Health conference debates ‘single payer’

As the nation is struggling with the uncertain future of the Affordable Care Act, California’s state legislature is pondering the idea of establishing a “single payer” system of health care for its residents.

The California Senate earlier this year approved a bill, SB 562, that would create a program in which the state is the only payer for health care, but the bill was pulled in June.

The topic was up for debate on Friday, at the Business Journal’s annual Health Care Conference held at the Hyatt Vineyard Creek in Santa Rosa.

The California Nurses Association has come out as supporting the bill, called The Healthy California Act, which would require the state to explore the idea. It has touted studies which suggest that the adoption of such a plan would save $37.5 billion annually in health care spending - even after adding the state’s nearly 3 million currently uninsured residents.

The problem with our current health care system is that we spend more than other countries and get less for it, and the unregulated insurance industry and fat in health care administration are to blame, said Sand Brim, with the California Nurses Association/National Nurses United.

“Private insurance is in the way and should be removed,” she said. “Other countries have a single payer system and are spending less with greater outcomes. The free market isn’t working for insurance.”

Brim also noted that one or two insurers generally control 94 metro areas in the U.S., and salaries of insurance CEO’s are inordinately high, part of the high management costs which are part of the country’s current health care system.

“We’re upside down,” she said. “Doctors are going out of private practice because it’s too complicated to manage insurance.”

The cost to implement and pay for “single payer” has also been an issue.

Brim said that with complete coverage and benefits for all in the state, the cost would run $331 billion, 10 percent less that what we are paying now.

The California Association of Health Care Underwriters comes down on the other side of the issue. CAHU claims nearly 500,000 jobs will be lost in California if the bill becomes law and will cost $400 billion, more than twice the size of the state budget, to implement.

“Vermont passed ‘single payer’legislation, but couldn’t figure out how to pay for it,” said David Fear Jr., president-elect of CAHU.

California embraced the Affordable Care Act, it’s been successful, and there is no reason to change that, he said. Fear believes the best way to is to offer universal coverage, through a government agency, with additional private insurance available as a choice. Countries like Canada and Japan, which have a “single payer” system, are now considering adding supplemental private insurance as a choice.

Detriments to “single payer” also include loss of current coverage and increase in taxes, Fear said.

“Let’s focus on the ACA. It has worked well and we can make it better.”

Also at the conference was a panel of local health care officials that included Judy Coffey, senior vice president, area manager, Marin and Sonoma, Kaiser Permanente, Mike Purvis, CEO Sutter Santa Rosa Regional Hospital, and Todd Salnas, president, St. Joseph Health, Sonoma County.

“We’re operating in an atmosphere of uncertainty, why make it more complicated? Why are we creating another (system of coverage) when we already have one?” Coffey said.


It’s still in the early planning process, but Sutter Santa Rosa Regional Hospital will be expanding with 40 more beds and more operating and emergency room, it was announced at the conference.

“When we opened in 2014 we were at capacity. It’s too early to say what (the expansion) looks like, but that’s what we’re thinking about,” said Purvis.

St. Joseph Health in Santa Rosa will build a 70,000-square-foot medical office plaza across from its Santa Rosa Memorial Hospital on Montgomery Dr., to centralize services. It will include ample room for parking, and the goal is for completion in January 2020, Salnas said. In 2030, an expansion is planned for the hospital.

Kaiser Permanente is also expanding in the North Bay, with a new office building on Mercury Way in Santa Rosa. In San Rafael, Kaiser is currently in the approval process with the city of San Rafael for conversion of a 148,000-square-foot building on Los Gamos Dr. to medical offices, and will also open a new oncology and infusion center at 820 Las Gallinas Ave. in late August, according to Coffey.

CORRECTION: Kaiser is in the approval process to renovate a building on Los Gamos Dr.

Cynthia Sweeney covers health care, hospitality, residential real estate, education, employment and business insurance. Reach her at or call 707-521-4259.

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