There are plenty of flaws in the universal care plans proposed this year both by Gov. Arnold Schwarzenegger and party leaders in the Legislature.
But there's also time and an apparent willingness in Sacramento to fix problems like deductibles set so high that health insurance wouldn't benefit many of the working poor and required payments from employers set so low that many might wind up offering health insurance inferior to what their workers get now.
So there's every likelihood that California politicians will pass something this year or next that actually improves a long-festering bad situation.
But California's possible move to a unique and pioneering law that recognizes health insurance as a fundamental entitlement of all citizens is now raising hackles in Washington, in large part because any expanded health care system would require more federal money than the state now gets.
This is something almost no one from other parts of America wants to give.
For decades, an "Anywhere But California" (ABC) attitude has governed in Washington, helped along by the striking disunity of this state's congressional delegation, which features ideologically polarizing figures on the right and left, from ultra-liberal Democrats Barbara Lee of Oakland and Henry Waxman of Los Angeles to ultra-conservative Republicans Dana Rohrabacher of Orange County and Duncan Hunter of San Diego County.
So strong is the ABC spirit that measured per capita, twice as many "surplus" military bases were closed in the last two rounds of base shuttering here than in any other state.
Besides ABC, what could possibly have moved Congress to place the National Earthquake Research Center in Buffalo, N.Y., which can't remember its last temblor?
The ABC spirit is one reason this state gets back just 79 cents of every dollar it pays in federal taxes, ranking a dismal 43rd in this category despite controlling more than one of every nine seats in the House.
Now comes the prospect of California drawing between $2 billion and $3 billion more in federal health care dollars than it now gets. "No," bleat the ABC-ers.
Leading the pack this time is Michael Cannon, director of health policy studies for the libertarian Cato Institute, headquartered just a few blocks from Capitol Hill. (Full disclosure: the author has twice been an unpaid participant in panel discussions at the Cato Institute.)
In an essay printed in newspapers around the nation, Cannon described California's possible health care changes this way to residents of other states: "You subsidize it. Schwarzenegger would fund nearly the entire plan through Medicaid (known here as Medi-Cal). Under that program's rules, roughly half the funding comes from California and half from the federal government in other words, from taxpayers in other states."
One question here: If Cannon is so exercised over taxpayers in Maryland and Virginia (both of which get back more federal dollars than they pay in taxes) helping pay for a California program, why has he never protested California taxpayers subsidizing highways and sewers and parks and zoos in those states and many others?
"Well," he responds in an interview, "bigger subsidies always flow from larger states to smaller ones because of the way the U.S. Senate is set up." What he means is that because small-population states like Alaska and Rhode Island and Wyoming get as many senators as California, they have the power to take money from bigger states.
"This is not justified," he says. "But the way the Senate is set up is simply imbalanced."
That's true. It's also true of the Electoral College, where small states have more clout than mathematically merited by their populations.
So why shouldn't California design a health care system based on partly redressing that imbalance?
"In the sense of an eye for an eye, that is justified," Cannon concedes. "But the bottom line is that if California does this, other states will follow and taxes will inevitably go up everywhere.
"Essentially, Gov. Schwarzenegger is making promises with other people's money."
The real question
Not true. Even if California should get fully $3 billion more in health care subsidies than it now does, the state would still be getting back only about 83 cents on every dollar. Instead of getting the 7th smallest return on its tax dollars, California would move near the middle of the pack.
The real question all this raises: With Californian Nancy Pelosi now sitting in the House speaker's chair, controlling committee assignments and chairmanships, can the ABC spirit be reduced?
Pelosi has already promised to see that her hometown of San Francisco is well cared for.
But if her district is the only part of California she looks out for, the state most likely will never get its fair share.