The California Senate passed a single-payer health care bill last week, but many key questions about the proposal remain unanswered.
Supporters and opponents both question how much more accessible health care would become to Californians if signed into law.
The California Nurses Association is a lead supporter of a single-payer health care bill. RoseAnn DeMoro, executive director of the association and of National Nurses United, says it would solve the problem of almost three million people who remain uninsured under Obamacare.
“A single-payer system gives everyone access and it treats everyone as human beings," DeMoro says. "It treats everyone equally, so you’re not a commodity.”
But Democratic state Senator and pediatrician Dr. Richard Pan abstained from the vote citing concerns about patient access to care.
He says some people already struggle to get care under the state-run health program Medi-Cal, which is underfunded.
“On one hand, being on Medi-Cal is certainly better than being uninsured, in many different situations, in most situations," Pan says. "But we also know there are access issues as well.”
Critics and proponents alike are also wondering how the system would be structured.
A Senate analysis raised concerns about the possibility of returning to a largely fee-for-service model.
Most of California's state-run health system, Medi-Cal, is now on managed care plans, where providers are paid by the number of people they cover, not by the number of treatments they dispense.
Scott Graves with the California Budget and Policy Center says some groups worry returning to a fee-for-service model will lead to higher health care costs.
"That's sort of the concern, that you may see providers racking up more services perhaps than are really medically necessary in order to bring more money into their practices," Graves says.
Democratic State Senator Ricardo Lara's office says his single payer bill includes language authorizing managed care and other models besides fee-for-service to remain under the new system.
Lara's office says it is continuing to look into the best methods for controlling costs.
The single-payer bill now heads to the Assembly.
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