annual insurance premiums over the last six years might just do the trick all by itself. Our legislators may be forced to initiate restrictive regulation of insurance companies (as Germany does), or to enact a single-payer system (as most other industrialized nations have), or both. If they really wanted to shock and awe us, Assemblyman Sam Blakeslee and State Senator Abel Maldonado would circumvent the inevitable, and choose to start California down the path toward recovery, by actively supporting Senate Bill 840.

SB 840 would commit the legislature to make a serious attempt at establishing a single-payer health insurance system for all Californians. Awaiting a hearing in the Assembly Appropriations Committee, SB 840 does not contain details concerning taxes, premiums, expenses, or other financial matters, but constructs a blue-ribbon panel, made up of statewide officers, to research and propose the funding mechanism which, along with the entire health-insurance plan, would be put it to a vote of the people.

According to 2005 data compiled by health care economists at The Lewin Group, the entire state’s medical bills would have been paid if workers paid a flat 3.78 percent of their annual income over $7,000, combined with an 8.17 percent-of-payroll premium from employers and the usual federal block grants for Medicare and MediCal. The 2005 premium income would have enabled repayment of an additional $8 billion of whatever start-up monies were required to establish the system; that way, nobody would have paid for two systems at the same time. The Legislative Analyst recently applied the assumptions of that study to a projection of health-care costs in 2011, based upon runaway cost inflation, and found SB 840 wanting, but that comparison was less than fair.

When critics recite their litany of single-payer evils, ask this question: In what other nation of the world do people go bankrupt due to unaffordable medical bills? Answer: Not one. According to the results of a 2002 study of bankruptcy filings by Harvard University researchers, published in the February issue of Health Affairs, 50 percent of U.S. bankruptcies are caused by illness or injury and 75 percent of those affected had health insurance at the time.

See the Web site of Physicians for a National Health Program (www.pnhp.org), which presents much of the following information.

Single-payer is not socialized medicine. The government would not own hospitals or employ health care professionals. Patients would continue to see the doctor of their choice.

Single-payer is government-run health care only to the extent that private health-insurance companies already use Medicare’s reimbursement schedules extensively to set their reimbursement for common procedures. The U.S. private health-insurance system of thousands of plans, each with its own underwriting, marketing, enrollment, claims, premiums, rules, and regulations, is extremely fragmented and complex; by comparison, the single-payer Medicare system is straightforward.

Health care rationing based on income, as it is in the U.S., is as unnecessary as it is immoral. Because insurance companies spend money determining to whom to sell (underwriting), denying claims, reviewing applications and cancelling policies, marketing 1500 different plans (in California alone), and paying sales commissions and executives’ salaries, administrative costs of 22 to 31 percent in the U.S. are excessively high. The administrative costs of Germany’s successful sickness funds are typically from 5 to 6 percent.

Speaking of honest labels, most health-insurance plans provide little incentive for paying the inflated costs of mammograms, colonoscopies, and, regular health screenings that may discover diseases before such conditions progress and become more expensive to treat. Call an irrational application of an insurance product that might make sense for property protection what it is: disease insurance.

Health care providers in single-payer countries pay much lower malpractice insurance premiums.

Health care is a basic human right. The sooner our legislators recognize that insurance companies add the same value as a government entity for the fiduciary function they perform, but at excessive cost, the sooner we can bring health care costs under control and cover the greatest number of people. Write Assemblyman Blakeslee at 1104 Palm Street, San Luis Obispo, CA 93401, and urge him to vote in favor of SB 840 so that Senator Maldonado will have the chance to vote to override Gov. Schwarzenegger’s veto in September.

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Walter Heath is the co-director of the San Luis Obispo County chapter of Health Care For All. Send comments to him at P.O. Box 549, Atascadero, CA 93422, or to the editor at [email protected].