They add nothing to the health or well-being of patients; indeed, their profit models are built on minimizing or denying care that can and does physically harm patients. The State, with public money, pays these chiselers a fixed per person fee to manage the health of some of the poorest and neediest people in California. To the extent that they minimize care, they minimize the share of the premium paid them by the State that goes toward a patient’s actual health provision. Those “savings” result in higher profits, all else being equal, that are the monetized value of withheld care. They have incentives to skimp if at all possible (the same applies to all private health care plans including so-called Medicare Advantage and Obama care plans).

Rather than having five Medi-Cal payers skimming public money, a single-payer system would pool all public resources–like traditional Medicare–and deal directly with health providers. The State fund (the single payer) would negotiate fair fees for all health goods and services provided using its aggregated purchasing power to counterbalance the monopoly market power of private hospitals, drug companies, device manufacturers and assisted living facilities. Because the single payer–the State–does not operate on a profit basis, such an arrangement reduces total health care expenditures while allowing patients to choose whatever providers they want, not those assigned to them in the captive managed care network. Health care provision will be based on the needs of patients as determined by their interactions with health care professionals,not Health Net/Centene, Molina, Anthem Blue Cross, Community Health Group or Kaiser Permanente corporate bureaucrats (https://sanjosespotlight.com/single-payer-health-care-back-under-san-jose-assemblymans-plan/#comment-44597).