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California's single-payer bill dies

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Re: California's single-payer bill dies

#51

Post by [deleted] »

colechristensen wrote: post #49
AnIdiotOnTheNet wrote: post #44

Earlier quoted context omitted.

> People who now pay almost no taxes and choose not to buy health insurance because they can’t afford it I guess that's one way to phrase "are completely priced out of something guaranteed as a human right in pretty much every civilized country". A good friend of mine is in this situation, and I have a very low tolerance for the attitude of the "fuck poor people because I don't like taxes" crowd.

It's market forces at work. When most people in a certain situation neglect a cost so they can afford everything else in their lives, everything else has a tendency to raise prices to eat up all of their income anyway. It comes down to most people paying a lot of money for rent and not being able to afford other things like healthcare. Well rent is that high because enough people neglected to pay for healthcare that…

[deleted]

Re: California's single-payer bill dies

#52

Post by Axsuul »

actually_a_dog wrote: post #48
Axsuul wrote: post #38

Earlier quoted context omitted.

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.

Have you ever stopped to consider for even one second that maybe capitalism is the problem? That maybe there should be an obligation? As I said in my other comment, you can't keep squeezing people for more and more and more and expect it to be sustainable. What good are fancy new drugs and treatments when nobody can afford them, even with insurance?

Would we still have these new drugs without capitalism? There still needs to be incentive and capitalism is the best model we have for that. It's the government that needs to implement policies however to make them more available for everyone. Humans can't be relied upon to develop novel solutions for the good of everyone -- there has to be something in it for them. That's just how they operate unfortunately. Long-term solutions require the right incentives.

Re: California's single-payer bill dies

#53

Post by anamax »

codyb wrote: post #9
cryonics wrote: post #7

Earlier quoted context omitted.

You realize Vermont tried this and costs swelled so much that Democrats themselves reverted it back to non single payer?

Don’t most national healthcare programs also add in collective bargaining? I can’t imagine it’d be possible to support on state coffers alone without that.

> Don’t most national healthcare programs also add in collective bargaining?

Which of the major cost drivers in US healthcare does collective bargaining address?

Yes, we could switch to paying marginal costs for drugs, but drugs don't happen unless the average costs are paid, so if someone is paying marginal, someone else has to pay above average.

There are things that we could do to reduce said average costs, but we can do them without doing anything else.

Re: California's single-payer bill dies

#54

Post by mindslight »

colechristensen wrote: post #40
mindslight wrote: post #30

Earlier quoted context omitted.

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…

A straw man is a statement that is trivially disprovable. Just because you stood them up without knocking them down does not stop them from being straw men.

That money comes from premiums for Medicare and money saved from private "insurance". The correct comparison is not simply your current tax rate, but rather your tax rate plus the amount you're currently paying for "insurance".

Medicare is not some free thing for the elderly, but rather is paid into by monthly social security payments. Adjust the premium amount to remove any retirement subsidy, and allow non-retired people to buy into the existing system. This would add a well-established competitor to a market currently dominated by the health "insurance" cartel.

The "free" healthcare is Medicaid which is available to everyone, but only after they're rendered unemployable and bankrupted due to medical problems. Doesn't it make more sense to allow people to buy into a healthcare plan and keep working rather than making them stay destitute so they can quality for medical care?

Re: California's single-payer bill dies

#55

Post by briHass »

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 US (meaning really, the American people) is expected both to innovate and subsidize the world?

See also, military spending. There's certainly an argument to be made that the US doesn't need to have quite the level of worldwide engagement it does, but what would that result in? Would China being an uncontested military superpower be good or bad for the world?

Re: California's single-payer bill dies

#56

Post by colechristensen »

actually_a_dog wrote: post #46
colechristensen wrote: post #37

Earlier quoted context omitted.

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 globall…

This is not a sustainable phenomenon, though. Americans can't continue to pay an increasing portion of their income to healthcare while exporting the benefits to everyone else. That's simply absurd. It's all right here: https://www.washingtonpost.com/business/2020/02/24/this-char... You can't keep squeezing people for more and more and expect to get anywhere in a sustainable fashion. This is the road to collapse. Wha…

All economics is cyclical, prices will rise until the pressure causes them to reverse the trend. Pretend any economic trend over a short period will continue forever and they’ll all be unsustainable.

Re: California's single-payer bill dies

#57

Post by s1artibartfast »

mindslight wrote: post #54
colechristensen wrote: post #40

Earlier quoted context omitted.

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…

A straw man is a statement that is trivially disprovable. Just because you stood them up without knocking them down does not stop them from being straw men. That money comes from premiums for Medicare and money saved from private "insurance". The correct comparison is not simply your current tax rate, but rather your tax rate plus the amount you're currently paying for "insurance". Medicare is not some free thing for…

I am a big proponent for an at-cost public option medicare, and always disappointed that it is rarely taken seriously.

That said, only a minority of Medicare funds come from payroll taxes. The biggest contribution is from other taxes. See page 7:

https://files.kff.org/attachment/Issue-Brief-Facts-on-Medica....

Re: California's single-payer bill dies

#58

Post by colechristensen »

mindslight wrote: post #54
colechristensen wrote: post #40

Earlier quoted context omitted.

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…

A straw man is a statement that is trivially disprovable. Just because you stood them up without knocking them down does not stop them from being straw men. That money comes from premiums for Medicare and money saved from private "insurance". The correct comparison is not simply your current tax rate, but rather your tax rate plus the amount you're currently paying for "insurance". Medicare is not some free thing for…

Indeed, that is not at all what a straw man argument is, go look it up.

Medicare is not at all comparable to the coverage you get with private health insurance.

Single payer healthcare systems have zero or very very low costs to the patient, nothing at all like the deductibles, coinsurance, and out of pocket maximums you find in private health insurance.

You don't really know what you're talking about on several points and it doesn't seem to be worth correcting each one of your misconceptions.

Re: California's single-payer bill dies

#59

Post by mindslight »

colechristensen wrote: post #58
mindslight wrote: post #54

Earlier quoted context omitted.

A straw man is a statement that is trivially disprovable. Just because you stood them up without knocking them down does not stop them from being straw men. That money comes from premiums for Medicare and money saved from private "insurance". The correct comparison is not simply your current tax rate, but rather your tax rate plus the amount you're currently paying for "insurance". Medicare is not some free thing for…

Indeed, that is not at all what a straw man argument is, go look it up. Medicare is not at all comparable to the coverage you get with private health insurance. Single payer healthcare systems have zero or very very low costs to the patient, nothing at all like the deductibles, coinsurance, and out of pocket maximums you find in private health insurance. You don't really know what you're talking about on several poin…

I said "straw men", not "straw man arguments". Each of my following sentences was a quick refutation of the fallacies you based your argument on. It's almost like they were talking points with no bearing in reality - for example, Medicare is decidedly distinct from the VA. It's difficult to have a discussion with someone who is drawing assertions from an alternate reality.

It's also funny you said I don't know anything about Medicare given that I handled my father's healthcare for several years. There were definitely deductibles, "coinsurance" (aka percentage-based deductibles), and out of pocket maximums for Parts A, B, and D.

I straight up said I'd prefer market based solutions, to actually address the administrative cancer that is responsible for ballooning healthcare costs - in what other industry are vendors allowed to keep prices secret and then send arbitrary bills afterwards based on how they feel? But I have seen no credible attempts for reform by the other Party, instead deferring to the absolutely insane status quo. And no, a few executive orders to publish fictitious chargemasters don't count - I'm talking real reform like requiring providers to set a single price schedule regardless of who is paying. Until there is a credible alternative plan for industry reform, then unfortunately M4A is the only plan addressing the insanity of the current system.

Re: California's single-payer bill dies

#60

Post by mindslight »

s1artibartfast wrote: post #57
mindslight wrote: post #54

Earlier quoted context omitted.

A straw man is a statement that is trivially disprovable. Just because you stood them up without knocking them down does not stop them from being straw men. That money comes from premiums for Medicare and money saved from private "insurance". The correct comparison is not simply your current tax rate, but rather your tax rate plus the amount you're currently paying for "insurance". Medicare is not some free thing for…

I am a big proponent for an at-cost public option medicare, and always disappointed that it is rarely taken seriously. That said, only a minority of Medicare funds come from payroll taxes. The biggest contribution is from other taxes. See page 7: https://files.kff.org/attachment/Issue-Brief-Facts-on-Medica... .

Taking page 7's 85% figure for high earners, the $578.30 Part B premium figure for high earners, the $77.90 Part D premium for high earners, and the $499 Part A premium for people who didn't pay in, creates a total monthly premium of $1271. This is for old people or disabled people who have many more chronic health problems. Surely this figure can be drastically reduced for younger people without chronic health problems, and can likely beat what the governmentesque "private" companies charge for non-employer plans.

Furthermore, there is probably no better solution to paying for bankruptcy-level chronic health problems than public funds, despite the cost. The prevailing fiction is that such expensive individuals will be part of some non-correlated social "group" and paid for by other members. But the incentives are completely wrong, in that an insurer or employer doesn't want to pay for that market-inefficient burden, and will look for every reason to deny claims or remove from group. So considering those extreme expenses a fixed cost (which are being paid by the public now regardless, through Medicare, Medicaid, or unpaid debt), implies that average individual premiums would be even less.

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