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The private man at the center of California's very public debate over single-payer healthcare

The private man at the center of California's very public debate over single-payer healthcare
Dale Fountain leads a campaign to place an initiative on the November ballot making it easier to fund a single-payer system. He is shown in a video of his testimony Feb. 7 before the California Legislature’s healthcare delivery and universal coverage committee. (Kaiser Health News)

Dale Fountain is an intensely private man. He won't say where he works. One of his oldest friends can't say for sure where he lives. His sister knows he was once married, but she isn't in the loop these days — they haven't spoken in two years.

"He keeps to himself," said Chris Pulliam, who went to high school with Fountain in Los Angeles and now lives in Silver Spring, Md. "I've just got into the habit of not asking about things."

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Yet the elusive 42-year-old Silicon Valley tech worker has inserted himself into the forefront of California's hottest healthcare debate: whether it should adopt a statewide single-payer healthcare system.

His Facebook group, Enact Universal Healthcare for California, has more than 106,000 followers — just one sign of the issue's general appeal to many voters.

Fountain is the unlikely leader of a campaign to place an initiative on the state's November ballot that would make it easier to fund a single-payer system — one in which the state would set the rules and pay the medical claims for all California residents.

It's a crusade that drove him to deliver a televised speech to lawmakers, clash with other single-payer advocates and endure a barrage of questions from a nosy reporter.

With slumped shoulders and in a faded black button-down shirt, he recently argued his case before a legislative committee. Though often detailed and convincing, his testimony at times was cryptic and awkward.

"Here's a simple diagram; please don't stare at it too long," Fountain suggested as he flipped through slides.

Afterward, he met with a reporter over a fruit cup and black coffee in the Capitol building. "I'd rather not [do this]," he said of running the political campaign. "But it needs to be done."

After two interviews, he stopped answering the reporter's questions and claimed she had urged him to break the law by asking him to bring copies of signed petitions to an interview.

Since a single-payer bill, Senate Bill 562, stalled in the state Legislature last year, many Democrats have moved toward more incremental approaches to universal healthcare, such as expanding insurance to people who are in the country illegally.

Supporters of single-payer health care march in Sacramento in April 2017. Senate Bill 562, which aims to remake the healthcare system by eliminating insurance companies and guaranteeing coverage for everyone, stalled in the state Legislature.
Supporters of single-payer health care march in Sacramento in April 2017. Senate Bill 562, which aims to remake the healthcare system by eliminating insurance companies and guaranteeing coverage for everyone, stalled in the state Legislature. (Rich Pedroncelli / AP)

But Fountain wants more than baby steps.

"We got used to this nightmare scenario of healthcare that we couldn't afford," he said. "It's not like that in most countries on this planet. Most countries take care of their citizens."

Calling personal questions "off-point and off-limits," Fountain describes himself "just an average guy" tired of hearing about people who can't afford health insurance or about outrageous medical bills.

He started his Facebook group after the November 2016 election and is asking followers to help him collect about 585,000 signatures for the ballot initiative he co-wrote. That's how many the "California Health Care Roadblock Removal Act" needs by April 23 to qualify for this fall's ballot.

Fountain is not paying signature gatherers — a strategy that experts say makes his prospects of success low. "No measure has made it to the ballot without paid signatures" in recent California history, said Thad Kousser, a political science professor at UC San Diego.

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The measure would not by itself fund a single-payer system. Instead, it would amend the state constitution to create a special fund for healthcare, and would exempt that fund from spending limits and from state budget rules that require a certain portion be spent on education.

"Thousands" of people have given to his cause, Fountain said, adding that donations average $15. But he wouldn't divulge how much he's raised, nor would he say how many signatures his group has gathered.

His group's Facebook page routes donors to a website run by ActBlue, a nonprofit fundraising platform for left-leaning candidates and causes. It's not clear from ActBlue's campaign finance reports to the California secretary of state how much Fountain's group has raised.

While trying to gather signatures, Fountain also has tried another tack: pressuring lawmakers to place the measure before voters, which requires a two-thirds vote in the state Senate and state Assembly.

No lawmaker has publicly stepped forward to lead the cause.

However, state Assemblyman Jim Wood (D-Healdsburg), who chairs the Assembly Health Committee and a special committee on universal healthcare, agreed with Fountain that it makes sense to remove the constitutional barriers to funding universal healthcare.

"The cleanest way to do this is to take it to the voters," Wood said.

Reputable policy experts, including the Legislative Analyst's Office and the California Budget and Policy Center, agree that single-payer would have the strongest legal footing if voters removed funding roadblocks.

According to a California Senate analysis, taxpayers would have to cough up $200 billion a year to fund a single-payer system in addition to the public money already dedicated to healthcare programs. On the plus side, California residents would no longer pay for insurance premiums, copayments and other medical expenses.

Raising that kind of money would be a tall order — even if Fountain's proposed initiative were approved.

He is undeterred. Fountain's sister, Rikka Fountain, 47, an attorney in Palmdale, speculated that her brother's passion for single-payer could be related to the death of their mother from breast cancer when Dale was a toddler.

"We didn't have any nearby family to help out," Rikka said. Their mother's death showed how health problems can "crop up and cause extreme difficulty for people," she said.

"Dale is very obstinate, and that is the kind of personality that you probably need" to champion the single-payer cause, she added.

Fountain's old friend Pulliam describes Fountain as practical, with a dry sense of humor. "He does things that need to be done, without anybody asking," he said. "It's a very big deal for him to be doing something so public."

Fountain insists his campaign to transform healthcare is not about him, but about the health of California's 39 million residents.

"We do this out of civic duty and wanting to help people," he said.

It’s a waste of time and money. He is literally irrelevant.


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Fountain apparently is able to afford health coverage for himself. He said he has a job working on computer systems at a tech company that he declines to name and has health insurance through Covered California, the state insurance exchange. He said he pays about the same amount as he would if he purchased coverage through his job.

In true Sacramento fashion, Fountain has already earned himself a political enemy who would seem to be a natural ally: the powerful California Nurses Assn.

The union has made enacting single-payer its signature issue. According to Fountain, the union approached him last year to join efforts to pass the single-payer bill that already had been introduced in the Legislature.

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For a while, he helped run its social media campaign, he said, but stopped in part because of the union's aggressive tactics. The union flatly denies that he worked with them.

"He tried to pimp off our work," said the union's public policy director, Michael Lighty, adding that he's surprised lawmakers have given Fountain the time of day. The nurses say their bill is written in such a way as to bypass funding obstacles.

"It's a waste of time and money," Lighty said of Fountain's effort. "He is literally irrelevant."

Amid challenges from skeptics and sworn enemies, Fountain has acknowledged that his efforts may not be successful this time around. That doesn't faze him.

"If we do fail," he said, "then we have that base already for the next session, and we continue to build."

Bartolone is a correspondent for Kaiser Health News, an editorially independent publication of the Kaiser Family Foundation.

pbartolone@kff.org

Twitter: @pbartolone

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