I’m thrilled to sit down with Faisal Zain, a renowned healthcare expert with a deep background in medical technology. With years of experience in the manufacturing of medical devices for diagnostics and treatment, Faisal has been at the forefront of driving innovation in the field. Today, we’re diving into the pressing issue of health care costs in California, a topic that’s taken center stage in the upcoming gubernatorial election. Our conversation explores why health care affordability is such a critical concern for voters, the feasibility of ambitious proposals like single-payer systems, the challenges posed by federal policies, and potential strategies to ease the financial burden on Californians.
How do you see health care costs shaping the priorities of voters in the upcoming California gubernatorial election?
Health care costs are undeniably a top concern for Californians right now. We’re seeing polls showing nearly 80% of likely voters worried about affordability, and it’s no surprise given the state’s high cost of living layered on top of rising medical expenses. Factors like an aging population, increasing chronic conditions, and pricey new technologies are driving up costs. For many, even those with employer-based plans, out-of-pocket expenses are becoming unmanageable. I think voters are looking for a governor who doesn’t just acknowledge the problem but offers tangible solutions to ease that burden. It’s not just about access anymore—it’s about whether people can afford the care they need without going broke.
What do you believe are the root causes behind the struggle so many Californians face with out-of-pocket medical expenses?
There are several layers to this issue. First, you’ve got providers raising prices, which is often tied to broader inflationary pressures. Then, there’s the reality of an aging population needing more care, coupled with a rise in chronic illnesses that require ongoing treatment. New medical technologies, while innovative, often come with hefty price tags. On top of that, even with insurance, copays and deductibles are climbing—family premiums for employer plans hit almost $27,000 this year, with workers footing a big chunk of that. For many, a single medical emergency can wipe out savings. It’s a perfect storm of systemic and economic factors hitting families hard.
How feasible do you think it is for the next governor to cap out-of-pocket costs, as so many voters are demanding?
Capping out-of-pocket costs is a popular idea—72% of likely voters want it prioritized—but it’s a complex challenge. It would require strong state-level regulation of insurance plans and provider pricing, which can face pushback from powerful industry players. The state could potentially set maximum limits on deductibles and copays for plans under its jurisdiction, like those in Covered California, but employer-based plans are trickier due to federal oversight. Funding mechanisms would need to be ironed out—possibly through subsidies or reallocating existing health care dollars. It’s doable, but it needs a governor with the political will to negotiate with stakeholders and a clear plan to avoid unintended consequences like reduced access to care.
What are some innovative approaches or technologies from your field that could help lower health care costs for Californians?
In the realm of medical technology, there’s huge potential to drive down costs through innovation. Telehealth devices, for instance, can reduce the need for expensive in-person visits by enabling remote diagnostics and monitoring, especially for chronic conditions. Wearable tech that tracks vital signs can catch issues early, preventing costly hospitalizations. On the manufacturing side, we’re seeing advances in producing more affordable diagnostic tools—think portable imaging devices that don’t require massive infrastructure. The key is scaling these solutions and ensuring they’re accessible through insurance or state programs like Medi-Cal. If the next governor partners with tech innovators, we could see real savings without sacrificing quality of care.
Can you break down what a single-payer health care system would mean for the average Californian, and how it might impact their access to care?
A single-payer system essentially means the government acts as the sole insurer, covering everyone under one public plan instead of a mix of private and public options. For the average Californian, this could mean no more premiums or copays at the point of service—care would be funded through taxes. Access could improve, especially for those currently uninsured or underinsured, as everyone gets the same baseline coverage. However, it’s not without challenges. Wait times for certain procedures might increase if demand spikes, and provider networks could shift. It’s a trade-off: broader access but potential bottlenecks unless the system is carefully designed with enough funding and infrastructure.
Given the estimated $400 billion annual cost of a single-payer system, how would you address concerns about its affordability at the state level?
That $400 billion figure is staggering, and it’s a valid concern. Funding a single-payer system would likely require significant tax increases, which can be a tough sell politically. One approach could be a progressive tax structure, where higher earners and corporations shoulder more of the burden, alongside reallocating existing health care spending from private premiums to public funds. Another angle is phasing it in—starting with certain populations or services to manage costs over time. Transparency is crucial; the state would need to show exactly how savings from eliminating private insurance overhead could offset expenses. Without federal support, though, California would be taking on a massive financial risk, so any plan needs a realistic roadmap.
With federal cuts to programs like Medicaid looming, how can California protect safety net programs like Medi-Cal from losing ground?
Federal cuts, especially the projected $900 billion reduction in Medicaid spending, are a huge threat—potentially pushing millions of Californians off Medi-Cal. The state can step in by increasing its own funding to backfill gaps, though that’s tough with budget deficits. Another strategy is legal action or negotiation to preserve federal dollars, as we’ve seen in the past. California could also focus on efficiency—using technology to streamline Medi-Cal administration and prioritize preventive care to reduce long-term costs. It’s about building resilience at the state level, but honestly, without federal partnership, it’s an uphill battle. The next governor will need to rally public support to pressure Washington while finding creative local solutions.
As premiums for Covered California plans are set to rise next year, what can the state do to help people afford coverage amidst uncertain federal support?
With premiums expected to double for ACA plans nationwide, Covered California enrollees are in a tough spot, especially without extended federal subsidies. The state could offer its own subsidies or tax credits to offset premium hikes, though that requires budget allocation. Another idea is expanding eligibility for Medi-Cal to cover more near-low-income folks who are getting squeezed by marketplace costs. Negotiating with insurers to keep rate increases in check is also an option, though it’s a hard line to walk. Ultimately, California needs to build a buffer—whether through state funds or innovative cost-sharing models—to ensure people aren’t priced out of coverage while federal support remains shaky.
How should California balance standing up to federal health care cuts while still maintaining a working relationship with Washington?f
It’s a delicate dance. California has a history of pushing back against federal policies—think legal challenges or state-level expansions to counteract cuts. But completely alienating Washington isn’t practical since the federal government is the largest funding partner for programs like Medi-Cal. The state needs to advocate fiercely for its residents, maybe through coalitions with other states to amplify its voice, while keeping channels open for negotiation. A governor who can frame California’s needs as a national issue—showing how cuts here ripple across the country—might find more traction. It’s about strategic resistance paired with pragmatic dialogue.
What is your forecast for the future of health care affordability in California over the next decade?
I think the next decade will be a defining period for health care affordability in California. If the state can innovate—through technology, policy, or partnerships—we could see real progress in curbing costs, especially if telehealth and preventive care scale up. But without bold action, the trajectory looks grim with an aging population and rising chronic disease rates. Federal dynamics will play a huge role; if cuts continue, California might have to go it alone, which could strain budgets and widen disparities. My hope is that the next governor leverages the state’s tech and policy leadership to set a national example, but it’ll require political courage and public buy-in to make affordability a reality.
