• Hey, guest user. Hope you're enjoying NeoGAF! Have you considered registering for an account? Come join us and add your take to the daily discourse.
  • The Politics forum has been nuked. Please do not bring political discussion to the rest of the site, or you will be removed. Thanks.

The California Senate Just Passed Single-Payer Health Care

AstroNut325

Member
Oct 15, 2011
11,558
1
0
San Gabriel Valley, SoCal
Since when does TN have single payer and free college? And no, it shouldn't be mandatory at all.



That's not a plan, it's just an analyst's estimate. The bill does not really say how they'll pay for it. That will have to be addressed. I think the 2.3% sales tax is severely underestimating the cost of such a thing.

1. Why should it NOT be mandatory?

2. On what basis are you saying this? Do you have any data to backup your assertion?
 

Electric Eye

Banned
Jan 5, 2016
2,036
1
0
I wonder if we are witnessing a new neo-norther block of states forming to drown out the stupid south? Destroy them with northern progress?
 

Rentahamster

Rodent Whores
Jun 26, 2007
45,301
17,836
1,910
Best Coast
I wonder if we are witnessing a new neo-norther block of states forming to drown out the stupid south? Destroy them with northern progress?

I doubt it's as coordinated as that kind of statement would imply. Theoretically, this is one of the philosophical tenets of federalism - have individual states experiment with different policies to see which ones work and which ones don't.
 

pinsomniac

Member
Oct 15, 2007
466
0
0
One of the plans have a 2.3% sales tax increase, seems like that would hurt poorer families
There's a tax credit for families currently on MediCal to offset that:

 

danthefan

Member
Sep 11, 2011
4,876
0
0
America has been such a shit show recently that I'll believe it when I see it, but I really hope it happens and I really hope it works.
 

AnathemicOne

Banned
Nov 15, 2011
8,977
0
0
California
Glad it passed in our state's Senate, hope iy it eventually comes to fruition! I'm always proud to be a Californian and this just vindicated that pride even more.
 
Sep 23, 2011
13,109
1
0
I'm too scared to be excited about this. Was there a timeline mentioned anywhere? I'd there anything else that needs to happen before this goes into effect?
 

Fried Food

Banned
Mar 11, 2012
8,029
1
0
so legal weed, great and varied terrain, beaches, weather, great food, great health care, gets all the good concerts and early movie screenings and stuff. Cali OP
 

matthewuk

Member
Dec 6, 2016
136
0
0
I hope you can make it work in California. Coming from a nation with free healthcare there are some changes that need to happen otherwise it won't work.

Drop the free dental care.(we don't have it unless your under 16) It's not uber essential. Save that money to keep the cost down.

Can California negotiate fair drug prices? If it can't then massively inflated drug costs are going to hurt. The NHS is a 600ib gorrila that drug company's have to offer a fair price to or loose one of there largest purchasers.

Doctors earn a lot in the UK but in the US they can get paid much more. Could Cali offset this by offering free education to those wishing to become doctor's. Or at least have better pay back terms

Have single payer. But keep the private market as well. With free healthcare as a competitor. The private market will have to play fair with those who choose not to have free healthcare. It also ensures that free healthcare is only used by those who need it and not free loaded on by the wealthy.
 
Sep 15, 2016
2,045
0
0
Drop the free dental care.(we don't have it unless your under 16) It's not uber essential. Save that money to keep the cost down.

.

Dental care isn't about having your teeth look good.

Stuff like gum disease makes you much more likely to have a whole host of other much worse problems health wise.
 

matthewuk

Member
Dec 6, 2016
136
0
0
I know, I'm going by how it works in the uk. Everyone no matter what income gets free healthcare. But with dental care it's only free if your under 16 or on a really low income.
 

netBuff

Member
Sep 11, 2011
3,357
0
685
I get healthcare thru my work, so nothing.

People being forced to stay in jobs they don't like because they don't want to lose their healthcare is terrible for the economy and strongly disincentives entrepreneurship. It's also a much more expensive system in general than universal single-payer healthcare would be.

I'm guessing you have great health coverage?

I work for the City of San Francisco. I have GREAT health coverage, but man I'd rather have my relatives and friends and strangers who need it, have health care....if it means I have to give. (even my "Great" coverage)

It's also very short-sighted for most people. You could always be fired, your employer could go under, your employer-provided plan could worsen.
 

Abstrusity

Member
Oct 1, 2015
3,239
0
240
Florida
If California can make it work, the country will be much better off with the active understanding that it DOES work. Slowly but surely...
 

Oriel

Member
Dec 30, 2013
4,210
0
0
People being forced to stay in jobs they don't like because they don't want to lose their healthcare is terrible for the economy and strongly disincentives entrepreneurship. It's also a much more expensive system in general than universal single-payer healthcare would be.



It's also very short-sighted for most people. You could always be fired, your employer could go under, your employer-provided plan could worsen.

Yup. Employer-based health insurance is also needlessly bureacratic and cumbersome for businesses who could be investing the money saved on such plans in hiring more workers or expanding. Let the state sort out healthcare for its citizens while companies focus on their own business. Why is this proving so hard to understand for some?
 
Jun 13, 2014
7,301
3
530
First, the state cannot require companies to take their existing healthcare payments and give it to the state. Thats not how taxes or healthcare works. They would have to implement a new tax and hope their number crunching was right on how much things costs and how much the taxes bring in and everything lines up. It would work similar to a state unemployment or disability tax, just another line item that taxes an amount based on the employees salary. I don't know what would be going on with part time or contract workers. Its not a given that all companies would be for this, some view healthcare as a core employee retention tool (our healthcare is better than what you'll get elsewhere) plus there are issues around what happens if contract jobs don't require the tax paid, in which case every employee would suddenly get turned into a contractor.

Second, the governor has already said he is against this whole thing and plans on vetoing any plan put forward that isn't realistic in its funding.
http://www.latimes.com/politics/ess...ealthcare-gov-jerry-1490226321-htmlstory.html

Third, there is literally zero chance of Trump ever approving the transfer of medicaid allocated funds (which he wants to CUT by the way, so the numbers get even worse) into any sort of single payer system, so it would have to wait until a new President.

Fourth, it would have to be approved by voters. Colorado already rejected it, 80% AGAINST and 20% FOR, once voters found out it would be implemented via a 10% payroll tax. Healthcare lobbies spent millions with scare ads about how businesses would flee Colorado, California would face the same marketing/messaging problem.

Even Bernie Sanders home state of Vermont abandoned a single payer system in 2014 after the sponsor said the tax hikes would probably hurt the state economy.

Its a good set of baby steps for California to start this but realistically it would take 10+ years for this to move along to the point where it could be put before voters.
 

Machina

Banned
Jun 11, 2015
6,609
5
0
Isn't there a very real risk that California's population could explode off the back of this? Last I heard you guys already had a massive problem with water
 

br3wnor

Member
Oct 29, 2013
2,021
2
0
Long Island, NY
But there is still a large cost that is part of your benefits. That's still real money being paid. And it's probably at least 20% of your monthly salary. Is just your employer paying it.

Do people really think employers would divert that money to employee salaries? They pay for health insurance because they have to, take that requirement away and they'll pocket most of the money.

What would stop NY from following suit?

Upstate and Long Island say hello. NYC is super liberal but rest of the state is much more conservative, no way in hell our legislature contemplates something like this.

Our state senate is usually Republican controlled
 

Juice

Member
Dec 16, 2004
14,722
3
0
So if the wealthier states all band together and do this, if there ever is democratic control federally, won't this create a powerful incentive to fuck the south over by never going national? (Because any national plan would have to be less generous thank california's and they won't like that.)

I can imagine a world where the coasts and some of the Midwest ends up with fabulous single payer and the south becomes a wasteland of religious fundamentalists and poor people who can't get out.
 
May 18, 2010
4,247
12
785
First, the state cannot require companies to take their existing healthcare payments and give it to the state. Thats not how taxes or healthcare works. They would have to implement a new tax and hope their number crunching was right on how much things costs and how much the taxes bring in and everything lines up. It would work similar to a state unemployment or disability tax, just another line item that taxes an amount based on the employees salary. I don't know what would be going on with part time or contract workers.

Second, the governor has already said he is against this whole thing and plans on vetoing any plan put forward that isn't realistic in its funding.
http://www.latimes.com/politics/ess...ealthcare-gov-jerry-1490226321-htmlstory.html

Third, there is literally zero chance of Trump ever approving the transfer of medicaid allocated funds (which he wants to CUT by the way, so the numbers get even worse) into any sort of single payer system, so it would have to wait until a new President.

Fourth, it would have to be approved by voters. Colorado already rejected it, 80% AGAINST and 20% FOR, once voters found out it would be implemented via a 10% payroll tax. Healthcare lobbies spent millions with scare ads about how businesses would flee Colorado, California would face the same marketing/messaging problem.

Even Bernie Sanders home state of Vermont abandoned a single payer system in 2014 after the sponsor said the tax hikes would probably hurt the state economy.

Its a good set of baby steps for California to start this but realistically it would take 10+ years for this to move along to the point where it could be put before voters.
Great post. If it comes to the people voting on it, they will see that tax increase and shut it down. I would love to vote for it but I don't think my fellow Californians would feel the same.
 

matthewuk

Member
Dec 6, 2016
136
0
0
If they pocket most of the money, then I can't imagine why republicans would be against it 😂.

Still I think Cali should definitely take baby steps. Setting up the ground work to make it work in the future.
 

FyreWulff

Member
Jan 21, 2010
39,735
1
0
The Internet
fyrewulff.com
If this passes the state assembly, are people with individual plans in California going to be forced to lose their plans to change to this one, or is there an option to stay on existing plans?

Cause this stuff makes me nervous since I'm in California and my meds are like $100,000+ per year to stay alive, but I have an old grandfathered pre-obamacare private plan that keeps my maximum out of pocket at about $6,000 per year which I can afford (it's a pay a huge deductible at the start of each year, and monthly premiums, but then once the deductible is met all meds/doctors cost $0 for the rest of the year). I'm definitely concerned if I ever have to change plans because even a plan that had me paying 20% co-pay or something would be $20,000+ a year for me to stay alive.

Under single payer you would pay nothing. Ever. Individual private plans are fairly moot, because now California is the sole payer of medical bills and therefore can use their millions-of-population clients to push prices downward.

tl;dr you won't be spending 6k out of pocket each year to stay alive, and will see a small tax increase to make up for it. that's it.
 

GoldenEye 007

Member
Jul 28, 2006
23,805
0
0
The Big D
First, the state cannot require companies to take their existing healthcare payments and give it to the state. Thats not how taxes or healthcare works. They would have to implement a new tax and hope their number crunching was right on how much things costs and how much the taxes bring in and everything lines up. It would work similar to a state unemployment or disability tax, just another line item that taxes an amount based on the employees salary. I don't know what would be going on with part time or contract workers. Its not a given that all companies would be for this, some view healthcare as a core employee retention tool (our healthcare is better than what you'll get elsewhere) plus there are issues around what happens if contract jobs don't require the tax paid, in which case every employee would suddenly get turned into a contractor.

Second, the governor has already said he is against this whole thing and plans on vetoing any plan put forward that isn't realistic in its funding.
http://www.latimes.com/politics/ess...ealthcare-gov-jerry-1490226321-htmlstory.html

Third, there is literally zero chance of Trump ever approving the transfer of medicaid allocated funds (which he wants to CUT by the way, so the numbers get even worse) into any sort of single payer system, so it would have to wait until a new President.

Fourth, it would have to be approved by voters. Colorado already rejected it, 80% AGAINST and 20% FOR, once voters found out it would be implemented via a 10% payroll tax. Healthcare lobbies spent millions with scare ads about how businesses would flee Colorado, California would face the same marketing/messaging problem.

Even Bernie Sanders home state of Vermont abandoned a single payer system in 2014 after the sponsor said the tax hikes would probably hurt the state economy.

Its a good set of baby steps for California to start this but realistically it would take 10+ years for this to move along to the point where it could be put before voters.
And if the state can offer a better deal for employers over what they pay currently to private insurers?

Are we considering that at all? Are you suggesting employers will just abandon nearly 40 million people simply because the checks they already write and have to dedicate entire departments to will simply change payees?
 

FyreWulff

Member
Jan 21, 2010
39,735
1
0
The Internet
fyrewulff.com
If they pocket most of the money, then I can't imagine why republicans would be against it 😂.

Still I think Cali should definitely take baby steps. Setting up the ground work to make it work in the future.

there isn't really a half step out there that works. The entire point of single payer is you save money by having a literal single payer that is the one point of rebate/filing, and that the payer has the weight of the entire population for purchasing power, forcing medical suppliers to innovate lower costs or not be in the largest market and go out of business.
 

Cellbomber

Member
Oct 12, 2008
1,693
0
0
Will fail for mutiple reasons and the mess of implementing people from employer plans will be choas and will hit major pushback from people not wanting to lose there current coverages. If it ever passed I could see an option for not opting into the state plan being available if you have a way to obtain insurance outside of it. Also any government plans (Medicare, VA, TriCare..etc) I dont think the state can technically remove and have everyone within there plan since these are federal plans.

Health care options for everyone is great. Forcing people into one plan not so much. You think current insurance plans limit you just wait for what a state plan tells you to do before you get covered for treatments and therapies. Just the limitations on the drug plans will put you at a disadvantage.
 

FyreWulff

Member
Jan 21, 2010
39,735
1
0
The Internet
fyrewulff.com
Will fail for mutiple reasons and the mess of implementing people from employer plans will be choas and will hit major pushback from people not wanting to lose there current coverages. If it ever passed I could see an option for not opting into the state plan being available if you have a way to obtain insurance outside of it. Also any government plans (Medicare, VA, TriCare..etc) I dont think the state can technically remove and have everyone within there plan since these are federal plans.

Health care options for everyone is great. Forcing people into one plan not so much. You think current insurance plans limit you just wait for what a state plan tells you to do before you get covered for treatments and therapies. Just the limitations on the drug plans will put you at a disadvantage.

So do you even know how the mechanics of health insurance work?

Employers can get kicked out by their insurer because a spouse of an employee has cancer and costs them money.

You're trying to say choice would remain, but who would choose to pay 3 to 4 digit percentage more over their tax bill for the year on health insurance? Smaller businesses would benefit as they no longer have to carry health insurance and risk getting kicked off if an employee gets sick.

When the government becomes the insurer, their client base is large enough to start pushing prices down. It's not possible to get them as cheap as single payer, no private insurer has the customer base to influence prices to that degree singlehandedly.
 

Cellbomber

Member
Oct 12, 2008
1,693
0
0
So do you even know how the mechanics of health insurance work?

Employers can get kicked out by their insurer because a spouse of an employee has cancer and costs them money.

You're trying to say choice would remain, but who would choose to pay 3 to 4 digit percentage more over their tax bill for the year on health insurance? Smaller businesses would benefit as they no longer have to carry health insurance and risk getting kicked off if an employee gets sick.

When the government becomes the insurer, their client base is large enough to start pushing prices down. It's not possible to get them as cheap as single payer, no private insurer has the customer base to influence prices to that degree singlehandedly.

Of course I do and I don't think you have a great understanding on how things work in healthcare.
 

FyreWulff

Member
Jan 21, 2010
39,735
1
0
The Internet
fyrewulff.com
Of course I do and I don't think you have a great understanding on how things work in healthcare.

K, so explain how a private insurer is going to be able to negotiate better rates than the State of California with 39.4 million customers?

A quick check shows that the largest single insurer in California is Kaiser with ~6 million.
 

Chmpocalypse

Blizzard
May 16, 2014
4,135
0
0
Will fail for mutiple reasons and the mess of implementing people from employer plans will be choas and will hit major pushback from people not wanting to lose there current coverages. If it ever passed I could see an option for not opting into the state plan being available if you have a way to obtain insurance outside of it. Also any government plans (Medicare, VA, TriCare..etc) I dont think the state can technically remove and have everyone within there plan since these are federal plans.

Health care options for everyone is great. Forcing people into one plan not so much. You think current insurance plans limit you just wait for what a state plan tells you to do before you get covered for treatments and therapies. Just the limitations on the drug plans will put you at a disadvantage.

Bookmarking this for when it succeeds and you're proven wrong, because you will be.
 

Ziltoidia 9

Member
Jul 1, 2013
5,451
0
430
Lewisville, TX
People being forced to stay in jobs they don't like because they don't want to lose their healthcare is terrible for the economy and strongly disincentives entrepreneurship. It's also a much more expensive system in general than universal single-payer healthcare would be.


This is basically another reason the system benefits the powerful. Traps people into not even thinking about competing.
 

EviLore

Expansive Ellipses
Staff Member
May 30, 2004
28,376
69,028
2,450
Health care options for everyone is great. Forcing people into one plan not so much. You think current insurance plans limit you just wait for what a state plan tells you to do before you get covered for treatments and therapies. Just the limitations on the drug plans will put you at a disadvantage.

Single payer universal health care solutions can and do in many cases maintain a layer of optional private coverage choices. The downward price pressure the single payer system exerts on all medical costs, along with an adequate baseline of coverage for everyone by default, just forces those optional private plans to be more competitive on price and/or what advantages they're offering to justify opting in.

If your employer is paying for the bulk of the premiums on a five star benefits package right now on your behalf, most of that overhead would free up on their side in this proposal. Obviously there would need to be effective negotiations at that point for employees to see any of that savings passed along, but that's far more likely to happen at a workplace where you would have ultralux benefits: as a desirable, skilled employee in a competitive field.

For working class folks none of that is relevant, and they're freed from the day-to-day stresses involved with health care coverage dependent on their current employer (if they have any benefits to begin with), and they should see a straightforward cost of living improvement.

In a vaguely competent implementation of single payer, employers and employees both win. Insurance company middlemen are the main losers, but can still stick around in some capacity. For medical professionals it'll vary a lot on the provisions of the system and what your specific job is in the field, along with how we address issues that force a higher compensation baseline for doctors, like student debt and malpractice insurance premiums et al.
 

Cellbomber

Member
Oct 12, 2008
1,693
0
0
Bookmarking this for when it succeeds and you're proven wrong, because you will be.

Lol ok..better bookmark for a long time then cause it will not be implemented even if it passes for years. I've seen state plans just end due to funding and budget shortfalls so what makes you think a plan amongst all state residents will work out any better? Also who will be running these plans? The same medical directors and people from insurers only now they have the ability to limit you even more. They are going to be tasked at keeping people on formulary and doing minimal amounts of what they consider unnecessary treatments. That's where I feel this falls short cause it is what they give you and you have no alternative.

Also one natural disasters or health outbreak could bankrupt a plan/state like this as well. Instead of the costs being split amongst 100's of payers it all falls onto the state.