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

Healthy California Act: proposal to make findings about single-payer healthcare

leginfo.legislature.ca.gov

Post reply on HN
Print view View original

351–360 of 468 posts

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#351

Post by astrange »

trishume wrote: post #108
TheSageMage wrote: post #57

Earlier quoted context omitted.

I'm very new to the single-payer idea, but Vermont rates 49th for population in the US, California ranks 1st. I thought one of the strengths of a single-payer system was to leverage the power of large numbers to help drive costs down. Would this not make it more viable?

We even know California's population is large enough to support its own single-payer system since Canada has a slightly smaller population and a single payer system. The trick is whether the transition to a single payer system is feasible. Both in terms of taxes, and existing organizations and incentives.

It's a bad idea to compare California to Canada or Australia, because even with our great economy we don't control our currency. Countries can deficit-spend but we have to actually pay for things.

This is the same flaw (see Strong Towns) that leads cities to tear down useful buildings and replace it with parking lots and highways, because the federal government gave them money to build them, but not to maintain them… so they go broke.

Huh, I just realized I'm wrong because California voters always approve state bond measures. We're safe after all.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#352

Post by mcbruiser »

Frondo wrote: post #312
mcbruiser wrote: post #285

Earlier quoted context omitted.

> I'm sure as shit happy to pay more in taxes for a universal single single-payer. I Great, you can opt in to that, but don't force everyone else who doesn't agree with you to subsidize everyone else's poor decisions

Ok, well, as a cyclist who doesn't own a car, and as a vegetarian who doesn't eat meat, and as a childless infertile dude, I'm sure tired of subsidizing you cow-eating motorist parents. Oh, wait, that's what society is--we all pay for communal stuff because we're all ultimately in this together.

sounds like communism to me. I prefer survival of the fittest, and you don't sound very fit to me, which makes it understandable why you would be in favor of everyone else supporting the load.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#353

Post by mindcrime »

charles-salvia wrote: post #183
mindcrime wrote: post #175

so should the government force those people to spend their earned income on healthcare for others? Absolutely not. Pretty much any question that starts with "should the government force ..." can be answered "no". You earned your income, it's yours and it should be up to you how to spend it. Using force / aggression (aka the government forcing you to do something) is a violation of your most fundamental rights, and st…

I understand that's the conservative/libertarian position - however the government forces you to pay taxes to support infrastructure and other things. Are you against that as well?

I understand that's the conservative/libertarian position

FWIW, conflating conservatism and libertarianism is a mistake. There's some incidental overlap, just like there is between libertarianism and liberalism, but that's pretty much the extent of it.

Are you against that as well?

Yes, of course. Basically, if the word "force" is involved, it's wrong. Come up with a way to collectively fund infrastructure that's voluntary and I'm all for it. But if your idea needs force / violence to be executed, then, well, maybe it isn't such a good idea after all.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#354

Post by nickv »

refurb wrote: post #301
nickv wrote: post #289

Earlier quoted context omitted.

How many Americans do you think get to go and get their cancer treated at Memorial Sloan Kettering? The US private health care system doesn't mean everyone who gets cancer goes to MD Anderson. And, you'd still be very hard pressed to have many private insurance plans cover truly experimental treatments. If I had to choose who gets advanced treatments between those who can pay the most vs those who need it the most I'…

I'm not arguing that people in the US don't get care, I'm arguing that if you want to cut healthcare spending in the US (to match other countries) people will have to get used to a lower level of healthcare.

I don't understand what you mean there. I think you underestimate the administrative costs alone of the US' hodgepodge system (an entire floor at UCSF is devoted to insurance processing, how many floors does UBC have for billing?)

The US health care system even for the middle class is a disaster. Deductibles are often nearly 8k or higher alone! And nearly ALL plans have "networks" so you can't go to whatever doctor you want anyway. (One of my canadian friends doesnt even know what a deductible is!)

You realize there are nearly as many Americans without any insurance as there are people in Canada (27M vs 34M)? And this was AFTER the ACA expansion.

I get trying to post an alternative view, but it's so out of wack. Have you experienced the US health care system for an extended period of time personally? It sounds like you haven't.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#355

Post by mindcrime »

Daishiman wrote: post #248
mindcrime wrote: post #175

so should the government force those people to spend their earned income on healthcare for others? Absolutely not. Pretty much any question that starts with "should the government force ..." can be answered "no". You earned your income, it's yours and it should be up to you how to spend it. Using force / aggression (aka the government forcing you to do something) is a violation of your most fundamental rights, and st…

Some people will never have the means to pay for their own health care. Some jobs that have social value do not pay enough money to care for people. In your worldview, those people don't deserve to have health. I'll stick with civilized societies thankyouverymuch.

In your worldview, those people don't deserve to have health.

No, that is not my worldview, not in the slightest.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#356

Post by chimeracoder »

SilasX wrote: post #303
chimeracoder wrote: post #286

Earlier quoted context omitted.

> Sure, you think it's expensive, but the demand is still there, people are willing to work for (net of costs) less than they currently are. That supports the claim that the service is priced above the market clearing level. * There are more people who apply for publicly-funded GME every year than there are positions available, yes. * However, almost nobody (roughly speaking) applies for self-funded residency positio…

I added an edit that there is plenty of room between full current subsidy and 0% subsidy. You're doubling down on the strawman of adding new slots at 0% subsidy, and you're not considering the possibility that the requirements are too stringent to begin with. (Full bachelor's plus MD plus full residency.) Edit: Also, it wouldn't be "seeing the effects" of it until the number of med school applications = number of med…

There is no "full current subsidy" - the existing contributions from Medicare are already a partial subsidy.

But this is kind of a meaningless debate after a point, because the number of unmatched residents is already an upper bound on the number of additional matches (you certainly wouldn't have more people interested when you increased the price to them). And even then, we wouldn't see a huge difference - the number of unmatched domestic applicants isn't enough to make a meaningful dent in the labor supply of practicing physicians - and that's assuming all of the unmatched doctors are as properly qualified as their matched counterparts.

In other words, no, we're not at the exact market-clearing rates for the medical education market, and we consistently bias in one direction from that equilibrium, but we're measurably not far off from it.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#357

Post by mindcrime »

hackuser wrote: post #215
mindcrime wrote: post #175

so should the government force those people to spend their earned income on healthcare for others? Absolutely not. Pretty much any question that starts with "should the government force ..." can be answered "no". You earned your income, it's yours and it should be up to you how to spend it. Using force / aggression (aka the government forcing you to do something) is a violation of your most fundamental rights, and st…

Government is "forcing" very few people. Most people participate in society voluntarily. For example, government doesn't force me to obey the law; I do it voluntarily. They don't force me to pay my bills, not shoot my neighbor, and pay my taxes. I do all that voluntarily. EDIT: I don't follow Hacker News' rules and norms because I'm afraid of being banned, but because I respect the other people here, respect that the…

The concept of force applies only to a very few.

No, it applies to everybody. That you, by happenstance, voluntarily do something that somebody is trying to coerce you into doing does not negate the threat of force.

Your position might change one day when your circumstances change, and then the seemingly benevolent government that you put your faith in may well show its teeth. But those teeth are always lurking, even if they're just out of sight.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#358

Post by tylersmith »

Apocryphon wrote: post #349
tylersmith wrote: post #341

Earlier quoted context omitted.

Exactly, that's the problem.

No man is an island, but if you want to try, there's still wilderness out there to build utopian Galt's Gulches without even having to seastead.

Yes, we're working on it. https://www.youtube.com/watch?v=cOubCHLXT6A

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#359

Post by cmurf »

stale2002 wrote: post #223
mmanfrin wrote: post #64

Earlier 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…

Uhh, no thanks. I'd rather be able to decide for myself what healthcare I buy, instead of being forced into a substandard single payer system. Ok, fine, create a public option. But don't force me to buy it. Let me buy my own healthcare.

I can understand it, but it's basically a classist system. The advocates are saying rich people are better than everyone else, they should be able to bribe their way into better health care because they can afford to. A single payer system that puts everyone, regardless of race, class, age, at the end of the line - and as they do not like how things work, they fix it. What's important is creating the auditing mechanisms for identifying and evaluating problems, prioritizing them, and then getting them fixed.

But the reality is, the for-profit system already forces people into a substandard single payer system in a huge portion of the U.S. where there's only one insurer, not least because health insurance is an anti-competitive business but aren't regulated per competition law.

Re: Healthy California Act: proposal to make findings about single-payer healthcare

#360

Post by DrScump »

acdha wrote: post #181
__realtime wrote: post #118

Earlier quoted context omitted.

Glad you have that luxury, CA has some of the highest taxes anywhere and I would definitely be opposed to more.

https://taxfoundation.org/state-and-local-sales-tax-rates-20... “The five states with the highest average combined state and local sales tax rates are Tennessee (9.46 percent), Arkansas (9.30 percent), Louisiana (9.0 percent), Alabama (8.97 percent), and Washington (8.90 percent).”

Most Californians live in areas with sales surtaxes, ending up at as much as 9.75%:

http://www.boe.ca.gov/app/rates.aspx?LETTER=S&LIST=CITY

Post reply on HN