He would be incremental on healthcare, Gov. Gavin Newsom said back when he was just a lieutenant governor seeking the Democratic nomination for the office he now holds.

When he didn’t say, perhaps he couldn’t know, was how large the increments would be.

At heart, Newsom would like California to have a single-payer healthcare system operating much like Medicare does for senior citizens and some others who qualify by dint of certain conditions and ailments. 

But he realized then and still does that this is not possible with a Republican in the White House, especially one as hostile to California as President Trump.

For a “Medicare for all” system would cost somewhere around $400 billion per year, far more than today’s entire state budget. Much of that money would have to come from shifting the monthly payments senior Californians now make to Medicare into state and not federal coffers.

That will not happen while Trump is president, and very likely not under any other Republican, either.

So Newsom the candidate called for other measures to bring California closer to his ultimate goal. Democratic dominance in both houses of the state Legislature will assure that he gets to sign off on many such changes this fall, when all the state Assembly and Senate votes are in.

A sweeping package of laws moving California well along toward universal healthcare has advanced steadily through the Legislature during the spring and summer. 

Backers claim these measures will reduce healthcare prices and improve quality, both claims still unproven.

The most radical shift will be to provide health benefits to many more undocumented immigrants, something Trump’s 2020 campaign manager immediately derided as being paid for by “taxing legal residents who don’t have health insurance.”

In fact, only a tiny percentage of the $100 million this will cost would come from Californians who lack health insurance of their own. 

And Newsom’s spokesman immediately responded that this spending will actually save money by providing care for Californians regardless of their immigration status before they become so seriously ill they must head for emergency rooms. That reasoning is similar to one of the arguments that was used against the 1994 Proposition 187 initiative which aimed to remove emergency room care and many other services from those here illegally – before it was struck down by federal courts.

It goes like this: The more serious illnesses and injuries can be prevented, the less urgent care people will need to seek out. 

Urgent, emergency treatments are among the most expensive elements of modern medicine, costing far more than preventive care like vaccinations and regular checkups.

Among other measures seemingly sure to pass during this session are bills to expand Medi-Cal (the California form of federal Medicaid) to almost all Californians, regardless of immigration status.

Another measure, this one authored by prime vaccination advocate Richard Pan, a Democratic state senator from Sacramento and the Legislature’s only pediatrician, would give state healthcare premium subsidies to middle-income Californians, funding them with a $695 yearly fine on those who fail to buy health insurance, whether from a private source or the state’s Covered California program.

More innovative is a bill carried by Democratic state Sen. Anthony Portantino of La Canada-Flintridge that would mandate insurance companies assure fertility preservation (freezing of eggs and sperms) when a medical treatment might threaten infertility.

Other bills aim to prevent the current phenomenon of many patients bouncing in and out of Medi-Cal eligibility as their job status changes in the gig economy and to make medically necessary prescription drugs available to everyone with health insurance, no matter where they buy those drugs.

Said Anthony Wright, executive director of Health Access California (a coalition of groups advocating expanded coverage and lower costs), “California is once again leading the nation to ensure our health care system works better for everyone, regardless of income, age or immigration status.” He is one who maintains the changes will lower costs while improving care.

Those were precisely the aims Newsom spelled out a year ago, which removes virtually all doubt about whether these measures will actually become law via his signature after their final legislative passage.

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