Part of a series called Crossroads: Policy and Politics written by Michael Lighty, President of Healthy California Now
After all the hoopla of the recall, was it just sound and fury signifying nothing?
That of course depends on what comes next – especially on what advocates for transformational change in California organize to do.
The issues on the state’s to do list that the media most often cite as causing voters’ dissatisfaction with California’s direction are homelessness, crime, and housing prices. But what underlines those issues is the profound social and economic inequities revealed and worsened by the COVID pandemic. A transformational politics would focus on inequity.
The pandemic is a public health crisis, which points toward a focus on healthcare as key to solving the states problems. Homelessness is exacerbated and sometimes generated by mental health crises. Crime rooted in addiction is also a public health issue. Healthcare is rationed based on ability to pay, accessed through fragmented systems that underserve Black and brown communities, and disregarding the specific needs of AAPI communities.
Fundamental to solving California’s problems is addressing the inequities in healthcare. As the Nobel prize winning economist Angus Deaton has argued, how healthcare is financed and delivered in the US is a driver of inequality.
We need the resources and a system for behavioral health treatment, we must expand the funding for local public health interventions, improve education and childcare with new resources, and build lots of affordable housing.
Where will the money come from?
Literally hundreds of billions of dollars could come from savings generated by single payer financing of health care. In fact, a recent study by the Healthy California for All Commission showed that the present healthcare system would cost $800 billion a year in 2031, and still not cover everyone. A universal system of guaranteed healthcare financing through a single, dedicated trust fund would cost $223 billion less in 2031, and save those hundreds of billions in the meantime. And relieve the state and local governments of over $90 billion in unfunded retiree health liabilities.
More important, such a system would guarantee healthcare and save lives: mental health treatment to keep people off the streets; robust public health programs to create healthier, more resilient communities; substance abuse treatment to prevent overdose deaths and reduce desperation leading to property crimes; and, fewer people incarcerated leading to less spending on prisons.
The virtuous circle of resources to solve California’s pressing problems and improving our health is within reach. To transform California, guarantee healthcare to all our residents.