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Healthy California Act: proposal to make findings about single-payer healthcare

leginfo.legislature.ca.gov

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Re: Healthy California Act: proposal to make findings about single-payer healthcare

#61

Post by surfmike »

old-gregg wrote: post #41
marcell wrote: post #27

I can't get over the cognitive dissonance of these two points: > (2) Californians, as individuals, employers, and taxpayers have experienced a rise in the cost of health care and health care coverage in recent years > (4) Individuals often find that they are deprived of affordable care and choice because of decisions by health benefit plans guided by the plan’s economic needs rather than consumers’ health care needs.…

Yes you can. As a 6th largest economy in the world [1] California can negotiate prices down by 50-60% to be comparable to Canada/UK. [2] Besides, the existing state program (medi-cal) already covers over 1/3 of CA residents [3]. So it looks like if we lower the cost by 60% we can get pretty close to normal healthcare situation using the existing budget. [1] https://en.wikipedia.org/wiki/Comparison_between_U.S._states…

It sounds fanciful to say that we'll just use our existing Medi-cal budget but now it will cover everyone.

If the government had so much bargaining power, then Medicare and Medi-cal would already have far smaller costs. We don't really see that.

Also, who exactly, would we be negotiating with? I don't know that you can squeeze the budgets of hospitals in California by 50% and have everything carry on like normal.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#62

Post by AnimalMuppet »

goodells wrote: post #45
marcell wrote: post #27

I can't get over the cognitive dissonance of these two points: > (2) Californians, as individuals, employers, and taxpayers have experienced a rise in the cost of health care and health care coverage in recent years > (4) Individuals often find that they are deprived of affordable care and choice because of decisions by health benefit plans guided by the plan’s economic needs rather than consumers’ health care needs.…

In a single payer system, there wouldn't be an insurance company sitting between a patient and the medical provider, extracting rent. The middleman and associated overhead would not exist (or be centralized), which could make the market more efficient.

OK, let's talk about overhead. Every doctor's office has one or two people per doctor who fight with insurance companies to see that the doctor gets paid. Every insurance company has people who fight with the doctors' people, trying to find ways to not pay them. Those people - on both sides - are a total waste to the business of actually delivering healthcare to people. Yes, we could cut a lot of overhead by getting rid of them.

That works... right up until the healthcare scheme is underfunded by the legislature, and then the single payer tries to find ways to reduce payments to the doctors, and then the overhead comes right back. So to reduce the overhead, the rules have to be really rules, not something the single payer tries to play with in order to control expenses.

Is that enough to get old-gregg's 50-60% reduction in expenses? I don't know. I'm a bit skeptical. It will get a large chunk of the way there, though.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#63

Post by tylersmith »

darkstar999 wrote: post #31

I don't understand this. Maybe I'm uneducated on "acts"? > It is the intent of the Legislature to enact legislation that would establish a comprehensive universal single-payer health care coverage program and a health care cost control system for the benefit of all residents of the state. This is literally the meat of the bill. The actual changes would still have to be voted on in separate bills, right? What is the p…

> Maybe I'm uneducated on "acts"?

"acts" are how smarter Californians let the lesser Californians what to do.

> What is the point of this?

To make people feel good about themselves.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#64

Post by mmanfrin »

gavman wrote: post #32

Vermont tried this a few years ago, they had to cancel it since in the end it wasn't financially feasible [1]. CA is already dealing with severe budget issues [2][3], so while it sounds nice in theory I'm hesitant to believe the finances actually work out. [1] http://www.politico.com/story/2014/12/single-payer-vermont-1... [2] http://www.latimes.com/projects/la-me-pension-crisis-davis-d... [3] http://www.cnbc.com/201…

[2] is about CalPERS, which is separate from the budget of the State. There may be a current budget shortfall, but CalPERS is fine (it is the largest non-country pension fund in the world; and comes in the top 10 when listed among countries).

[3] mentions that tax revenues will fall because of the end of temporary tax increases; those increases are likely to be renewed.

Categorizing these as 'severe budget issues' is disingenuous and misleading. California has had a bumper crop in terms of tax revenue over the past decade, and this stupid meme about California being out of money needs to be corrected.

That being said, health care is not an inexpensive line-item, and will have to be funded with taxes.

But as a Californian, I'm sure as shit happy to pay more in taxes for a universal single single-payer. I have many friends who are either contractors or who earn very little and find themselves in that uncomfortable valley of having to pay for expensive insurance -- I'd rather that people (like me) who are better off financially foot a bit more of a communal bill so that no one would need to worry about it.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#65

Post by sbov »

old-gregg wrote: post #41
marcell wrote: post #27

I can't get over the cognitive dissonance of these two points: > (2) Californians, as individuals, employers, and taxpayers have experienced a rise in the cost of health care and health care coverage in recent years > (4) Individuals often find that they are deprived of affordable care and choice because of decisions by health benefit plans guided by the plan’s economic needs rather than consumers’ health care needs.…

Yes you can. As a 6th largest economy in the world [1] California can negotiate prices down by 50-60% to be comparable to Canada/UK. [2] Besides, the existing state program (medi-cal) already covers over 1/3 of CA residents [3]. So it looks like if we lower the cost by 60% we can get pretty close to normal healthcare situation using the existing budget. [1] https://en.wikipedia.org/wiki/Comparison_between_U.S._states…

The driver of the cost of insurance is the cost of care, and I haven't seen much, even in the form of rhetoric, paid this way.

So, can they really? Part of the reason places like Canada and the UK can do this is they can threaten to run around the industry when they try to fleece their citizens. Ultimately CA may be unable to do anything to combat the costs of medical care because the laws that give pharmacies and the AMA their monopoly in the field are enacted at the federal level.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#66

Post by vkou »

marcell wrote: post #54
old-gregg wrote: post #41

Earlier quoted context omitted.

Yes you can. As a 6th largest economy in the world [1] California can negotiate prices down by 50-60% to be comparable to Canada/UK. [2] Besides, the existing state program (medi-cal) already covers over 1/3 of CA residents [3]. So it looks like if we lower the cost by 60% we can get pretty close to normal healthcare situation using the existing budget. [1] https://en.wikipedia.org/wiki/Comparison_between_U.S._states…

Some of the numbers for [2] confuse me. How can an office visit cost $30 in Canada? When I go in for an office visit, it typically takes about 30 minutes of staff time, around 15 minutes with a medical assistant and 15 minutes with a doctor. If that's $30, the implied wage is $60/hr for the medical staff, if you assume that all the money goes to staff. That just doesn't seem feasible. Some of the other numbers seem m…

Some office visits are shorter then others. (Although less scrupulous doctors in Canada aggressively optimize for faster visits - more money for them, worse outcomes for their patients.)

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#67

Post by tylersmith »

mmoche wrote: post #3
exabrial wrote: post #2

Who will pay for it?

All of its residents.

If that were true there would be no need for taxes. But in reality poor people will steal from non-poor people. That's what taxes are. "everybody pays" is a worthless statement if you don't include amounts.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#68

Post by amluto »

ThomPete wrote: post #48

Here is the problem. How do you deal with illegal immigrants? At least in the current system there are ways for them to get treated, but in a single payer system? Single-payer works great in countries were everyone have a ssn. Not sure its feasible in the US as much as i think it would be great.

By giving them healthcare? There aren't actually a large number of illegal immigrants sitting around contributing nothing to the CA economy.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#69

Post by Keverw »

Seems like an interesting idea. With California being the only state in the country doing this, I wonder what is there to stop people from other states using it. Someone from Washington or Texas driving up and getting a short term apartment/changing their ID just so they are covered for a really expensive surgery.

It seems like if they're the only state doing it, it'd be a target for the entire nation to go to when they really need care they cannot afford where they are currently.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#70

Post by Abundnce10 »

chrismealy wrote: post #52
michaelchisari wrote: post #34

Earlier quoted context omitted.

Doesn't seem like a hard sell to get Oregon & Washington on board, politically.

WA isn't even meeting its constitutional mandate for funding education.

I'd like to learn more about this, can you provide a source?
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