What about California?

In the 1940s, Gov. Earl Warren promoted a universal health care plan, but the Legislature shot it down in the face of opposition from businesses and physicians. In 1994, voters rejected a plan placed on the ballot by groups including the AARP and a nurses’ union.

In 2002, a single-payer option outlined by the state Secretary of Health and Human Services died in a legislative committee. In 2006, the Legislature passed a single-payer bill, but then-Gov. Arnold Schwarzenegger vetoed it.

Labor groups have largely been behind these efforts. The California Nurses Association, the most vocal force for such a system in the state, echoes Sanders’ views on the issue. Nurses attended hearings, protests and marches across the state last year to press for a single-payer system and mounted a short-lived recall move against Assembly Speaker Anthony Rendon when he shelved last year’s bill.

Not all health providers are supporters. Physicians have not, by and large, backed such proposals. They say the plans are too bureaucratic, could reduce their fees, could compromise patient privacy and might cover too little, possibly even leading to rationing of care.