Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

California's single-payer bill dies

politico.com

Post reply on HN
Print view View original

21–30 of 67 posts

Re: California's single-payer bill dies

#21

Post by actually_a_dog »

AniseAbyss wrote: post #5
bitwize wrote: post #2

Quoted post unavailable.

Extreme, but I have to admit I'm getting the popcorn ready for the next Presidential election. But if the American people literally don't want affordable healthcare that is their choice.

Bizarrely, 90% of Americans only favor Medicare for All if it means not abolishing private insurance: https://thehill.com/hilltv/what-americas-thinking/428958-pol...

Yet, 94% of Medicare recipients "report being very satisfied or satisfied with the quality of their medical care": https://www.kff.org/report-section/medicare-covered-older-ad...

At the same time, 19 out of 22 studies in a systematic review concluded that M4A would produce immediate cost savings, and one additional study predicted savings over time. These studies were funded by "organizations across the political spectrum": https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961869/

I have no idea how to reconcile these findings, except to conclude that the average American has no clue how insurance works, while, at the same time, they want to keep what they have. I think it's propaganda that's getting in the way of people making an informed decision here.

Re: California's single-payer bill dies

#22

Post by zytron3 »

cryonics wrote: post #8
bitwize wrote: post #6

Earlier quoted context omitted.

The American people want it. Powerful business lobbies ensure it gets blocked. Things like that are why the USA is not a democracy but a corporate oligarchy.

How can the American people want single payer when a supermajority opposes abolishing private insurance?

It's a difference in how the question is phrased. Most people do essentially no research and make no effort to understand the details of things. In this case it's choice = good. No further thought is required as to the actual value added by private insurance.

Re: California's single-payer bill dies

#23

Post by actually_a_dog »

colechristensen wrote: post #20
toomuchtodo wrote: post #17

Earlier quoted context omitted.

No, the data showing Americans spend more on healthcare than every other OECD country with worse outcomes does that. https://www.harvardmagazine.com/2020/05/feature-forum-costli... https://www.kff.org/health-costs/issue-brief/americans-chall... https://insights.som.yale.edu/insights/why-is-healthcare-so-... Not even the wealthy get better healthcare with their dollars. https://astralcodexten.substack.com/p/highlights…

How many drugs, medical devices, etc. were developed in the US and are being sold to all of those OECD countries at a significant discount? If that pricing was forced on Americans as well, where would the now missing money come from? Is it a bunch of corporate fatcats getting rich or is the richest country in the world subsidizing the healthcare of the rest of the world? (I mean, probably both, but is your intention…

Wait up. The US develops all these things, and yet, you think they should be given away to the world at a discount, while Americans pay full fare or more? How does that make any sense to you?

Re: California's single-payer bill dies

#24

Post by colechristensen »

KerrAvon wrote: post #14
colechristensen wrote: post #11

Earlier quoted context omitted.

I’m an American person, I don’t want it. Just look towards how the VA or operated and how many problems people have it and tell me you want to force that experience on everyone. People want healthcare to be magically free, that’s not how it’ll be. People who now pay almost no taxes and choose not to buy health insurance because they can’t afford it and their other life choices will suddenly be taxed quite a lot for “…

If single payer is funded through a payroll tax, it should be a net savings for those of us who do choose not to live dangerously. There’s a lot of pressure to fix the system, and there has been for decades. It’s blunted by politicians responsive to corporations and not to individuals (other than right-wing extremists, who they fear).

The pressure to fix is blunted by the issue's complexity and a public distaste for complexity. There isn't one issue, there are a million issues, and they have to be well understood to be fixed.

"Single payer" is easy to rally behind but it is not a complex solution to a complex problem. There's no guarantee that the result wouldn't be similarly expensive helathcare which was now mandatory with taxes and no longer had economic competition as a pressure to fix.

Re: California's single-payer bill dies

#25

Post by lotsofpulp »

kazinator wrote: post #19

California is a Democrat-run state. > The stakes were especially high given that Gov. Gavin Newsom, who campaigned for governor on the promise of single-payer, has been notably uninterested in the bill Just watched this seemingly highly relevant video yesterday: https://www.youtube.com/watch?v=hNDgcjVGHIw

Population wide benefits without population wide taxing power will never work. Net benefit recipients will move in and net benefit payers will move out.

Which is why healthcare (including mental healthcare), and homelessness/housing require a federal solution.

I assume any non federal politician campaigning on taxpayer funded healthcare is just posturing for votes, because the math is never going to work out on a state or smaller level.

Re: California's single-payer bill dies

#26

Post by notch656a »

lotsofpulp wrote: post #25
kazinator wrote: post #19

California is a Democrat-run state. > The stakes were especially high given that Gov. Gavin Newsom, who campaigned for governor on the promise of single-payer, has been notably uninterested in the bill Just watched this seemingly highly relevant video yesterday: https://www.youtube.com/watch?v=hNDgcjVGHIw

Population wide benefits without population wide taxing power will never work. Net benefit recipients will move in and net benefit payers will move out. Which is why healthcare (including mental healthcare), and homelessness/housing require a federal solution. I assume any non federal politician campaigning on taxpayer funded healthcare is just posturing for votes, because the math is never going to work out on a sta…

>Population wide benefits without population wide taxing power will never work. Net benefit recipients will move in and net benefit payers will move out.

Taxing some or all of the middle/upper class to pay for healthcare of those who aren't paying taxes, is exactly this.

Also California's tax burden is nearly double that of the least burdensome states. Clearly there's something more at play here than merely the fear people will move out of California; California has demonstrated clearly they aren't terribly worried about the effects of higher taxation on emigration.

Re: California's single-payer bill dies

#27

Post by colechristensen »

actually_a_dog wrote: post #23
colechristensen wrote: post #20

Earlier quoted context omitted.

How many drugs, medical devices, etc. were developed in the US and are being sold to all of those OECD countries at a significant discount? If that pricing was forced on Americans as well, where would the now missing money come from? Is it a bunch of corporate fatcats getting rich or is the richest country in the world subsidizing the healthcare of the rest of the world? (I mean, probably both, but is your intention…

Wait up. The US develops all these things, and yet, you think they should be given away to the world at a discount, while Americans pay full fare or more? How does that make any sense to you?

The only countries with higher median incomes than the US are Norway, UAE, Luxembourg, and Switzerland. UAE and Norway because oil, Luxembourg and Switzerland because they are tiny and very specialized.

The rest of the world can't afford as much, plenty of people will argue for humanitarian reasons that things should be lower cost to those countries which can't pay as much, and in order to sell in those other countries companies simply have to lower prices.

A similar thing happens with video games, movies, streaming services, etc. etc. etc. it's called price discrimination. (it is of course not universal, but it is still quite common for companies to lower their prices in markets which can't afford as much)

Re: California's single-payer bill dies

#28

Post by actually_a_dog »

colechristensen wrote: post #27
actually_a_dog wrote: post #23

Earlier quoted context omitted.

Wait up. The US develops all these things, and yet, you think they should be given away to the world at a discount, while Americans pay full fare or more? How does that make any sense to you?

The only countries with higher median incomes than the US are Norway, UAE, Luxembourg, and Switzerland. UAE and Norway because oil, Luxembourg and Switzerland because they are tiny and very specialized. The rest of the world can't afford as much, plenty of people will argue for humanitarian reasons that things should be lower cost to those countries which can't pay as much, and in order to sell in those other countri…

I'm sorry, but that still does not make sense to me. The US (meaning really, the American people) is expected both to innovate and subsidize the world? Come on, now. If the US develops it, why shouldn't the US benefit the most? If prices keep going the way they have over the past 40 years, we're not going to be able to afford all these fancy treatments and drugs, anyway.

Imagine a corporation developing a product, then marketing it for sale, yet not only not giving its employees a corporate discount, but making them pay more for it. Again, how does that make sense?

Re: California's single-payer bill dies

#29

Post by KptMarchewa »

colechristensen wrote: post #20
toomuchtodo wrote: post #17

Earlier quoted context omitted.

No, the data showing Americans spend more on healthcare than every other OECD country with worse outcomes does that. https://www.harvardmagazine.com/2020/05/feature-forum-costli... https://www.kff.org/health-costs/issue-brief/americans-chall... https://insights.som.yale.edu/insights/why-is-healthcare-so-... Not even the wealthy get better healthcare with their dollars. https://astralcodexten.substack.com/p/highlights…

How many drugs, medical devices, etc. were developed in the US and are being sold to all of those OECD countries at a significant discount? If that pricing was forced on Americans as well, where would the now missing money come from? Is it a bunch of corporate fatcats getting rich or is the richest country in the world subsidizing the healthcare of the rest of the world? (I mean, probably both, but is your intention…

Don't confuse being fleeced with others getting a discount.

Re: California's single-payer bill dies

#30

Post by mindslight »

colechristensen wrote: post #11
bitwize wrote: post #6

Earlier quoted context omitted.

The American people want it. Powerful business lobbies ensure it gets blocked. Things like that are why the USA is not a democracy but a corporate oligarchy.

I’m an American person, I don’t want it. Just look towards how the VA or operated and how many problems people have it and tell me you want to force that experience on everyone. People want healthcare to be magically free, that’s not how it’ll be. People who now pay almost no taxes and choose not to buy health insurance because they can’t afford it and their other life choices will suddenly be taxed quite a lot for “…

That's four straw men in a row. Medicare is not the VA. People who pay no taxes won't suddenly be taxed "quite a lot". Medicine isn't being "given away", but rather paid for at rates set by collective bargaining. The government seems quite alright at handling Medicare payments.

I'm a proponent of markets - single payer ultimately feels like giving in to the ever-growing cancer of medical administration. I'd prefer to reform the industry to have functioning market dynamics regardless of who pays. But you're grossly mischaracterizing M4A. If rallying around giving everyone access to Medicare is what it takes to stop a lot of needless administrative suffering and end a significant drag on the labor market, I'm all for it.

Post reply on HN