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California Considers Doubling Its Taxes

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Re: California Considers Doubling Its Taxes

#261

Post by rapind »

Justin_K wrote: post #210
no_wizard wrote: post #4

> to fund a first-in-the-nation single-payer health-care system. This is key here. So instead of paying this out to a private insurance company I pay it in taxes, there by my actual change is net zero, in most cases. I have a feeling most reactions might be headline driven here. I think it’s worth doing the math on how much it costs you in healthcare coverage before really judging a book by its cover here. If my comp…

Except anybody you consider to be a "good" doctor won't take this insurance because the payouts are too low. So, your employer will still buy "aftermarket" plans to provide better care. Now you'll be paying both for a plan you won't use and a plan you will use.

FWIW, as a Canadian, I don’t have any health insurance beyond what my government provides and I don’t think or worry about it.

I have a lot of complaints about my government (like most people), but the idea of universal healthcare isn’t one.

Re: California Considers Doubling Its Taxes

#262

Post by jjav »

likeabbas wrote: post #180
ARandumGuy wrote: post #158

Earlier quoted context omitted.

While the US does contain some stellar hospitals and surgeons, by broader metrics the US performs poorly. From 2010 to 2015 (before COVID messed with the data), the US ranked 43rd [1] in overall life expectancy. This is behind countries like Cuba and Slovenia, and well behind other rich countries like Japan, Canada, or the UK. Healthcare costs and outcomes can't be separated from each other. The more expensive it is…

Right but if you only consider those that are covered by health insurance then overall health quality is top notch. In the US system you have the luxury of choosing your providers and having your insurance cover things (like elective surgeries) that wouldn't be covered by single payer systems. For example, I had a knee surgery for a partial patellar tendon tear last year that cost me <$500 out of pocket (insurance wa…

> Right but if you only consider those that are covered by health insurance then overall health quality is top notch.

That is debatable. I have the top-tier plan my employes makes available (blue shield platinum). It's $2500/month.

That still doesn't guarantee anything, if the insurance company doesn't feel like paying it because it cuts into their profit margin too much.

Right now I've been prescribed some medicine I need to heal some damage and I can't get it because insurance company says "too expensive, we don't feel like paying for it, sucks to be you".

(Wrapped in many pages of legalese, not those exact words.)

> In the US system you have the luxury of choosing your providers and having your insurance cover things

Well no, not really. If you mean chose between gold and platinum levels offered by employer, ok, but that's the extent of the choice.

I'd like to choose an insurance company that gives me the medicines my doctor prescribes me. But no, I have no such choice available.

Re: California Considers Doubling Its Taxes

#263

Post by jimbob45 »

The best proposal I've heard is not to have government-run single-payer but to instead have a public option. That way, if insurance companies truly are colluding and providing a worse product, then the government can compete and bring costs down to a reasonable level by providing baseline competition. Compared to a government potentially mismanaging and ruining care for millions, it seems the safer alternative.

I've never heard a solid argument against the public option and both sides in general seem to agree on it. The fact that it was Lieberman and not a Republican that killed it in 2010 [0] makes me very hopeful that a public option would be highly politically viable now 12 years later.

[0] https://newrepublic.com/article/73683/the-public-option-stil...

Re: California Considers Doubling Its Taxes

#265

Post by seanmcdirmid »

parkingrift wrote: post #229
Maxion wrote: post #34

Earlier quoted context omitted.

Why do you believe single-payer is a bad idea? The model works very well in most European countries.

Not OP, but I'll answer. Switching to a single-payer will be too costly for any political party to tolerate. The US spends $3.8T on health care per year. That's $11,500 for every single person in the United States. In order to fund (raise taxes) to a single-payer system that number will need to drop dramatically. We'll have to cut out middlemen, reduce bureaucracy, negotiate domestically, etc. That $11.5k needs to dr…

Oddly enough, the USA already publicly funds about 40-50% of all healthcare already via medicare, health insurance for federal employees (and military), the VA, etc... So they aren't going from 0 to 100%.

But I agree in general: healthcare reform should do something about costs, and healthcare is so much apart of our economy that any attempted cost reduction will be painful.

Re: California Considers Doubling Its Taxes

#266

Post by cagey »

wbsss4412 wrote: post #200
commandlinefan wrote: post #49

Earlier quoted context omitted.

> my actual change is net zero Really? From what I can find on the internet, CA state income taxes are usually in the 10% range for most folks. Are you really paying 10% of your income for health insurance? I'm paying about 2.5% right now.

What your employer obliges you to pay directly is arbitrary. What matters is what percentage of your total compensation from your employer is healthcare costs. I highly doubt that number is only 2.5%.

Data point: I just switched from FTE to unemployed (likely transitioning to retirement) and am leveraging COBRA to pay in full to retain my former employer's High Deductible Anthem PPO plan (plus dental plan and VSP) for a family of 4.

The COBRA monthly pricetag is $2093.

While employed (at this Fortune 300 company's San Jose, CA office), I was paying $425 per month out of pocket for the same set of plans.

Re: California Considers Doubling Its Taxes

#267

Post by jjav »

vondur wrote: post #5

I can't imagine something like this working out well here. In the current environment, I'd imagine a big chunk of the tech force that can work remotely will simply leave the state. This would devastate the states income tax collection.

Why you think so? As a highly paid tech worker, if this were to pass (I doubt, insurance companies have too much political influence, but let's dream) it would make me stay in CA forever.

Re: California Considers Doubling Its Taxes

#268

Post by ___q »

wsinks wrote: post #67
no_wizard wrote: post #4

> to fund a first-in-the-nation single-payer health-care system. This is key here. So instead of paying this out to a private insurance company I pay it in taxes, there by my actual change is net zero, in most cases. I have a feeling most reactions might be headline driven here. I think it’s worth doing the math on how much it costs you in healthcare coverage before really judging a book by its cover here. If my comp…

Yeah, that was my exact reaction here. "Doubling my taxes?!" Oh... for a CA based single payer healthcare system that for the last 10-20 years people have continually asked for again and again? (Ok, maybe not just for CA, but... sometimes ya gotta start somewhere) So now I'm back into the evaluation phase after headline whiplash. Will definitely consider the 'total compensation package'.

> after headline whiplash

The headline is no accident, The Tax Foundation is a center-right, fiscally conservative organization, generally critical of tax increases.

Re: California Considers Doubling Its Taxes

#269

Post by jjav »

alexjray wrote: post #66
distrill wrote: post #21

Earlier quoted context omitted.

They really aren't. 100 people moving to a town in Idaho makes a big impact on that town in Idaho but is not felt at all by California.

38% decrease in people moving to California 12% increase in residents moving out of state last year. In San Francisco Bay Area, it's even more stark. There was a 45% decrease in entrances from other states to the Bay Area and a 21% increase in residents leaving for other states.

That explains why real estate prices are falling and properties languish for sale for months if not years.

Re: California Considers Doubling Its Taxes

#270

Post by prirun »

onphonenow wrote: post #167
oxymoran wrote: post #152

Earlier quoted context omitted.

It’s the preexisting injury part that jacked up the prices. They aren’t allowed to deny enrollment or charge significantly higher premiums if some was has cancer or something. And that totally makes sense morally, but that causes the risk burden to be offset on the aggregate of the subscribers resulting in higher premiums for everyone. It would be kind of similar to forcing auto insurance carriers to afford coverage…

I've NEVER seen an employee denied (or asked) about their medical conditions ever. The enrollment paperwork to the carrier is like basic address / name / effective date for coverage. That is it.

Last year I went to Mayo Clinic. I have ACA insurance, but it is HMO-only (all ACA insurance in Indiana is HMO, not PPO), and Mayo is not in network. I actually considered getting married just so I could get PPO insurance (life change event) and be covered at Mayo.

Since the insurance companies now have to cover pre-existing conditions, and don't want to do that, they came up with another plan: don't answer the phones except during open enrollment. I tried calling several insurance companies (major carriers) just to get quotes for health insurance, and none returned my call. Some had phone trees that went in a circle so you could not get to a person. I did get one broker to talk to me, and he said pre-existing conditions weren't covered for 24 months. First, that's a lie, and 2nd, it's illegal (ACA outlawed this practice).

By only accepting applications during open enrollment, the insurance companies have effectively done an end-run around the law against pre-existing conditions.

Note: this is for an individual to get insurance. I'm sure companies can get insurance for their employees any time they want it.

Follow-up: it turns out that if I did have PPO insurance and was covered at Mayo, then with the same bill from Mayo it would have cost me $8000 more with coverage than it did without insurance, paying cash. That's truly f'd up!

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