Healthy California Act: proposal to make findings about single-payer healthcare • Hacker News Board

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

#191

Post by sharkmerry » Thu, Mar 09, 2017, 1:26 AM UTC

Upvoter33 wrote: post #138

__realtime wrote: post #118

Earlier quoted context omitted.

Glad you have that luxury, CA has some of the highest taxes anywhere and I would definitely be opposed to more.

um, not really. the property taxes are so broken that many people own multi-million dollar homes and pay for them as if they were worth nearly nothing. that said, sales tax and state tax rates are high, so if you just mean that, you are right.

>> that said, sales tax and state tax rates are high, so if you just mean that, you are right.

This is a result of the property taxes being fixed(ish) though, isnt it? Since they cant get true value from that, they have to raise other taxes to make up for it.

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

#192

Post by wapz » Thu, Mar 09, 2017, 1:28 AM UTC

ra1n85 wrote: post #170

notliketherest wrote: post #134

Earlier quoted context omitted.

It's the insurance companies dance with the healthcare providers. Over many decades, the insurance companies have negotiated payments much less than the quoted payment. In turn, the healthcare providers raise their rates in order to make sure they can still make money even with the discount they give insurance. When the time comes for the insurance companies to renegotiate, the same thing happens, and the healthcare…

Great insights - never considered this. I can't imagine that insurance not being available for purchase across state lines is helping here, either.

It's really ridiculous, too. I went to the ER for stomach pains in california for 3 hours (ct scan, IV, and morphine). It was $3500 (no healthcare). I was in college and talked to them and paid around $800. I went to the ER in Japan overnight (12 hours) ct scan, IV, and it was $40 (insurance covered 70% so it was about $130).

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

#193

Post by chimeracoder » Thu, Mar 09, 2017, 1:28 AM UTC

narrator wrote: post #151

rdmcfee wrote: post #72

A single payer system is a step in the right direction, however, there are deeper issues with the American healthcare system. The unit cost of healthcare is so much higher than in other developed countries. In British Columbia, physicians bill at total of around $31 CAD ($23 USD) for a standard office visit. They pay all their overhead out of this fee. Typically doctors keep 65% of their billings and the offices take…

For one, doctors educational costs are astronomical in the U.S compared to other countries. The amount of people able to become doctors is artificially limited. Drug prices are unregulated. The cost of developing drugs is high and has been getting higher. Hospitals have little price transparency and the cost of same procedures at different hospitals is wildly different. The same bag of saline can cost 10x more at one…

> The amount of people able to become doctors is artificially limited.

It is not artificially limited, and this is a common misconception that simply won't go away.

The bottleneck is currently the number of people who can complete residency training. Residency programs are not self-sufficient, so most of them are funded by Medicare. That's not an artificial limit - that's a natural one (the sheer economics of the process).

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

#194

Post by Girlang » Thu, Mar 09, 2017, 1:29 AM UTC

mmanfrin wrote: post #64

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…

California confiscates 13.8% of every dollar I earn (my husband's income puts us into that category). There are already two "millionaire" taxes that kick in for incomes over $1,000,000.

Californians are evil, so they try to always tax "other people" and not themselves.

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

#195

Post by ceejayoz » Thu, Mar 09, 2017, 1:29 AM UTC

mindcrime wrote: post #175

so should the government force those people to spend their earned income on healthcare for others? Absolutely not. Pretty much any question that starts with "should the government force ..." can be answered "no". You earned your income, it's yours and it should be up to you how to spend it. Using force / aggression (aka the government forcing you to do something) is a violation of your most fundamental rights, and st…

> Using force / aggression (aka the government forcing you to do something) is a violation of your most fundamental rights, and strips you of your agency and dignity as a human being.

So you assert, as if this were universally accepted.

I assert being bankrupted or killed for want of affordable, accessible healthcare is a violation of my most fundamental rights, and strips me of agency and dignity as a human being.

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

#196

Post by hackuser » Thu, Mar 09, 2017, 1:29 AM UTC

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…

> it sounds nice in theory I'm hesitant to believe the finances actually work out.

Many places pull it off around the world, though at a national level. Probably few are as wealthy as California.

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

#197

Post by tylersmith » Thu, Mar 09, 2017, 1:29 AM UTC

cortesoft wrote: post #163

tylersmith wrote: post #76

Earlier quoted context omitted.

He can afford it. Others can't. Why should he pay for them just because they have a lower value?

So these 'lower value' people should just die when they get cancer? I find the idea that not being able to earn a high enough salary means you are unworthy of basic medical care repugnant.

It depends on how much the people that know how to treat your cancer want to charge and if the hypothetical person with cancer can afford it. Nowhere else in the world do we say "This person can't afford this? Oh well we'll ignore it then. cortesoft finds it repugnant!"

I wouldn't call cancer treatments "basic" by any stretch of the imagination.

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

#198

Post by bdamm » Thu, Mar 09, 2017, 1:30 AM UTC

mindcrime wrote: post #175

so should the government force those people to spend their earned income on healthcare for others? Absolutely not. Pretty much any question that starts with "should the government force ..." can be answered "no". You earned your income, it's yours and it should be up to you how to spend it. Using force / aggression (aka the government forcing you to do something) is a violation of your most fundamental rights, and st…

The difficulty here is making health care a profitable business, which is at odds with providing good health care. American health care, even for the wealthy, is a miserable affair when someone really needs major care (such as following a traumatic accident). The patient becomes a liability for the insurance company and a profit center for the hospital, all of which is more important than the patient's long term recovery. That is not the only way American health care fails.

I would definitely welcome a unitified health care system in California.

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

#199

Post by tylersmith » Thu, Mar 09, 2017, 1:30 AM UTC

thescriptkiddie wrote: post #106

tylersmith wrote: post #44

Earlier quoted context omitted.

Even easier if people could just let others take care of _every_ whim. If there was a guaranteed income there wouldn't even be a need for entrepreneurship!

If anything, people would be more likely to start their own businesses if they had a guaranteed income, because it would mitigate the opportunity cost of quitting their day job.

Yes they would be more likely, but they wouldn't need to.

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

#200

Post by dmoy » Thu, Mar 09, 2017, 1:30 AM UTC

pvelagal wrote: post #179

TheSageMage wrote: post #57

Earlier quoted context omitted.

I'm very new to the single-payer idea, but Vermont rates 49th for population in the US, California ranks 1st. I thought one of the strengths of a single-payer system was to leverage the power of large numbers to help drive costs down. Would this not make it more viable?

I have an common sense observation and questions. Apple, Microsoft etc you name it, all get their hardware products manufactured in china & Asian countries mainly to drive down costs (People blame CEOs but really ? do they have a choice ? Will wall street show mercy on them ? It is easy to forget that US consumers are the primary beneficiaries, and Wall street is happy - means - 401ks, IRAs of regular US citizens gro…

It's not a commodity good (in part bc of drug patents). An iPhone may cost more in Asia, but drug treatments are way cheaper. The comparison doesn't really work.