Once the State is the Payer, they will have a say in what healthcare is available to everyone in the system. Basically, they will become a "death panel", much like Obama envisioned. “Maybe you’re better off not having the surgery, but taking the painkiller”. I have zero doubt that CA will prioritize treatment based on race, sex, "social factors", and age. As the "single payer", I expect they will try to gain control of retired Californian's Medicare benefits.
And Newsom wants to be president. Lots of people on the left want him as potus, so he can push this on the entire country. Single payer will be his top issue, claiming he "successfully covered every man, woman and child in the largest state in the nation".
England has done this for decades, and my grandfather was denied cancer treatment and given painkillers because he was 80, and they wouldn't waste treatment on someone who had outlived their usefulness.
“Outlived their usefulness…” the ultimate “social credit” solution.