California's Health-Care Example for Washington

(Bloomberg View) -- As Republicans in Washington contemplate the uncertain fate of their health-care bill over the July 4 recess, they might consider recent events in another legislature on the opposite coast of America.

Earlier this month, Democrats in the California state senate passed their own big, bold, bad health-care bill. The legislation would have required the state government to supplant insurers, providing health insurance to all residents and negotiating medical costs with hospitals, doctors and other providers.

There were a few complications. Most notably, the bill lacked a source of funding, and its estimated cost -- some $400 billion -- was more than twice the state’s annual budget. In effect, the senate had passed single-payer legislation without ensuring a single payer.

Governor Jerry Brown was not impressed. A state-based single-payer system, he said, took one problem -- lack of affordable access to health insurance -- and made it into an “even a bigger problem.” The state assembly essentially agreed. Last week Assembly Speaker Anthony Rendon shelved the legislation, despite pressure from liberal interest groups and the vocal followers of U.S. Senator Bernie Sanders.

There are at least two lessons to draw from this episode. The first is that Democrats are not immune to the kind of ideological pressure that has all but squeezed moderation out of the Republican Party in Washington. A single-payer system may well make more sense than the public/private mandate-and-subsidy system embodied by Obamacare (and its proposed replacement, by the way). But California, already a high-tax state, is in no position to establish a comprehensive single-payer system -- and it’s better to acknowledge reality than to pretend legislative wishes come true.

The second lesson is that, despite such pressures, politicians are not powerless to lead. They can say no. Republicans in Washington, who now stand on the brink of denying access to health care for millions, have no obligation to follow through on a project borne of an excess of partisanship. They can pull back from an unreasonable bill and prevent its inevitable harm.

Republicans in Washington, in other words, can still do what Democrats in California did: Just walk away. And don't come back until you have something better. 

To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net.

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