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California Considers Doubling Its Taxes

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Re: California Considers Doubling Its Taxes

#341

Post by qaq »

rrrrrrrrrrrryan wrote: post #314
qaq wrote: post #234

Earlier quoted context omitted.

You have to realize that there is decent amount of people who lived through the collapse of USSR on HN, so just because someone mentions USSR in the context that is upsetting to someone with left leanings does not mean that it's without merit.

Yeah, USSR references betray one's age more than anything. When socialism comes up today, left-leaning people reference the Nordics, and right-leaning people reference Venezuela.

Aside from actual age I mean literally were born in USSR and lived through it's collapse.

Re: California Considers Doubling Its Taxes

#342

Post by parkingrift »

beeboop wrote: post #303
parkingrift wrote: post #229

Earlier quoted context omitted.

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…

How much of the $3.8T is profits that don't need to exist? Why should public medicine be for-profit when public education isn't? Why does no one complain that the military doesn't turn a profit yet also costs nearly a trillion a year? Presumably the entire industry isn't going to magically become less complicated when a single payer option begins. There will still be a need for many of those roles, but they will be e…

> Why does no one complain that the military doesn't turn a profit yet also costs nearly a trillion a year?

People complain all the time. The military budget is $700 billion. Healthcare expenses would be $5T to cover everyone in our current situation.

For reference, the total federal tax revenue is $3.86T. That’s individual, corporate, payroll, everything.

> Presumably the entire industry isn't going to magically become less complicated when a single payer option begins. There will still be a need for many of those roles, but they will be employed by the state instead of private companies siphoning profit.

Yes that’s the exact problem. How to not destroy millions of lives and the economy. You’re suggesting these people will go work for the state? We will literally have to, at minimum, double the effective tax at every single level. Double the federal income tax, double the payroll tax, etc.

Would you personally vote to double your total effective taxes? I would not.

Single payer just isn’t going to happen in the US anytime soon. Democrats can’t even corral the votes to fund an infrastructure bill that is a fraction of the cost an single player health plan would cost.

…and Democrats are going to get thrown out of Congress this year. So it’s time to move on to reforms that might actually happen.

Or we can keep endlessly chasing the perfect outcome and endlessly achieve nothing.

Re: California Considers Doubling Its Taxes

#343

Post by hotpotamus »

onphonenow wrote: post #251
hotpotamus wrote: post #166

Earlier quoted context omitted.

How many millions are waiting in the US because they can't afford care?

My point is simply, if the UK is the "best" example of universal coverage - that's very very very worrisome! I happen to think the UK is not close to the best example.

How would you measure best?

Re: California Considers Doubling Its Taxes

#344

Post by salawat »

jjav wrote: post #290
salawat wrote: post #259

Earlier quoted context omitted.

Blue Shield is notorious for not paying out enough of premiums for care. If you're having issues though, figure out who your PBM. (Pharmacy Benefits Manager) is that Blue Shield is contracting the pharmacy adjudication out to. Basically, get in contact with them, try and get an override, or get them to explain why you are not covered. If it isn't in the formulary your employer opted into, you're hosed; but there is u…

Thanks for the tips, it is very exhausting to fight these. > Also remember: You can pay out of pocket, but you'll be at the whims of that pharmacy. They'll generally help you work through coupons. I did ask, but it was nearly $1K/week so can't afford that.

Ouch!

You have now reached beyond my "letters/phone calls to Congress" threshold. Generally doesn't get an instant response, a d may take months, but surprisingly does occasionally get some traction. More out of spite than anything else. However, there is increasing regulatory attention being directed at the space, and even some states have insurance regulators you might be able to hit up.

It's unfortunate, but there are some drugs that insurers are simply not willing to be on the hook for, and if you're the unlucky person suffering from a rare, expensive to treat condition; the only way around it is to make a lot of noise and waves, and be open to trying alternative regimens.

No one should have to go through that though. Good luck.

Re: California Considers Doubling Its Taxes

#345

Post by DougN7 »

lax4ever wrote: post #11
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…

Do you actually pay that much a year in insurance premiums? I don't live in CA, but I sure don't and my health coverage is pretty good. Keep in mind, this is also just the insurance premium, there's no talk of what co-pays or deductibles would be. In addition, your employer now has to pay more based on their gross receipts and if you make more than 150k a year you are paying even more.

If you get health insurance from the federal marketplace, and get no help offsetting the cost, $14K/year for a couple is typical. Don’t ask me how I know :’(

Re: California Considers Doubling Its Taxes

#346

Post by ThePowerOfFuet »

Sparyjerry wrote: post #327
jjav wrote: post #211

Earlier quoted context omitted.

Kaiser posted $3B in profits in a quarter. All that money is overhead that can be removed from the costs if health care didn't have to funnel through a private company taking profits from it. https://www.fiercehealthcare.com/hospitals/kaiser-permanente...

If you had no profit motivation then there is no incentive to do the best and most efficient job. This is why government organizations are always extremely bloated, inefficient, and employees don't care about the service level. It's because a monopoly means you don't have to care about any of that anymore.

Spoken like someone who's never had experience with a public healthcare system anywhere else in the world.

Re: California Considers Doubling Its Taxes

#347

Post by Maarten88 »

nomendos wrote: post #286
Maarten88 wrote: post #196

Earlier quoted context omitted.

> socialization of the health-care system shall produce the following [...] It should also produce better health outcomes for the people living there. Maybe you have a well-paid job and good insurance plan, and can enjoy good healthcare now, but that is not the case for many others and can change for you if you are unlucky. Even a very poor country like Cuba has higher life expectancy than the US. Most developed coun…

We can moralize 2nd but fundament is always numbers. To remind ~150K earners pay ~50% of CA taxes. Let that sit in your mind 1st, then ask yourself if ~1/2 of those flee to where it is better for them, the effect is and can only be either or both; worsening of health care and/or further raising the taxes. This is known effect that happens. Major HighTech companies are disincentivized and are already taking difficult…

> We can moralize 2nd but fundament is always numbers.

So you think it is moralizing to take people and fairness as the fundament? I certainly prefer that over numbers, if that makes me moralizing then so be it.

What you are implying is that you think the janitor (not an employee of course) of that hightech company who can't afford insurance does not deserve treatment when she gets hit by cancer. Paying for that would be too disincentivizing for the employees and shareholders, and the company should consider moving to another place that is more considerate of its needs.

I think the whole idea of poor people getting the same healthcare as rich people is really what is putting off many people in the US. Even if it would be better for everyone and have no downsides at all, it would still face opposition.

Re: California Considers Doubling Its Taxes

#348

Post by ceejayoz »

conanbatt wrote: post #317
dragonwriter wrote: post #250

Earlier quoted context omitted.

> You can't complain to the government. Yes, you can. And you get a vote on who is running it, too

Voting is not a great way to give customer service feedback to your doctor

How do you currently give customer service feedback to your doctor?

Re: California Considers Doubling Its Taxes

#350

Post by onphonenow »

hotpotamus wrote: post #343
onphonenow wrote: post #251

Earlier quoted context omitted.

My point is simply, if the UK is the "best" example of universal coverage - that's very very very worrisome! I happen to think the UK is not close to the best example.

How would you measure best?

Availability of service is number one. Can you even get care at all. If you have to wait a year or more for service, that has a major impact on your life.

These are for what in the US are considered relatively routine and available services - things like a pacemaker. Or knee and joint work.

“The pain is so bad now I don’t want to live much longer,” she explained. “I get up in the morning [and fear] making it to the bathroom without wetting myself as the pain and stiffness overwhelms me. Then, after losing my dignity, I attempt to make it down the stairs."

So we need to begin with just the basics - can you even get care at all - period.

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