A well-executed single-payer system would make California even more attractive for entrepreneurship and increase labor mobility for everyone. Life would be much easier if we could start companies or switch jobs without worrying about healthcare.
Very much agree. I wrote this about single payer, entrepreneurship and my time in Italy: https://journal.dedasys.com/2017/02/22/entrepreneurship-and-...
Healthy California Act: proposal to make findings about single-payer healthcare
141–150 of 468 posts
Re: Healthy California Act: proposal to make findings about single-payer healthcare
#142Earlier quoted context omitted.
[2] is about CalPERS, which is separate from the budget of the State. There may be a current budget shortfall, but CalPERS is fine (it is the largest non-country pension fund in the world; and comes in the top 10 when listed among countries). [3] mentions that tax revenues will fall because of the end of temporary tax increases; those increases are likely to be renewed. Categorizing these as 'severe budget issues' is…
> as a Californian...I'd rather that people like me... There is crux of the issue: not everyone shares the same opinion and belief, so should the government force those people to spend their earned income on healthcare for others? Personally I think it won't end up how you anticipate but that's just me. Right now the working people of America are already subsidizing healthcare for the masses and all I ever hear is pe…
Re: Healthy California Act: proposal to make findings about single-payer healthcare
#143Seems like an interesting idea. With California being the only state in the country doing this, I wonder what is there to stop people from other states using it. Someone from Washington or Texas driving up and getting a short term apartment/changing their ID just so they are covered for a really expensive surgery. It seems like if they're the only state doing it, it'd be a target for the entire nation to go to when t…
You could say the same thing for people qualifying for in-state tuition to University of California colleges (which is significantly cheaper than out-of-state tuition). Just moving to CA and making yourself a CA resident isn't enough, I think the rule there is you need have physically lived in a residence in CA for 1 year and intend to stay living in CA. No reason why they couldn't make a similar restriction for heal…
Re: Healthy California Act: proposal to make findings about single-payer healthcare
#144Vermont tried this a few years ago, they had to cancel it since in the end it wasn't financially feasible [1]. CA is already dealing with severe budget issues [2][3], so while it sounds nice in theory I'm hesitant to believe the finances actually work out. [1] http://www.politico.com/story/2014/12/single-payer-vermont-1... [2] http://www.latimes.com/projects/la-me-pension-crisis-davis-d... [3] http://www.cnbc.com/201…
Yep. Trying to solve this at the state level is a nice idea (and it certainly needs to be solved!), but it's actually harder to solve than at the federal level because you get all the same issues plus a few new ones, plus you can't actually change some key rules that are set at the federal level. If your proposed solution doesn't start with a plan to bring healthcare costs into line with the OECD average, then even i…
That is to say, we've reached a scale where we absolutely can start thinking and acting like a nation state. That doesn't mean that smaller, poorer, and weaker states can simply copy what we do directly, one-by-one. But it does mean they can band together to see that a demonstrably good model gets implemented at the Federal level.
Re: Healthy California Act: proposal to make findings about single-payer healthcare
#145I'm excited to see this show up on hacker news. As a Santa Monica resident, I'd gladly pay more in taxes for universal coverage. The only way that we are going to achieve federal universal coverage is via states paving the way. Just as "Romney care" was a predecessor to the ACA, so can healthy California pave the way for the US to join the rest of the modern world with guaranteed access.
Just curious why you would gladly pay more? Can you elaborate?
For one, having health care tied to a job is a big burden. As an employee, it makes choosing to leave my job extremely worrisome, especially if the federal government repeals the pre-existing conditions portion of the ACA. I can never leave my job while I am sick, or my kids are sick.
Tying your health care to work also makes it harder to start a small business. You need to offer your employees health care to compete for good workers, but it costs a lot more per employee for a small company to get insurance than for a big company (a big company can get a better deal because they have a larger cohort).
An even more insidious fact of employer based health care is that it doesn't cost the same for everyone. If I am going to hire someone and offer health care, it will be MUCH more expensive for an employer if the person is going to have their children and/or spouse covered as well. It will cost more if they are older. It will cost more if they have medical conditions.
This adds a perverse incentive to employers to favor hiring younger, single, people. As an employer, I should not be worried about the marital and familial status of my employee. I should pay them the salary we agree to. There are laws against discriminating against some of these groups, but if you are a small company it makes a huge difference to your bottom line.
I also fear getting a major illness. Suppose I am doing everything right, working and I have health insurance. I get cancer, and it is treatable, but it might take years to beat. I start out fine, with my good insurance. One year in, it becomes clear I can't keep working my job, so I am let go. I can keep paying for my own insurance through COBRA, but my savings are dwindling because I am no longer working. Even if I am suddenly able to work again, I wouldn't be able to get new insurance because of my pre-existing condition.
There is literally NO amount of planning I could have done to avoid this situation. I was doing everything right, and an illness can make you go bankrupt.
The last argument for why I would pay more for health insurance is a moral one. I find it immoral to not provide basic health care to everyone. I feel it is an obligation we have to each other, and the most efficient way to meet that obligation is through a single payer system. Insurance works best with the largest possible pool of people to spread the risk, and you can't get a larger pool than everyone.
So yes, I am willing to pay a little more for a single payer system, for both selfish and altruistic reasons.
Re: Healthy California Act: proposal to make findings about single-payer healthcare
#146Re: Healthy California Act: proposal to make findings about single-payer healthcare
#147Vermont tried this a few years ago, they had to cancel it since in the end it wasn't financially feasible [1]. CA is already dealing with severe budget issues [2][3], so while it sounds nice in theory I'm hesitant to believe the finances actually work out. [1] http://www.politico.com/story/2014/12/single-payer-vermont-1... [2] http://www.latimes.com/projects/la-me-pension-crisis-davis-d... [3] http://www.cnbc.com/201…
California could get rid of their budget issues instantly with a progressive property tax. How about an extra bracket for nonhomesteads starting at values over $1M?
Re: Healthy California Act: proposal to make findings about single-payer healthcare
#148Re: Healthy California Act: proposal to make findings about single-payer healthcare
#149A single payer system is a step in the right direction, however, there are deeper issues with the American healthcare system. The unit cost of healthcare is so much higher than in other developed countries. In British Columbia, physicians bill at total of around $31 CAD ($23 USD) for a standard office visit. They pay all their overhead out of this fee. Typically doctors keep 65% of their billings and the offices take…
Re: Healthy California Act: proposal to make findings about single-payer healthcare
#150A well-executed single-payer system would make California even more attractive for entrepreneurship and increase labor mobility for everyone. Life would be much easier if we could start companies or switch jobs without worrying about healthcare.
Here's the only thing I'm confused about. Do we have examples of the government running a service better than the private sector? I'm not 100% on this, but it seems all of the best aspects of American services come from competition and letting capitalism thrive. Would love a counter opinion.
Every other first world country?
https://en.wikipedia.org/wiki/List_of_countries_with_univers...