Talking Points on Transition to a Unified Financing System

Healthy California for All Commission

Register for 12/9/21 Zoom.

  • No transition to a unified financing system of guaranteed healthcare for all (aka “single-payer”) is possible unless we address the crisis among nurses and other healthcare workers, and ensure that staffing, pay and working conditions improve to enable culturally competent and coordinated care.
  • We need to address short staffing. From the November jobs report: The number of people employed in education and health services is still 793,000 below its pre-COVID levels.
  • Most short staffing reflects the deplorable treatment of nurses and other health workers. Nearly 1 in 5 health care workers have simply left the profession, in a pandemic when they are desperately needed. 12% of healthcare workers have been laid-off!
  • It’s the fault of for-profit hospitals and nursing homes that would prefer profit maximization to adequate staffing ratios.
  • An effective transition requires establishing the infrastructure for lowering costs, negotiating rates, and setting global budgets and a state health care budget.
  • An effective transition begins with:
    • the elimination of health plans that divert revenue to profits and that create administrative complexity;
    • the standardizing of benefits;
    • the elimination of barriers to care – including networks that limit access – and moving to eliminate out of pocket costs.
  • There is no legitimate role in the transition or in a new system for entities that allocate care based on financial risk or restrict access to care based on financial incentives.
  • Integrated care delivery based on insurance-risk, or anti-competitive consolidation of hospitals, or purchase of medical groups by hospital systems for revenue-maximation, is not efficient, diverts resources from patient care, and raises costs.
  • Care coordination particularly for low-income people and people with chronic conditions is essential and can be established during a transition based on alignment of services and enhancement of clinical-based decision making based one the professional judgement of providers.
  • We must take seriously that “the political determinants of health” will decide the ability of California to transition to a system of guaranteed universal healthcare.
  • Public officials need to articulate the urgency for a new system of “unified financing,” especially considering the profound inequities revealed by the pandemic.
  • Utilizing the Commission report should drive timing – since momentum will be a key to a successful transition.
  • Overcoming the intense political opposition will require persistence and making the establishment of a unified financing system – aka “single payer” – a priority otherwise it simply will not happen.
  • Providing healthcare to all undocumented people in California is an essential, immediate step in the transition to a guaranteed healthcare for all.