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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

#211

Post by [deleted] »

apathy wrote: post #165
jbhatab wrote: post #128

Earlier quoted context omitted.

Why is single payer better? Genuinely curious. I just don't have any solid proof of the American Government doing a better job than the private industry enabled by competition.

assuming you're asking in good faith, the answer is pretty simple. A larger population has more leverage, and if all of the citizens bargain as one bloc (i.e., if the government does so on their behalf), it drives the market. Note that a tremendous chunk of the market needs to be involved for this to have maximum effect -- if a physician can "opt out" of Medicare/MediCal and make more money, they will, by and large.…

[deleted]

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

#212

Post by hprotagonist »

nickff wrote: post #208

The problems with your last argument are that almost nobody is actually a utilitarian, and utilitarianism is wrong.[1][2][3] edit: full disclosure; I am an ethical intuitionist.[4] [1] http://degreesofclarity.com/writing/utilitarianism/ [2] https://en.wikipedia.org/wiki/Trolley_problem [3] https://en.wikipedia.org/wiki/Utilitarianism#Criticisms [4] https://en.wikipedia.org/wiki/Ethical_intuitionism

But it sounds good to sell it to the "fiscal conservatives". I am not a utilitarian, but nobody likes to be hectored into doing things -- and it's easy for an argument from, e.g., personal morality to sound that way.

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

#213

Post by FullMtlAlcoholc »

__realtime wrote: post #93
mmanfrin wrote: post #64

Earlier quoted context omitted.

[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…

> as a Californian...I'd rather that people like me... There is crux of the issue: not everyone shares the same opinion and belief, so should the government force those people to spend their earned income on healthcare for others? Personally I think it won't end up how you anticipate but that's just me. Right now the working people of America are already subsidizing healthcare for the masses and all I ever hear is pe…

> Right now the working people of America are already subsidizing healthcare for the masses and all I ever hear is people complaining about it.

We do pay for the roads in Los Angeles and EVERYONE complains about the traffic. People bitch about everything

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

#214

Post by refurb »

alexqgb wrote: post #135
__realtime wrote: post #93

Earlier quoted context omitted.

> as a Californian...I'd rather that people like me... There is crux of the issue: not everyone shares the same opinion and belief, so should the government force those people to spend their earned income on healthcare for others? Personally I think it won't end up how you anticipate but that's just me. Right now the working people of America are already subsidizing healthcare for the masses and all I ever hear is pe…

The problem with this frame is that it assumes costs under a more socialized system wouldn't budge, making a single-payer system nothing more that simple wealth-transfer. The thing to recognize is that the every-person-for-themselves approach leads to outcomes that drive costs up extraordinarily. Avoiding the US model is why every other OECD country offers universal coverage and boasts longer lifespans, even though h…

the major advantage of single-payer is massively reducing the costs of health care

It's cheaper because less is offered. Of course one can argue the extra you get under the US system doesn't really add value.

Keep in mind that single payer systems are struggling with costs as well. It's just easier for them to say "no one gets this new treatment".

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

#215

Post by hackuser »

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…

Government is "forcing" very few people. Most people participate in society voluntarily.

For example, government doesn't force me to obey the law; I do it voluntarily. They don't force me to pay my bills, not shoot my neighbor, and pay my taxes. I do all that voluntarily.

EDIT: I don't follow Hacker News' rules and norms because I'm afraid of being banned, but because I respect the other people here, respect that there need to be rules, and respect our hosts' authority and need to make them. It's something (almost) all learn as children; it's healthy social interaction.

Most people are responsible members of their communities. The concept of force applies only to a very few.

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

#216

Post by SilasX »

chimeracoder wrote: post #193
narrator wrote: post #151

Earlier quoted context omitted.

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 pro…

And (per previous discussion [1]) that doesn't explain it. If there is still excess demand for MD degrees, then there is still room for potential MDs to borrow any shortfall that residency subsidies won't cover.

The argument is like saying that Hamilton showings are limited by how much the government will pay in subsidies for the tickets. No. The demand is enough to cover expansion.

And even if it weren't there's still the issue of how much training is actually required to fill the functional role of a doctor. I'm pretty sure that there's some fat to cut out when you're making someone go all the way through a bachelors before they can even start.

[1] https://news.ycombinator.com/item?id=13593944

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

#217

Post by FullMtlAlcoholc »

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…

You must not be familiar with market failures

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

#218

Post by neltnerb »

chimeracoder wrote: post #184
neltnerb wrote: post #152

Earlier quoted context omitted.

Off the top of my head, and certainly some are up for debate. But consider how well these systems worked prior to government intervention. You may think medicare, for instance, is run horribly -- but I'm pretty confident that seniors are far happier with it than they were pawning off their possessions to get medical treatment prior to it being created. - Medicaid - Medicare - The USPS (which, let's be honest, is frea…

> You may think medicare, for instance, is run horribly -- but I'm pretty confident that seniors are far happier with it than they were pawning off their possessions to get medical treatment prior to it being created. Sure, but empirically, seniors are far happier with privatized Medicare plans than they are with publicly-administered Medicare plans. Original Medicare has the lowest satisfaction rates of all major Me…

If the proposals on the table were to simply allow private companies to offer competing options, I would have few concerns that I could back up with factual analysis.

I suspect it would be highly case-by-case, which is fine and how a deliberative legislative body should function. I'd still be extremely leery of private police, military, fire, or infrastructure, it just seems like a transparently bad idea.

Like our security contractors paid by the military, who cost vastly more than public employees and have far less oversight. And who (possibly coincidentally, but come on) are to blame for the worst abuses by our forces overseas.

But for some specific, narrow market (like space travel or health care or even retirement funds) I'd be absolutely willing to give them a chance as long as it didn't break the existing government system.

Charter schools seem like a good case study in that, which I say not because the data completely backs up the idea that government run is always better, but because it's a very complex system with many examples that provide insight in both directions.

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

#219

Post by smogcutter »

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.

This premise is not as self evident as you believe.

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

#220

Post by maxerickson »

toomuchtodo wrote: post #150
jbhatab wrote: post #121

Earlier quoted context omitted.

Here's the only thing I'm confused about. Do we have examples of the government running a service better than the private sector? I'm not 100% on this, but it seems all of the best aspects of American services come from competition and letting capitalism thrive. Would love a counter opinion.

> Would love a counter opinion. Every other first world country? https://en.wikipedia.org/wiki/List_of_countries_with_univers...

Several of those countries implement universal coverage using a private insurance model.
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