Lara and Atkins said they are working to address concerns that have killed past single-payer proposals. A wide-ranging financial analysis is under way.Atkins has floated an idea to offset steep costs by dissolving workers’ compensation insurance. Under that change, people with work-related illness or injuries could use their regular doctors, eliminating those costs for employers.“In the past I’ve said it wasn’t possible,” Atkins said. “What makes us different now is the experience with the Affordable Care Act…I’m hearing and seeing an appetite to do more.”
This adds a new wrinkle to California’s consideration of single payer medical care that could help overcome opposition due to the entrenched dominance of employer-sponsored group health coverage for the majority of working age people. The apparent idea here is make a payroll tax to finance single payer more politically palatable to business and employer organizations by eliminating the medical treatment component of state mandated workers’ compensation insurance.
This isn’t the first time the idea of providing medical coverage for both vocational and non-vocational injuries and illnesses through an integrated care system has come up in California. In the 1980s and 1990s, the idea was termed “24-hour care.” California Congressman John Garamendi, who served as the state’s first elected insurance commissioner in the 1990s, was a big proponent of the concept, saying it was wasteful to pay for separate forms of insurance for medical care. Garamendi served on Hillary Clinton’s health care reform task force and influenced it to include 24-hour care in the Clinton administration’s health care reform proposal.
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