California Considers Doubling Its Taxes • Hacker News Board

Re: California Considers Doubling Its Taxes

#331

Post by jjav » Sat, Jan 08, 2022, 5:51 AM UTC

conanbatt wrote: post #324

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...

Profits is not what makes healthcare expensive…

What do you think makes it expensive in the US then?

Certainly not the salaries to actual health professionals (doctors, nurses, techs, etc).

When you see a doctor for 10 minutes and get billed $400, the vast majority of that money goes all the layers who are extracting their slice of profit from it, only a small bit goes to the doctor.

Re: California Considers Doubling Its Taxes

#332

Post by jjav » Sat, Jan 08, 2022, 5:53 AM UTC

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.

The insurance company profit motive only achieves them maximizing their profit margin at all times. Which is done by charging as much as possible and blocking services as much as possible so they don't have to pay.

Re: California Considers Doubling Its Taxes

#333

Post by dillondoyle » Sat, Jan 08, 2022, 6:13 AM UTC

sokoloff wrote: post #165

dillondoyle wrote: post #82

Earlier quoted context omitted.

It goes beyond deductions too. Though maybe you're referring to total costs of premiums or company pays costs that probably come out of your comp. I was shocked to learn how much my parent's insurance costs. Even though ostensibly employed by a huge multi-national, my dad technically operates as his own S-corp so they have to buy on the market. That seems to be a trend in the gig economy which is worse for low 'wage'…

> By the time they are 75 or even older the cost would be insane if this continues. That's more or less why Medicare exists.

Yeah it does look helpful and pretty good for what it does cover.

But still a lot of out of pocket costs and premiums if you want drug coverage and more.

Correct me if I'm wrong but it doesn't really cover if you need long term care which is insanely expensive.

Re: California Considers Doubling Its Taxes

#334

Post by France_is_bacon » Sat, Jan 08, 2022, 6:30 AM UTC

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Re: California Considers Doubling Its Taxes

#335

Post by pandaman » Sat, Jan 08, 2022, 7:42 AM UTC

seanmcdirmid wrote: post #330

conanbatt wrote: post #323

Earlier quoted context omitted.

Uh, you can change group plan providers. You cant change the gov. Hell you might not even be able to vote at all.

You can change jobs you mean? Group plans are provided by employers, the majority way that Americans get health insurance.

Employers change plan providers all the time. It happens because, unlike the government, people in charge of choosing the provider are also affected by their choice.

Re: California Considers Doubling Its Taxes

#336

Post by pandaman » Sat, Jan 08, 2022, 8:02 AM UTC

HideousKojima wrote: post #254

onphonenow wrote: post #55

Earlier quoted context omitted.

I've got access to employer numbers. Grandfathered plans are an absolutely screaming deal. You can do an HSA plan with a $2000 deductible and low OOP max, fully fund the HSA ($7,200) and come out way ahead at modest cost. This let's you do things like vision / dental / chiro / accu / whatever day to day stuff on the HSA, then keep costs controlled (after 2K) for a major issue. If you don't end up using the HSA you ca…

>I like obamacare, but something happened as part of obamacare that has CLEARLY driven up costs. Is it the lack of limits (ie, $10M in coverage during last weeks of life?) Is it some sort of other mandate? That's an easy one, Obamacare mandated that insurance companies couldn't charge more than X times as much for their most expensive plans vs. their cheapest plans, The people pushing it were either tremendously igno…

This and the cap on the profit margin[1]. The logic in this case is even more bizarre. A regular company can increase its profit either by raising prices or by reducing costs so it strives to do both. An health insurance firm can only do the former. If an insurance firm were to reduce its costs then it would have been forced to reduce the price to remain within the profit margin. But if it increased them instead then it could raise price and get more money in the same profit margin.

[1] https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-In...

Re: California Considers Doubling Its Taxes

#337

Post by ravenstine » Sat, Jan 08, 2022, 10:35 AM UTC

rrrrrrrrrrrryan wrote: post #312

ravenstine wrote: post #97

Earlier quoted context omitted.

Exactly. Leave it to California to foul something up. No matter what one's stance is on health care, I don't get how Californians can have faith in their establishment. The things we have that are relatively turnkey ways of bringing in money like the ports, the farmland, Hollywood, and Silicon Valley serve to paint over the rot. If we had none of those things and we governed ourselves the way we have been for decades…

> the ports, the farmland, Hollywood, and Silicon Valley serve to paint over the rot. In what universe are these things a coat of paint? In California's economy, these things are the whole damn tree: the roots, the trunk, the leaves, all of it. It might have a couple rotting branches, but it yields so much fruit that people just don't care.

They're gold mines. Even if you're a mismanaged mining company, you still have guaranteed access to gold. That is until you've mined all the gold, and then what? Oh, what's that? You spent all the money you made and your business is designed in a way that it only can survive when there's a gold surplus? Well, now.

What California has is not the norm. Other states and countries might have one of those things; maybe they've got ports, or maybe they've got farmland in an optimal climate, or they've got something else. But until things change (which they will), no one has been able to have Hollywood or Silicon Valley as well as everything else. Once those things are sufficiently dissolved and others drink from our milkshake, it will suddenly be apparent how few of the people in California cared, to use your words; when the money dries up, it will be apparent how few things we actually have better than other parts of the country, as well as other countries. It's easy to ignore outdated and crumbling infrastructure, the crime and the homelessness, and budget being utterly wasted when the money keeps rolling in and the beach is no more than an hour away.

Re: California Considers Doubling Its Taxes

#338

Post by danielrpa » Sat, Jan 08, 2022, 10:42 AM UTC

Please help me understand one thing, while having in mind that I'm not particularly for or against single payer. My problem is that I don't buy the top argument for single payer I'm seeing here.

Many people here are arguing that healthcare is expensive, is a basic human need and it's really hard to get it in the US if you don't have a job paying for it. Even when jobs help out with the premiums, it's still hard to pay for it in California. All true.

Do you know another basic human need? A place to live. Without a place to live, you are homeless - which is normally seen as even worse as not having access to healthcare.

A place to live in the bay area is really expensive, more so than healthcare. I don't live in the bay area, but it appears that a reasonable rent for a place for 3 people is around $3500/mo or 42K/year. This is more than out of pocket (no subsidies) Kaiser + average healthcare expenses.

If the government is supposed to pay for healthcare in California, why isn't it supposed to pay for rent? Both are basic needs and quite expensive. Serious question.

Re: California Considers Doubling Its Taxes

#339

Post by conanbatt » Sat, Jan 08, 2022, 11:37 AM UTC

jjav wrote: post #331

conanbatt wrote: post #324

Earlier quoted context omitted.

Profits is not what makes healthcare expensive…

What do you think makes it expensive in the US then? Certainly not the salaries to actual health professionals (doctors, nurses, techs, etc). When you see a doctor for 10 minutes and get billed $400, the vast majority of that money goes all the layers who are extracting their slice of profit from it, only a small bit goes to the doctor.

Doc salaries account for 10-20% of national healthcare spending. The us hS one of the lowest per capita counts of doctors in the world and the most expensive education system for them. Single payer does not fix this.

The us has the most expensive drug approval process in the world making any drug that goes to market needing high prices to exist. Around 10% of NH spending here.SP does not fix this.

Hospitals receive large gov funding, regulatory protection that includes the inability to build or run new or for-profit hospitals, and with the constant moral hazard of running hospitals in the red and getting bailed out. Almost all hospitals are non-profit. About 40% of NH spending. SP makes this even worse by eliminating forever the risk of bankrupcy.

Re: California Considers Doubling Its Taxes

#340

Post by sneak » Sat, Jan 08, 2022, 11:47 AM UTC

SSilver2k2 wrote: post #307

sneak wrote: post #144

Earlier quoted context omitted.

You don't need to move to contribute to charity that helps others.

Charity helps specific people. Taxes help everyone. I always vote to increase my property taxes. Libraries, Schools, Emergency Services all get better with that increased revenue.

There are many charities that help as wide a range of people as possible.

I don't think there are any taxes anywhere that help "everyone". I don't even think there are any taxes anywhere that help "everyone" in a specific jurisdiction.