Closer Look at Other Health Care Systems Exposes Myth of Universal Health Care Through Single-Payer

In the debate on health care, the two words most confused or misunderstood are “universal” and “single-payer.” They often are used interchangeably, and even standing alone, are defined incorrectly. This confusion or error has completely skewed the dialogue on what is an ideal model for California health care and how to improve health care in California.

Very few, if any, would disagree that all the citizens and legal residents of a state or country should have access to quality, affordable health care. That is the widely accepted definition of “universal” health care—when all citizens and legal residents have access to health care.

Health Care


Promote a sound and affordable health care system. Work to contain costs and avoid unnecessary and expensive regulatory controls, including mandates.

Major Victories

Kept lid on health care costs in 2017 by:

  • Stopping well-meaning but flawed mandates increasing health care costs (SB 349, SB 172, SB 399, AB 1601, AB 1110, SB 221,
    AB 1107).
  • Advocating amendments to narrow the overly broad scope of required screening for blood lead levels in children to subjects whom a physician determines are at risk for lead poisoning (AB 1316).
  • Winning removal of language that would have limited access to care from in-home respite care provider agencies (AB 1380).

Stopped plan in 2017 for single-payer, multibillion-dollar health care system with unspecified funding plan (SB 562).

Stopped health care mandates in 2016 that threatened the long-term affordability of health care premiums (AB 2209, AB 3400, SB 1034, AB 1763, AB 2004, AB 2764).

Supported enactment in 2016 of special session measure to preserve a crucial state-federal funding mechanism for the Medi-Cal program (SBX2 2).

Opposed initiative defeated by voters in 2016 that would have increased health care premiums and out-of-pocket costs by shifting the cost of prescription drugs from government purchasers to private payers (Proposition 61).

Supported well-crafted health care funding proposal signed into law that preserves critical funding for the state’s Medi-Cal program, which is critical for the health care delivery system, without undermining the affordability of commercial health care purchased by employers, families, and individuals. (SBX2 2 of 2016)

Stopped 2015 Job Killer that would have increased health care costs by granting ability for state regulators to unilaterally alter large-group rate changes (SB 546.)

Controlling Health Care Costs in 2015:

  • Stopped coverage mandates that would have increased employer premiums (SB 190, SB 289).
  • Supported legislation signed mid-year to extend funding for program to provide the Legislature with valuable independent analyses of medical, financial and public health impacts of proposed health insurance mandates (SB 125).
  • Blocked new targeted taxes on employer health insurance (SBX2 14, ABX2 19, ABX2 4)

Stopped state proposals in recent years that would have increased health care premiums by establishing numerous health care coverage mandates.

Promoted voter rejection of ballot measures in 2014 that would have led to increased health care costs: Proposition 45 and its fundamentally flawed approach of giving the state Insurance Commissioner authority to approve health insurance rates (thereby potentially delaying health care decisions); and Proposition 46, which would have removed the longstanding cap on pain and suffering awards in medical malpractice lawsuits.

Blocked legislative proposals in 2014 that would have increased health care costs, including new health care mandates (AB 1771, SB 1053) and bills that would have undermined managed care plan savings (AB 2533) or nonprescription-based health care products and services (AB 1917).

Supported urgency measure in 2014 helping small employers control health care costs by allowing them to extend pre-Affordable Care Act policies through the end of December 2015 (SB 1446).

Advocated signing of legislation in 2014 eliminating confusion on waiting period limitations for health care coverage (SB 1034).


Rather than upending the health care system that polls say many Californians are satisfied with (except for costs), any reform to the system should focus on those who cannot gain access to affordable health care.

The CalChamber supports the following, including:

  • Access to affordable health care through an insurance model or clinic model;
  • Cost-containment on medication and treatment;
  • Reducing administrative work for providers, such as by using uniform forms to claim reimbursement; and
  • Expanding the investment by the state to increase the number of health care providers, especially physicians.


Issue Summary

Affordable Care Act

Position: The CalChamber will:

  • Continue to promote efforts to contain health care costs and improve access to high-quality health care by supporting a health care system that is affordable and improves the overall health of California citizens.
  • Continue to work to avoid unnecessary, expensive regulatory controls and the imposition of new coverage mandates and allow market forces to continue playing a predominant role in driving innovation and transforming health care delivery.

Affordable Care Act

Recent News

The interplay of costs, subsidies and pre-existing conditions in the health care debate is explained by CalChamber President and CEO Allan Zaremberg at the CalChamber Capitol Summit on May 31, 2017.

CalChamber President and CEO Allan Zaremberg discusses the political pressures affecting lawmakers’ attitudes toward government-run health care at the CalChamber Capitol Summit on May 31, 2017.

Health Care Bills



Staff Contact

Karen SarkissianKaren Sarkissian
Policy Advocate,
Health Care, Education