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California's single-payer bill dies

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Re: California's single-payer bill dies

#31

Post by pessimizer »

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…

> Net benefit recipients will move in and net benefit payers will move out.

The numbers don't bear this out. What we see is a bunch of anti-welfare state conservatives taking credit for poor people being gentrified out of desirable high-tax areas.

Re: California's single-payer bill dies

#32

Post by pessimizer »

actually_a_dog wrote: post #21
AniseAbyss wrote: post #5

Earlier quoted context omitted.

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 tha…

> they want to keep what they have

And why wouldn't they? Significant changes in the US are only successful when they are backed by people who will profit massively from them. You can either continue to manage as you have, or waste effort on what is likely either an honest candidate who is going to get totally demolished or a corrupt candidate who is going to make your situation worse.

Re: California's single-payer bill dies

#33

Post by csnover »

zytron3 wrote: post #22
cryonics wrote: post #8

Earlier quoted context omitted.

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.

Defending America’s status quo by saying “choice = good” is one of the crazier things that comes up in these discussions.

A person on Original Medicare today has much more choice because there is no “in network”. All physicians[0] and hospitals and clinics are accessible, without restriction. Also, countries with national care systems like Canada and the UK still have supplemental insurance markets, if you really want that extra choice—but they are small because most people are satisfied with the state-funded care.

The main “choice” you get with the private insurance system these days is which company you want to be locked into using for the rest of your life, as they seem to be increasingly dividing the market so that doctors from health care system A only accept insurance A, and doctors from health care system B only accept insurance B. Sure, you can “choose” another insurer, but then you can’t see any of the doctors you’ve built relationships with. Choice, indeed.

[0] Technically physicians can opt out of accepting Medicare; in practice I’ve never found one who opted out of Medicare that didn’t simply refuse all insurance.

Re: California's single-payer bill dies

#34

Post by pessimizer »

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 “…

If the government isn't going to do it, no one is going to do it, so you're complaining about a system (with good reason) that you're determined to preserve.

Re: California's single-payer bill dies

#35

Post by pessimizer »

colechristensen wrote: post #18
toomuchtodo wrote: post #15

Earlier quoted context omitted.

You're in the minority. > Among the public overall, 63% of U.S. adults say the government has the responsibility to provide health care coverage for all, up slightly from 59% last year. Roughly a third (37%) say this is not the responsibility of the federal government, according to a Pew Research Center survey conducted July 27 to Aug. 2 among 11,001 adults. [1] If you read the post from Pew, you'll find that Dems ov…

“responsibility to provide health care coverage for all” can mean lots of different things to survey respondents, and does not imply single payer, which is but one way of implementing this. I would also probably respond “yes” to this question, but there are indeed other solutions.

Not when you include the word "provide". If you change it to "make accessible" or something else, something other than single-payer is possible. Government provision of health care coverage for all === single-payer.

Re: California's single-payer bill dies

#36

Post by nybble41 »

jevoten wrote: post #12
cryonics wrote: post #8

Earlier quoted context omitted.

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

I don't know about single-payer specifically, but: Among the public overall, 63% of U.S. adults say the government has the responsibility to provide health care coverage for all https://www.pewresearch.org/fact-tank/2020/09/29/increasing-...

As zytron3 said, it's all about how the question is phrased.

> > Do you want the government to give you free health care / health insurance?

> Sure, why not?

> > Do you want the government to be the only source of health care / health insurance, with everyone making more than $50k/year paying at least as much in additional taxes as they currently would pay for an unsubsidized ACA marketplace insurance plan to cover the expense?

> Wait, what?!

The question is meaningless if it only asks about what people want and not what they're willing to pay for it.

Re: California's single-payer bill dies

#37

Post by colechristensen »

actually_a_dog wrote: post #28
colechristensen wrote: post #27

Earlier quoted context omitted.

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, th…

Welcome to macroeconomics, free trade, globalization, and simple business strategy, topics which can't be adequately conveyed in a forum comment.

Almost every product you buy benefits from the lower costs of labor and everything else in foreign economies in one way or another. The flip side is you generally have to lower your own prices to sell in those economies as well.

You could try to keep prices constant globally, but in much of the world there would just be 0 sales. The strategy is to make up for a smaller profit margin with larger volume.

Buy at a discount from foreign countries, sell at a discount to foreign countries, as a result, pull their economies closer to your own and create new markets for your higher grade products.

Everyone on HN is always on about selling your product for what people will pay for it (usually with regards to raising prices) and paying employees market rates. Well it works both ways and you sell your products for what you can get, especially when their is moral pressure all around to not be seen profiting too much from the poorest countries.

Re: California's single-payer bill dies

#38

Post by Axsuul »

actually_a_dog wrote: post #28
colechristensen wrote: post #27

Earlier quoted context omitted.

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, th…

The analogy that the people in the US are “employees” of pharm companies is the wrong analogy. There is no obligation here.

Companies price discriminate all the time. It’s capitalism. I run a SaaS and offer lower pricing to businesses from lower cost countries. But it doesn’t mean I’m subsidizing costs thanks to richer countries. It’s so I’m not leaving money on the table.

Re: California's single-payer bill dies

#39

Post by SyzygistSix »

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 “…

The VA is not single payer; it is single provider. Those are two entirely different things.

Re: California's single-payer bill dies

#40

Post by colechristensen »

mindslight wrote: post #30
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 “…

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…

I don't think you know what a straw man is.

The US spent $4 trillion last year on medicine, $670 billion was Medicare spending. I don't know where you think the remaining $3+ trillion dollars are going to come from except through doubling tax revenue. (The US took in $4 trillion last year)

You can't just tax high income people double, I already pay 26% in federal taxes with another 8% in state taxes... I don't think raising my income taxes from 34% to 60% is going to go over very well with everybody else (even remotely) similarly effected... money is going to have to come from people who are paying very little in taxes now too.

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