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

leginfo.legislature.ca.gov

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

#91

Post by seanieb »

marcell wrote: post #54
old-gregg wrote: post #41

Earlier quoted context omitted.

Yes you can. As a 6th largest economy in the world [1] California can negotiate prices down by 50-60% to be comparable to Canada/UK. [2] Besides, the existing state program (medi-cal) already covers over 1/3 of CA residents [3]. So it looks like if we lower the cost by 60% we can get pretty close to normal healthcare situation using the existing budget. [1] https://en.wikipedia.org/wiki/Comparison_between_U.S._states…

Some of the numbers for [2] confuse me. How can an office visit cost $30 in Canada? When I go in for an office visit, it typically takes about 30 minutes of staff time, around 15 minutes with a medical assistant and 15 minutes with a doctor. If that's $30, the implied wage is $60/hr for the medical staff, if you assume that all the money goes to staff. That just doesn't seem feasible. Some of the other numbers seem m…

A doctors visit isn't a good example. Folks don't go bankrupt from doctors visits. The important stuff is drugs and hospitals.

For example an asthmatic in any other country in the world pays ~$10 for a Ventolin inhaler (including tax and a % of profit), Americans pay $55-$65 and that price is increasing.

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

#92

Post by chaostheory »

mmanfrin wrote: post #64
gavman wrote: post #32

Vermont 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…

[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…

> is about CalPERS, which is separate from the budget of the State. There may be a current budget shortfall, but CalPERS is fine

It's 'separate' from the state budget, but doesn't California still ultimately pay for pensions? How is this fine when there's a huge difference between the projected costs and the actual costs? Doesn't 70% of CA tax revenue go towards paying pension obligations?

Current CA pension debt is $965 Billion.

http://news.stanford.edu/2015/10/15/cali-pension-tracker-101...

http://www.pensiontracker.org/index.php

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

#93

Post by __realtime »

mmanfrin wrote: post #64
gavman wrote: post #32

Vermont 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…

[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 people complaining about it.

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

#94

Post by mahyarm »

amluto wrote: post #68
ThomPete wrote: post #48

Here is the problem. How do you deal with illegal immigrants? At least in the current system there are ways for them to get treated, but in a single payer system? Single-payer works great in countries were everyone have a ssn. Not sure its feasible in the US as much as i think it would be great.

By giving them healthcare? There aren't actually a large number of illegal immigrants sitting around contributing nothing to the CA economy.

A lot of them even pay taxes with stolen SSNs!

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

#95

Post by gavman »

mmanfrin wrote: post #64
gavman wrote: post #32

Vermont 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…

[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…

Thanks for the details regarding the budget, I didn't realize the pension budget shortfall was separate from the state budget.

In that case stupid question: if CalPERS owes much more than it can afford to pay, where is the rest coming from? The LA Times article, in multiple places, talks about how much the shortage will cost the "taxpayers" (see quote below for example), how is this not related to the CA budget which is, well, funded by taxpayers?

> "This year, state employee pensions will cost taxpayers $5.4 billion, according to the Department of Finance. That’s more than the state will spend on environmental protection, fighting wildfires and the emergency response to the drought combined."

That makes it seem like it's related to the budget...

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

#96

Post by Lazare »

gavman wrote: post #32

Vermont 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 if your plan works it's like trying to bail out a leaky boat by scooping water up and pouring it back into the boat.

This one...doesn't even try. Yes, if health care cost the same in the US as it did in Germany this plan would work great...but it doesn't. You can paint a Yugo red, but it doesn't magically turn into a Porsche.

(And before anyone asks...no, the best estimates of potential savings from switching to single payer is orders of magnitude too low. The NHS works because medical care is cheap to provide in the UK; medical care isn't cheap to provide in the UK because of the NHS.)

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

#97

Post by thelsdj »

darkstar999 wrote: post #42
wjossey wrote: post #30

I'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?

I'm not OP, but I'll answer. I care about my fellow human beings. I make more than most. I want them to have health care. I am willing to pay more taxes into a system that covers everyone so they can all have health care. I could go around and throw a few dollars into every GoFundMe for healthcare that I come across, but in the end it is more efficient to have everyone under the same system driving costs down than it is for people to have to beg and plead for charity to help cover their medical bills.

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

#98

Post by cmdrfred »

I don't think single payer is viable in the US, yet I am happy that it is being attempted here. America was originally designed to be a marketplace of ideas. With a limited federal government each state can enact laws that it sees fit. If the law works well, more states will adopt it.

This is a perfect example of "states rights" at work. I hope it gets implemented (if the people of California wish it so) and that comprehensive data is provided so I and others can make a truly informed decision on the matter.

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

#99

Post by birken »

Keverw wrote: post #69

Seems 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 health care.

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

#100

Post by foota »

Abundnce10 wrote: post #70
chrismealy wrote: post #52

Earlier quoted context omitted.

WA isn't even meeting its constitutional mandate for funding education.

I'd like to learn more about this, can you provide a source?

https://www.courts.wa.gov/appellate_trial_courts/SupremeCour...
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