Californians Will Vote on Single-Payer System in Upcoming Referendum

Rebecca Voelker
JAMA. 1994;272(13):991-992. doi:10.1001/jama.1994.03520130023006.
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WITH CONGRESS mired for months in partisan politics, advocates of health system reform are following Horace Greeley's advice and turning their attention toward the West.

Next month, California voters will decide a controversial ballot initiative that would create a statewide single-payer system. As the weeks wind down to the November 8 election, the vote is attracting nearly as much notice as the national health system reform debate that has raged for 2 years.

"This is rapidly becoming the most important thing that is going to happen in health care this year, given that Congress has proven itself incapable of voting on health care legislation or passing it," says Sara Nichols, staff attorney with the consumer advocacy group Public Citizen, Washington, DC.

Physician-Backed Initiative  Placed on the California ballot as Proposition 186, the California Health Security Act was spearheaded by Californians for Health Security, a coalition of single-payer advocates. But it


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