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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

#331

Post by alexqgb »

refurb wrote: post #295
alexqgb wrote: post #280

Earlier quoted context omitted.

No, this is demonstrably wrong. Cutting $87,000 in markups from the price of $1,700 off-patent drugs does not mean "less is offered". To the contrary, far more people get access to the drug in question. It may mean that the system as a whole offers far less opportunity to predatory rent-seekers, but that's a feature, not a bug. And yes, you can very easily argue that many other costs don't add value. That's why point…

To the contrary, far more people get access to the drug in question. There are plenty of drugs you can get in the US that single payers systems simply won't cover. The Cancer Fund in the UK is a great example. NHS said "nope too expensive" to several drugs so unless the Cancer Fund pays for it, you're SOL. That's how single payer systems save money. That's why pointing to the superior overall life-expectancy in other…

Part of the reason those drugs exist in the first place is that they've been engineered to extract the maximum amount of cash possible from our nightmare of a system. Yes, you may blow through your lifetime cap on one ailment, but the incentives are in place for pharma makers to see that as much of your cap ends up in their pockets, rather than the competitions. Treatments for Hepatitis-C are one of the more notorious examples of drugs being developed to maximally exploit our system.

The point of controlling costs is to provide incentives for developing drugs that not only work, but that do so at non-ruinous prices.

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

#332

Post by nikdaheratik »

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

There is no one moral philosophy that adequately covers every situation. If there was we'd just use that and not have all of these other options. They are tools to consider (and sometimes reject) just like other parts of philosophy.

What Utilitarianism is good for is making policy decisions that are not directly related to human rights, and therefore may not have a clear cut answer in other philosophies. [edit clarity]

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

#333

Post by DrScump »

unabridged wrote: post #117
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…

California could get rid of their budget issues instantly with a progressive property tax. How about an extra bracket for nonhomesteads starting at values over $1M?

The Legislature is free to pass a Legislative Constitutional Amendment to remove part or all of Prop 13 protections (e.g. for commercial or rental property at least); all it would take is a simple majority of voters to take effect. They can even pick and choose which statewide election to use.

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

#334

Post by belovedeagle »

hackuser wrote: post #206
__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…

Another new account making a trolling comment which adds no knowledge to the conversation. > all I ever hear is people complaining about it Government funded healthcare is widely supported in the U.S., including Medicare, Medicaid, and the Affordable Care Act.

Let's not do the thing where everyone you disagree with is a troll, mmkay?

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

#335

Post by hackuser »

white-flame wrote: post #325
hackuser wrote: post #215

Earlier quoted context omitted.

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 the…

> 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. That sounds like the IRS's shtick about income taxes being "voluntary". From a technical perspective, these decisions are under duress, under threat of legal repercussion, even if you find that choice agreeable and would act in the sa…

> From a technical perspective

I'm not sure what this means. I'm aware of the theoretical argument.

The great majority obey the law because they want to. The threat of jail is actually minor; you can get away with quite a bit.

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

#336

Post by neltnerb »

gator-io wrote: post #258
neltnerb wrote: post #188

Earlier quoted context omitted.

I'm pretty confident that if you get rid of individual mandates while not disqualifying sick people or enforcing benefit caps, premiums will skyrocket. I'm not sure there's really a middle ground here, it's just unavoidable actuary math. So if it is, as you say, a moral imperative, what are your choices? Maybe the EBI will need to be ridiculously high to actually provide the coverage you agree is a moral imperative t…

The individual mandate is moot in this system, as everyone will have money they can only spend on insurance. Benefit caps are a really tricky issue. As a society, are we willing to spend a million dollars to extend life for a week? Probably not. On the other hand, do you cut off a cancer patient after a million? Probably not. But there has to be a rational way to balance this without people freaking out over 'death-p…

If they can only spend the EBI on insurance, it's a fixed health care subsidy or tax credit depending on how you frame it. I may simply be confused though, because every example I know of for EBI means "unrestricted base income".

Can we just call it something other than EBI if you're talking about restricting how it is spent?

In any event, if I understand you, it's a fixed amount per person.

That doesn't seem like it does much to address the moral imperative of guaranteeing affordable health care if sick people are on much more expensive health care plans or if the available affordable plans don't cover what they need. So you'd have to offer varying amounts depending on need, in order to meet that moral imperative.

And once you're talking about varying the amount, it is not very close to what I think you're describing.

Is there some way to reconcile these ideas and constraints that I'm missing? Because I suspect Congress would love to hear it...

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

#337

Post by [deleted] »

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…

[deleted]

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

#338

Post by tylersmith »

darkstar999 wrote: post #203
tylersmith wrote: post #84

Earlier quoted context omitted.

Because for hundreds of years collectivism has been accelerating and it's become nearly, if not entirely, out of control at this point.

Serious question: what do you propose we do with the people dying in the street?

Make them move out of the streets and into the country.

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

#339

Post by seanmcdirmid »

piedpiper_ wrote: post #305
hprotagonist wrote: post #123

Earlier quoted context omitted.

>not everyone shares the same opinion and belief, so should the government force those people to spend their earned income on healthcare for others? Yes. Ideally, that's what governments should do: require citizens to act in our collective and long-term best interests, not only their own. In the case of healthcare: a healthy population is a productive, happy, and peaceful population. All of those things are good for…

> Yes. Ideally, that's what governments should do: require citizens to act in our collective and long-term best interests, not only their own. That's starting to sound a lot like Marxism where the value of the individual is less so than that of the collective (Government / State). I'm sorry but no thanks. Who determines what our best interest is? The only person on this planet that can determine my best interest is m…

It's starting to sound like civilization. When we live together, I don't want to subsidize your poor decisions.

If you want to live your life alone in a forest somewhere, you can pay no tax and make all your own decisions.

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

#340

Post by dang »

nikdaheratik wrote: post #313
mcbruiser wrote: post #285

Earlier quoted context omitted.

> I'm sure as shit happy to pay more in taxes for a universal single single-payer. I Great, you can opt in to that, but don't force everyone else who doesn't agree with you to subsidize everyone else's poor decisions

Yeah, I'm sure all the people who chose to get cancer or be born prematurely are just leeching off the rest of us. Even if you rarely ever use the system, you're still better off having a country where people don't have to worry about going bankrupt of something terrible happens to them and they need healthcare. Also, it actually makes things easier for businesses to not have to deal with figuring out how to pay for…

> Yeah, I'm sure all the people who chose to get cancer or be born prematurely are just leeching

Please don't vent snark like this on HN, even when someone else is wrong and/or started it. Your comment would be just fine without that.

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