Why Did Single-Payer Health Care Fail in California?

By Lenny Potash for Labor Notes

Though it’s passed the legislature twice before, a bill to establish a single-payer universal health insurance system in California failed in the state senate in January.

Not surprisingly, the bill received no Republican votes, but it fell just two votes short of passage when two Democrats voted no and four Democrats failed to vote, despite intense lobbying efforts by community and some labor health care activists.

Angry activists pointed to the fact that five of the six errant Democrats had received money from the insurance industry and Big Pharma, ranging from $100,000 to over $250,000. Three of the six senators had been endorsed by the California Labor Federation which, along with unions such as the Service Employees and AFSCME, was on record supporting the single-payer bill. The California Democratic Party was also on record supporting it.

Similar bills passed the legislature fairly easily in 2006 and 2008, only to be vetoed by then-Governor Arnold Schwarzenegger. At a time when premiums were rising and there were few other proposals out there, it was an easy vote for Democrats certain of the governor’s veto.

But when Congress passed federal health reform in 2010, defending that bill, as well as President Obama, became paramount for many Democrats. It became more difficult for legislators to vote for a single-payer bill that might be interpreted as deserting the president, and the Democratic leadership refused to put the bill up for a final vote in the Assembly.

In 2011-12 the issue in some ways became even more loaded, with a Democratic governor facing massive budget deficits. Even though single payer would save Californians much more money in the medium term by reducing the huge overhead costs of insurance and drug companies, Governor Jerry Brown did not express support for the measure, and some Democrats feared to be seen backing an expensive bill.

Much of organized labor also hung back for similar reasons, despite the fact that almost all contract struggles and strikes today are to maintain health benefits. Insurance premiums have been rising four times faster than wages, and unions are battling employer efforts at shifting those costs to workers in every sector.

Unions that did back single payer this term included the California School Employees, California Nurses, both statewide teachers unions, and many locals who belong to the single-payer Campaign for a Healthy California.

The failure to pass single payer in California is a dose of reality for the movement. Although a 2009 New York Times/CBS survey confirms that 65 percent of Americans support a single-payer health care system, political and institutional support is lagging. Historically, labor’s support has been essential to the passage of any progressive social legislation, and that is even more important in the continuing face-off with the corporate health insurance behemoths.

“It will take a mighty grassroots movement to prevail over this concentrated corporate power and win health care for all,” said Mark Dudzic of Labor Campaign for Single Payer in a message to activists, adding that delegates from 28 unions, non-profits and grassroots organizations met in Portland two weeks ago to launch a new coalition to win universal health care in Oregon.

“Rather than starting off with a developed piece of legislation that would rely on the good will of the Democratic legislative caucus to advance, they have determined to focus first on grassroots community organizing and outreach,” he said, following the Vermont model.

Lenny Potash is a long-time AFSCME activist and is co-chair of Labor United for Universal Healthcare, a Los Angeles-based coalition of more than 40 unions in California.


  1. Jack Lohman on February 23, 2012 at 12:44 pm

    The problem is simple… campaign bribes… and until we throw them ALL out of office we’ll never win.

    • Joseph Kallas on February 23, 2012 at 2:16 pm

      As usual, Jack Lohman is right on the money. The California vote makes
      me ashamed to be a Democrat.

    • Gcasillas on February 23, 2012 at 6:01 pm

      Juan Vargas is a disgrace to the Democratic Party. He has taken so much money from the insurance industry. When he was termed out as an Assembly member he was given a high paying job by the insurance industry. This guy has no shame and is using his money from insurance donations to buy the local politicians and labor organizations.

    • John "Hai" Knapp on February 23, 2012 at 8:44 pm

      I couldn’t say it better, campaign bribes. Call it lobbying, it is still bribery; using money big insurance STOLE from their customers. Bribery is illegal, unless you are big huge corporations. It would land me in jail; kind of double standard.

    • How to throw them out of office?
      Inform Americans.
      1. Tell Americans what the subject is, how it will benefit them.
      2. Answer their questions and concerns.

    • Alán Alán Apurim on February 27, 2012 at 12:46 am

      Wrong approach, “Throw them all out” … and replace them with a fresh crop of amateurs who will once again be corrupted? No, it’s the SYSTEM that must be changed! We are a republic, not a democracy (there IS a difference). We must initiate a grassroots movement to convene a U.S.Constitutional Convention, creating amendments to be ratified by state legislatures (bypassing the corrupt U.S. Congress that won’t bite the hand that feeds it) as provided for under Article V. For real SOLUTIONS to our national problems, study scientist and U.S. Presidential candidate Harry Braun’s website http://Braun2012.US and the sub-page on 21st-Century amendments /Amendments.html for explanations. Education, Environment and Ecology, Economy, all can be solved by developing a Solar-Hydrogen Economy; but first we need a Democracy Amendment so citizens, not legislators, approve the bills legislators create (removing the incentive for corporations and lobbyists to bribe Congress). So only a few voters would bother to read the bills and vote on them? That’s better than a few bribed committee members in Congress controlling what goes into the bills or which ones even get considered!

  2. Walter Ebmeyer on February 23, 2012 at 12:45 pm

    So how is Vermont doing with single payer?

  3. jim fisher on February 23, 2012 at 12:54 pm

    Until we get public financing of elections, health insurance companies and pharma will control our healyh care.

  4. Larry Racies on February 23, 2012 at 12:55 pm

    An example should be made of those legislators who defeated the bill.

    Spend a few hard earned bucks on advertising: This man prevented California from achieving REAL health care. How much did it cost to buy him? (include a picture)

    Make it easy for legislators to vote for it and very very difficult for them to either abstain or to vote against it.

    Regroup and give it another try.

  5. Eddie Stiel on February 23, 2012 at 12:57 pm

    Typical politics. The corporate controlled Democrats voted for the bill when they knew that the Republican governor would veto it. With a Democratic governor in office, enough Dems vote against the bill to prevent its passage and to avoid putting Jerry Brown on the spot.

    Works the same at the federal level. Corporate tool Obama is now talking about jobs and taxing the rich when he knows that the Republican controlled Congress will never pass his rhetorical plan. Where was he when the Democrats had a super majority in the Senate and controlled the House during his first two years?

    Until activists find another tactic (a militant Occupy movement), there will be no progessive change. Relying on the lesser evil in a two party military corporate dictatorship is a dead end.

  6. J C Court on February 23, 2012 at 1:05 pm

    You should at least give readers the NAMES of the Democrats refusing to vote or voting against, or did I miss something? Their constituents need to know which way they are leaning. If we don’t know who these people are, how can we confront them on their votes? Be a journalist and get all of the information readers need when you write.

  7. sandy sanders on February 23, 2012 at 1:16 pm

    The results speak for itself. When Schwarzenegger was gov the Dems knew it wouldn’t pass so they voted for it so the could LOOK progressive. Brown, because of who he wants people to think he is would have signed it, so the Dems sabotaged it. THE DEMS ARE THE STRAIGHT MAN for the Reps. The agenda is the same, they both represent the 1%, but they must present a false theater of difference to fool the electorate into believing they are TRYING to serve the 99%. Protagonist vs antagonist, red or blue, blue or red, conflict that underpins attaining hierarchy within the pyramid scheme (and “rising” to the top): the modality and immorality of capitalism.

  8. Vic Anderson on February 23, 2012 at 1:24 pm

    Part of the Undercover Brother Neo”liberal” CREEP (Campaign to RE-Elect President) Obamanable Baracketeer, in spite of his abysmal lying DEM serial reneging!

  9. david78209 on February 23, 2012 at 1:28 pm

    Churchill once said the Americans can be counted on to do the right thing — after first trying everything else. “Obamacare” is, I hope, the last of the everything else we try before going to single payer.

  10. Jonathan Nack on February 23, 2012 at 1:31 pm

    We are being gamed by the Democrats. They twice passed Single Payer when they that knew then Gov. Schwarzenegger (R) would veto it, which he did. Now, they want to protect Gov. Brown (D), who opposes Single Payer, from having to face a situation where he vetoes it after his own party passed it.

    • Faye on February 23, 2012 at 5:53 pm

      Your right we are being gamed. Looking at the Democrats who did not vote for and when their terms expire, 5 of the 6 will not be up for reelection until 2014. I have notice this game with the U.S. Senate, the ones who are up for reelection on the near term vote with the people. For example, Senator Kerry was always in favor of allowing purchase of drugs from Canada, but voted against it when his vote was needed to kill the proposal – bingo – he was not up for reelection. I have notice this with almost every one of our “representatives”.

      We need to vote them all out.

  11. Armando Corpus on February 23, 2012 at 1:34 pm

    Millions of Americans suffer countless miseries and medical cost-induced poverty while politicis and other corporatist cash their medical industry pay-off checks. When will we be done with the rest of the world exposing us as cash-ruled, bloodthirsty savages?

    • Rodney Hytonen on February 23, 2012 at 2:54 pm

      Not to mention 3750 Americans DIE for lack of affordable or adequate coverage health care (or inability to afford ANY insurance)
      3,750 EVERY MONTH
      – as many as we lost total,
      in TEN YEARS of two ACTUAL WARS, but

      Every month that we deny what we know is inevitable, as health insurance greed continues to skyrocket premiums, rescind policies of the ‘unprofitable’ sick & elderly, deny claims, and refuse coverage..

  12. Kenny Jones on February 23, 2012 at 1:56 pm

    Single-Payer is thwarted by the same systemic ill that halts every other populist endeavor: the corporate lock on our electoral system. Are efforts to amend the Constitution (reversing Citizens United) likely to be successful? A strategy with a high likelihood for success is to force democracy upward from the local/grassroots level. Take a serious look at the Community Constitutional “Bill of Rights” strategy used by over 150 municipalities. These local ordinances are deliberately worded to set the stage for a “crisis of jurisdiction”–essentially inviting a fight in which corporate-controlled state & federal prosecutors will be forced to argue in open court that corporate “constitutional rights” are superior to the inalienable rights of citizens to self-government. Pittsburgh’s fracking-ban ordinance is one example of this strategy. Peruse CELDF.org.

  13. Ron Cohen on February 23, 2012 at 1:57 pm

    Politics, politics, politics. Campaign donations, lobbyist payouts, bribes. The people always come last. The Senators and Congressmen care only about themselves and their party. Unless the people vote these idiots out of office and grill the next ones that run for office to make sure they are different, nothing will change. The mentality in the state capitals and Washington must change for this country to move forward. Also, the biggest change that is absolutely required is for all insurance companies to become non-profit. It’s the profit lines that drive the companies and the politicians see it as easy money.

    • John Kolstad on February 23, 2012 at 3:22 pm

      To Ron Cohen,
      We in Minnesota require all health insurance companies be Non-Profit. It does not change anything. They rename their profits “Reserve Funds” and pay their executives a fortune.
      One must view the Health Insurance Companies as the mythical Vampire. You must catch them when they are vulnerable and drive a wooden stake thru their heart to permanently kill them. As long as these companies exist they will find a way to screw us again.
      The only way to solve this is Public Financing of Elections. With out that we have no democracy or Republic.
      Ironically, Americans would not tolerate such bribery for their favorite Pro or College Sports team. If one team were allowed to give 3 times as much money to the Officials of the game as the other team, would anyone accept the results?

  14. Scott on February 23, 2012 at 2:12 pm

    Lets be honest-insurers are the only industry to routinely and legally kill Americans through rescission, the denial of coverage after, say, 20 years of premium payments, for failing to mention a grass allergy when you were 10 and you now have cancer so actually NEED insurance. Read about those killed here: http://www.npr.org/templates/story/story.php?storyId=105680875

    What Massachusetts and now the nation’s healthcare delivery system represents is the grandest money laundering scheme ever hatched where our premium dollars are scrubbed clean by insurers then used to lobby against any kind of movement towards slowing the rapid siphoning of what little disposable income remains for the ailing American consumer who is now mandated to buy insurers deadly product.

  15. Gerry on February 23, 2012 at 3:23 pm

    Private insurers offer health insurance “plans” that offer cost reimbursement for certain NON-EXEMPTED healthcare ailments that are delivered only by certain selected healthcare providers.

    EXEMPTED CONDITIONS mean that there are always Gatekeepers of access to a provider, Gatekeepers of diagnosis coverage by the plan, Gatekeepers of treatment coverage by the plan, and Gatekeepers of payment authorizations for plan benefits obstructing your doctor’s decisions. If these gatekeepers are ineffective, there are other gatekeepers of your personal health history looking for other conditions or any inconsistencies by which to disqualify your claims.

    Multiple gatekeepers mean that a significant portion of your premium dollars (30-35%) are being spent to obstruct care, not to pay for delivery of care. The gatekeepers are the “Death Panels”, not the single payer organization.

    Remember, choice and clairvoyance are synonyms so whatever “plan” you choose will be perfect for your future healthcare needs.

  16. Paul Glover on February 23, 2012 at 4:21 pm

    Pushing past corporate insurance will require, among other things, an uprising led by the uninsured. That’s why the League of Uninsured Voters (LUV) has begun organizing. http://luvpower.org Here’s an introductory article: http://www.tikkun.org/tikkundaily/2011/10/03/healthy-rebellion-the-uninsured-step-forward/

  17. Anthony on February 23, 2012 at 5:32 pm

    Eh, Im moving to Europe until US gets its act together.

  18. Marc H. Toureille on February 23, 2012 at 5:40 pm

    It should be clear to any sane person, that we are no longer a Democracy, but a plutocracy. Big money controls the great majority of our Senators and Representatives who are very unlikely to change the system. They are bought and paid for by the supermillionaires and their lobbyists.
    History has taught us that this disparity between the people and their rulers will bring us uprisings and Revolution. It has happened and continue to do so in many parts of the world. We did it in 1776 and can do it again if necessary.

  19. Richard Conn on February 23, 2012 at 11:35 pm

    What designates a country as a failure: Too much cruelty, greed, superstition, and fear of progress. That didn’t exist in Canada when it took only 5 years to go from private health care to public health care…successfully.

    • David Johnson on February 27, 2012 at 12:11 pm

      Thank god for Tommy Douglas the saint who made it happen in Canada.A relentless effort by ONE PERSON CAN MAKE THE DIFFERENCE.I am scared to death to get more then a half hour from the Canadian border after experiencing the Canada system its awesome.Dont let some hillbilly senator tell you “we dont want ot be like Canada” who’s never even been there,in Canada EVERYBODY gets taken care of even Americans Nobody Left behind,at little or no cost.I wish I were Canadian!

  20. Bill on February 24, 2012 at 8:47 am

    I continue supporting Single Payer, until this system defeats insurance profit business.

  21. Judy Lujan on February 25, 2012 at 12:25 pm

    Six Democrats need to be voted out of office and replaced with Democrats who aren’t in the pocket of big insurance.

  22. Wayne M. Collins on February 27, 2012 at 6:41 pm

    Worse yet. A few years back when Schwartzenegger did put together a health care package similar to Obamacare then President pro Tem of the Senate Don Perata – Democrate, took it off the voting calendar using his prerogative as chief of the senate. The excuse…it cost too much.

    No one said a word, of course – he was a democrat.

  23. Dusty on March 6, 2012 at 1:41 pm

    AS a retired RN who for years saw many patients suffering per not having insurance to the high cost you pay even with insurance? Many families today are dropping their policies per the high gas cost and rising food cost? Now what do they do along with unemployed and millions who have no coverage at all? WHY can we not have health care one payer for all in this rich country way richer then Canada or England and many others who have socialized? Used the system in Ireland and Canada? Ireland you can have private and it only cost $800 a year along with their socialized? WHAT are the Republicans going to give us the citizens if they cancel Obama care I hear let the private companies compete good luck? Go to your state and look up what it cost to get health care today and most offer the same choices nothing and high prices? No, not everyone can get medicaid many immigrants have, WHY? So we see in this article that many of the Democrats, who did not vote for this were being funded by the medical system oh surprise surprise. Throw out the bums on either side? We have a free health clinic here in Jasper, Ga Good Samaritan for those without coverage. Been here for 8 years staffed by all volunteers and gets busier and busier no where else to go? Hospital is so expensive in the ER we the tax payer pay for this WHY? To keep the health insurance companies like the gas companies making high profits while so many today are suffering without health care? Wake up America and see what is going on and the divide in this country and WHY? Without your health what can you do? I heard the other day this was amazing and I hope the MEDIA puts this out there? Santorum was asked why he does not give more then 2% to his Catholic church that he is throwing out to women? His comeback the cost of medical for his ill daughter, WHAT? He has Congress health care doesn’t he? If not enough guess what this is what the rest of the world goes through former Senator? Please someone ck out did he stand up for the drug companies with one mother who was asking about chemo for a childs medicine and he was like what can the drug companies do they have a business? Like did I hear wrong please ck this out? If wrong fine? Also this not paying to his church and why he doesn’t but he wants to get rid of Obama care and do what?