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Single-payer will pose massive ethical and economic dilemmas for California

Single-payer will pose massive ethical and economic dilemmas for California
Gov. Gavin Newsom presents his first state budget during a news conference on Jan. 10 in Sacramento. (Rich Pedroncelli / AP)

To the editor: Your editorial on Gov. Gavin Newsom’s push for single-payer healthcare in California is spot on when it states, “Once the state becomes the only insurer, it raises more pointed questions.”

Those questions are both ethically as well as economically the most difficult to answer.

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Currently, Medi-Cal is the 49th lowest (of all the states) payer to hospitals and care providers, creating essentially a hidden tax on everyone who purchases healthcare. About one-third of all Californians and 40% of Los Angeles County residents are eligible for Medi-Cal coverage.

If the federal government approves Newsom’s request to “mingle federal dollars” and create one purchasing pool for healthcare, basic economics will pose a massive dilemma, as there will be nowhere near enough money in this pool. Either we dramatically increase our taxes, we dramatically ration medical services, or do some combination of the two.

Howard C. Mandel, MD, Los Angeles

The writer is vice president of the Los Angeles City Health Commission.

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To the editor: Shouldn’t Newsom first check with some veterans and those of us on Medicare if we’re OK with “mingling” federal healthcare dollars with the state’s money?

I don’t know why anyone of right mind would agree to turn over their healthcare dollars to California willingly. Medicare has been around and functioning well for a long time; veterans have had some problems that seem to have been worked out.

The idea of turning my medical insurance dollars over to a California bureaucracy that would determine my level of care and subsidize — or just plain gift — healthcare coverage to residents in this country illegally is enough to make me ill.

Jeff Rupp, Pasadena

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