It’s not just Cal­i­for­nia, but a num­ber of states are look­ing to find a solu­tion to the “prob­lem” sup­pos­ed­ly caused by The Afford­able Care Act.  The ACA didn’t cause the prob­lems – it mere­ly rode the coat­tails of prob­lems that have always exist­ed.  Some blame the insur­ance com­pa­nies, but in fact while they don’t real­ly help they also are not the cause – costs are up, thus rates are up, and car­ri­ers have no appar­ent han­dle on any of this.  Will the gov­ern­ment?  At least car­ri­ers are dri­ven by a prof­it motive (even the non­prof­its) while the gov­ern­ment is dri­ven more by social motives which, of them­selves, aren’t bad, but they can be so inclu­sive as to dri­ve costs up even more as they accom­mo­date all the claims and demands made on the sys­tem.  The alter­na­tive, of course, is that the gov­ern­ment is less accom­mo­dat­ing, in which case you have a sit­u­a­tion with cost con­trols that can’t be appealed and no option if you don’t like them.

OK, here are the basics in Cal­i­for­nia – the Sen­ate has have passed a bill but now they have to fig­ure how to pay for it (that means replac­ing pre­mi­ums with tax­es).  Ini­tial esti­mates are a sys­tem cost of $400 bil­lion, which we ain’t got.  There are pro­po­nents who counter, how­ev­er, that the amount of mon­ey that will be saved from installing a Sin­gle Pay­er sys­tem will coun­ter­act these costs – but how?  Thus cost is the ulti­mate conundrum…and will deter­mine how, if or how well a Sin­gle Pay­er sys­tem may work here.

Oh, and the bill is only twen­ty pages…the Afford­able Care Act was 2,000 (to start).  So…