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The California Senate Just Passed Single-Payer Health Care

slit

Member
Jun 3, 2009
17,040
1
960
In the US, the cost of an aspirin in a hospital is like $50 a pill.

Private insurers that have contracts with a health system don't pay anything like that. It's much more in line with what a gov't pays hospitals under UHC.
 

Loki

Count of Concision
Jun 6, 2004
7,526
562
1,670
yeah, all those illegal immigrants that pretty much already pay every tax minus income (and then, they can do that if they get an EIN) but can't actually use most of the services will be the dead weight in this system?

el

oh

el

Enlighten me: how will they have the healthcare-specific tax being discussed in this thread (which is what will actually fund the system) levied against them? If they can't, and won't, then yes the system will be financially unsustainable. Librul-GAF tears notwithstanding.

People talking about how they pay sales/other taxes are entirely missing the point: so does everyone else. Yet there's a reason Cali will be levying new taxes to support this program. Why would they do that, if sales and other taxes were sufficient to fund this program? Oh, wait, that's right - because they're not.
 

Loki

Count of Concision
Jun 6, 2004
7,526
562
1,670
Seriously, illegal immigrants pay more taxes than some extremely large corporations. Not even as a percentile, but in actual raw dollars.

That's a separate and even more indefensible issue. And again, it's not about the total amount of tax being paid, it's about the specific tax being discussed here and whether it can/will be levied against illegal immigrants.
 

FyreWulff

Member
Jan 21, 2010
39,735
1
0
The Internet
fyrewulff.com
Enlighten me: how will they have the healthcare-specific tax being discussed in this thread (which is what will actually fund the system) levied against them? If they can't, and won't, then yes the system will be financially unsustainable. Librul-GAF tears notwithstanding.

People talking about how they pay sales/other taxes are entirely missing the point: so does everyone else. Yet there's a reason Cali will be levying new taxes to support this program. Why would they do that, if sales and other taxes were sufficient to fund this program? Oh, wait, that's right - because they're not.

Part of the proposal is that companies will be taxed on gross receipts starting at 2 million dollars. Ergo, illegal immigrants buying goods will fund the healthcare system from purchasing in-state goods, even taxless goods like food.

Yes, new taxes will be needed to fund the system. One, because yes, it costs money, you can't never add or never raise a tax if you want a functioning government, so "it costs a bit more" isn't really a resounding death blow to implementing universal healthcare. Secondly, shifting the taxes around means California captures tax dollars from tourism and so on from out of state and out of country visitors - those dollars will be a net positive. Finally, doing a general tax is a hell of a lot cheaper than trying to means test people or sending everyone an individual health bill. This is not hard to grasp. If you want nice things you have to pay for them. It will still be cheaper per person in tax dollars to get constant healthcare than under the current system.
 

YourMaster

Member
Jan 26, 2006
1,451
1
990
Germany
I wonder how huge the first-day lines would be if and when this ever gets implemented. Of all the people who have some sort of health problem now but can't afford care.

I also wonder if and by how much total health expenditure will go down when people can go to the doctor when their problems are just starting instead of almost too late. There's a huge cost difference between removing a small tumor and treating full blown cancer for example.
 

FyreWulff

Member
Jan 21, 2010
39,735
1
0
The Internet
fyrewulff.com
I wonder how huge the first-day lines would be if and when this ever gets implemented. Of all the people who have some sort of health problem now but can't afford care.

I also wonder if and by how much total health expenditure will go down when people can go to the doctor when their problems are just starting instead of almost too late. There's a huge cost difference between removing a small tumor and treating full blown cancer for example.

For starters, you would gain a lot of productivity back if everyone in California was provided a full shot regimen each year.
 
Apr 10, 2007
15,230
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Can anyone explain why this needs to get approved by a public vote? Things like these should never be put up for a vote. 9 times out of 10, people will reject any new taxes even if its better for them in the long run.
 

Killthee

helped a brotha out on multiple separate occasions!
Jun 6, 2004
17,268
0
0
Can anyone explain why this needs to get approved by a public vote? Things like these should never be put up for a vote. 9 times out of 10, people will reject any new taxes even if its better for them in the long run.
IIRC, tax increases in CA require a supermajority of the legislature to vote for it or to pass by referendum and apparently voters also have to exempt it from spending limits and budget formulas in the state constitution.
 
Aug 25, 2007
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http://www.ktvu.com/news/263562267-story

SACRAMENTO, Calif. (AP) -- The prospects of a government-run health care system in California dimmed Friday when the leader of the state Assembly announced he doesn't plan to take up the single-payer bill this year.
The bill, which has passed the Senate, lays out a plan for a government-run health system in California, but it doesn't include a way to pay for it. Rendon said the bill also doesn't adequately address delivery of care and cost.

The bill has an estimated price tag of $400 billion per year. Paying for it would require new taxes and cooperation from President Donald Trump's administration to redirect existing federal money.

It would guarantee health care for all California residents and eliminate out-of-pocket costs for consumers, like copays and deductibles. The legislation was championed by the California Nurses Association and the Democratic Party's more liberal wing.
Rendon suggested the Senate draft a new version of the bill that addresses how to finance the plan and more clearly details how it would work. He also suggested the plan could be taken to voters in the form of a ballot measure. In the meantime, he said he would not advance the bill through the Assembly committee process.

"This action does not mean SB 562 is dead," Rendon said. "In fact, it leaves open the exact deep discussion and debate the senators who voted for SB 562 repeatedly said is needed."
 

Not

Banned
Jun 7, 2012
17,579
1
0
More Democrats need to pull a Trump and stop worrying about practical shit and just push stuff through and see how far you get. It's the only way to stay competitive with the Dark Forces now. It's a new era. A stupid new era, but a new one nevertheless.
 

Kevinroc

Member
Oct 24, 2014
3,094
0
0
The nurses are pissed at Rendon. And so are a lot of the left.

It's that he did this on a Friday evening that a lot of people find especially galling.
 

commedieu

Banned
Jan 10, 2009
27,354
1
0
Is it normal to expect the details like how it's going to be paid, to be in a draft or is he being a dick?

What other options did he have on the table?

How do we run him out of town, if I'm not happy with the responses?

What's next?
 

Kevinroc

Member
Oct 24, 2014
3,094
0
0
Is it normal to expect the details like how it's going to be paid, to be in a draft or is he being a dick?

What other options did he have on the table?

How do we run him out of town, if I'm not happy with the responses?

What's next?

If you live in California, call your representative in the assembly (especially if your representative is a Democrat). The nurses have also advised calling and faxing Rendon to voice your disapproval.

I also saw on twitter that people were canvassing Rendon's district. I don't know if that was only for one day or if that will happen again.
 

commedieu

Banned
Jan 10, 2009
27,354
1
0
If you live in California, call your representative in the assembly (especially if your representative is a Democrat). The nurses have also advised calling and faxing Rendon to voice your disapproval.

I also saw on twitter that people were canvassing Rendon's district. I don't know if that was only for one day or if that will happen again.

I'll do my part.
 
Sep 19, 2015
3,096
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Is it normal to expect the details like how it's going to be paid, to be in a draft or is he being a dick?

What other options did he have on the table?

How do we run him out of town, if I'm not happy with the responses?

What's next?

I'm not a politician - and I am not necessarily against single payer. My knowledge is obviously very limited in politics - but my ignorant ass would vote against this bill if it was presented to me because I don't know how much it's gonna cost, how we are paying for it, and if we are raising taxes on my constituents and, if so, how much.
 

David H Wong

Banned
May 7, 2008
1,156
0
0
www.cracked.com
I'm not a politician - and I am not necessarily against single payer. My knowledge is obviously very limited in politics - but my ignorant ass would vote against this bill if it was presented to me because I don't know how much it's gonna cost, how we are paying for it, and if we are raising taxes on my constituents and, if so, how much.

I mean, that's kind of the whole thing.
 

B-Dubs

No Scrubs
Mar 19, 2012
60,817
0
685
Is it normal to expect the details like how it's going to be paid, to be in a draft or is he being a dick?

What other options did he have on the table?

How do we run him out of town, if I'm not happy with the responses?

What's next?

I mean, I want them to succeed, but that's stuff that needs to be worked out. The bill passed the State Senate, the fact they didn't work that shit out to some degree is bonkers. It's not a draft anymore considering it's passed one house of the legislature. How the hell is it going to become a law without that stuff getting worked out? Even in the Assembly fixed it up, the State Senate would have to wind up voting on it again due to the changes.
 

water_wendi

Water is not wet!
Oct 8, 2006
19,066
0
0
Anthony Rendon. Some of his top donors for election include Abbott, AbbVie, Sanofi, McKesson, and GlaxoSmithKline. The money he takes from the healthcare industry probably has nothing to do with his decision here.
 

B-Dubs

No Scrubs
Mar 19, 2012
60,817
0
685
Anthony Rendon. Some of his top donors for election include Abbott, AbbVie, Sanofi, McKesson, and GlaxoSmithKline. The money he takes from the healthcare industry probably has nothing to do with his decision here.

I mean sure, but according to the article the bill is still lacking a lot of important details.
 

AmayaPapaya

Banned
Jul 20, 2013
692
0
0
California
I mean sure, but according to the article the bill is still lacking a lot of important details.
It's not perfectly written, but a lot of the details could be hashed out later, and a real effort by the state would go a long way in smoothing out the flaws.

Problem is, they can't make that effort and they don't want to because donors. The only way to get this passed is if California corporate democrats are dragged through the process.
 

XMonkey

lacks enthusiasm.
Jun 10, 2004
8,238
0
0
I don't see how we can fully implement this unless we can re-allocate the Federal funds we currently receive and we all know that's not happening with the GOP and Trump. I'm ok with them trying to hash out the details in the meantime so we have something more concrete by the 2018 midterms.
 

ahoyhoy

Unconfirmed Member
Mar 25, 2008
10,533
1
0
They can't risk the first state to implement single payer failing because they didn't hash out the general payment structure ahead of time. It will reflect very poorly on Democrats and will give the GOP ammo to fight other single payer efforts for the next decade.

Please get this right California.
 

gdt

Member
Oct 20, 2007
40,428
2
0
32
Pennsylvania
Isn't this a regression for every single californian currently on an employer sponsored health plan?

Nothing is hashed out yet so it might be it might not be.

But a slight regression would be worth it. And maybe "free" government run health care is better than employer sponsored healthcare....overall.
 

n0razi

Member
Nov 8, 2011
4,967
841
900
Whats sucks is that even if this is a resounding success... the GOP will never swallow their pride and follow California
 

ntropy

Member
Apr 25, 2008
3,831
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1,415
They can't risk the first state to implement single payer failing because they didn't hash out the general payment structure ahead of time. It will reflect very poorly on Democrats and will give the GOP ammo to fight other single payer efforts for the next decade.

Please get this right California.
single payer already failed in Vermont
 

superdeluxe

Member
Apr 27, 2008
5,903
0
1,050
So are people upset that rendon is being disengious when he says he wants to see a finding mechanism in place before moving forward? Or people just don't care how this is funded, they want it pushed through with no plan.

California needs to get this right before it can be pushed out to other states.
 

iamblades

Member
Mar 5, 2007
9,307
411
1,410
A payroll tax can be imposed on either the employer or the employee. So basically impose the majority of it on the employer (to replace the premiums they are paying for you) and a smaller portion of it on the employer (to replace the smaller portion of the premiums that you currently pay) and that should take the burden off individuals without hurting companies too much.

That's not how any of this works.

It doesn't matter how you split the payroll tax between the employer and the employee, it still adds to the cost of compensation for said employee.

There is no functional difference between your employer paying 10% of your salary directly to the government or paying you the 10 percent and it getting taken out of your check. It's just a dishonest way to hide the true amount of cost that taxation imposes on the individual.
 

Macho Madness

Member
Aug 18, 2007
16,553
0
1,270
States have tried to implement and failed before. If you want it, keep up the pressure. Keep them honest and make sure they're serious. Though a plan like this is better implemented at the federal level, I applaud any attempt.
 

t0va

Member
Jun 6, 2007
393
0
0
I mean, this makes total sense...I don't know why people are upset. Without funding the program ceases to exist. Are they going to raise taxes? If not, are they going to pull funds from another program to cover the costs? What about the countless other state and federal health services like Medicaid? How do they fit in? Will they be consolidated and, if so, will the law need changed to reflect this? What are the potential roadblocks?

Funding might actually be the easy part. The legal aspect of this will be unbelievably complex. Legal experts/politicians will need to debate every little detail, and many might not see eye to eye. They will need to study foreign models and fine tune it to state and federal laws.

So I really don't get why people are upset. The bill that was passed is just us Liberals patting ourselves on the back for our progressive ideals, as well as a big "Fuck You." to conservatives, which is fine as long as we appreciate the many complexities of embracing an entirely different model. Relax, we're going to get this done, Its just going to take some time. We cannot be incompetent while the rest of the country is watches.
 

kiunchbb

www.dictionary.com
Aug 6, 2009
5,793
263
1,200
The state suck at negotiating reimbursement rate with hospital at drug company. The state actually rely a lot on private insurance to determine the fair price to reimburse hospital and drug company. That's why a lot of health care program ran only by government got rip off.

A more recent example I can think of is Adult Day Health Care Center (healthy elderly go there for free lunch, exercise, check up, and socialize with no nurse or doctor for 4 to 5 hours), those guys were billing the states nearly as high as Long Term Care facility that requires 24 hours nursing per day.

For small care facility that bill the state for taking care of the limited able, the state will reimburse the operation expense and salary. So the whole family will get into the business, the mother will be a nurse that get pay $200k per year, the son is IT that get pay $90k, daughter the accountant for 80k, father is the manager, etc. etc (none of them are ever at the site except for the caretaker that got paid minimum wage). They will buy luxurious SUV to take residences to doctor check up/park, renting property that had higher invoice value that what is being paid, Iphone for business use, laptop, etc etc.

Let's not even talk about the clinic run by local government, the depressing thing is they are not even trying to scam the State, they are just that expensive.

This is just one or two example that I can disclose without getting in trouble, imagine this covering every single Californian. Private insurance have more incentive to decrease cost for profit. Government on the other hand will just increase your taxes or shut down all your parks. I have no idea how single payer is working so well for other countries, may be they have a really well funded auditing department?
 

Future

Member
Aug 5, 2004
9,452
151
1,305
lol at this passing with no plan on how to pay for it.

Next at 11: senate passes bill to provide McMansions to all California residents
 

B-Dubs

No Scrubs
Mar 19, 2012
60,817
0
685
single payer already failed in Vermont

That's because they couldn't find the money for it. Outside of California and New York none of the states looking at single payer would be able to pay for it, which is why it's so important that it's flawless when both states implement it.

I mean, this makes total sense...I don't know why people are upset. Without funding the program ceases to exist. Are they going to raise taxes? If not, are they going to pull funds from another program to cover the costs? What about the countless other state and federal health services like Medicaid? How do they fit in? Will they be consolidated and, if so, will the law need changed to reflect this? What are the potential roadblocks?

Funding might actually be the easy part. The legal aspect of this will be unbelievably complex. Legal experts/politicians will need to debate every little detail, and many might not see eye to eye. They will need to study foreign models and fine tune it to state and federal laws.

So I really don't get why people are upset. The bill that was passed is just us Liberals patting ourselves on the back for our progressive ideals, as well as a big "Fuck You." to conservatives, which is fine as long as we appreciate the many complexities of embracing an entirely different model. Relax, we're going to get this done, Its just going to take some time. We cannot be incompetent while the rest of the country is watches.

Exactly. We've got two shots to show the rest of the country that this works and we can't waste either one. First impressions will be everything here.
 

cpp_is_king

Member
Mar 1, 2011
16,816
105
590
That's because they couldn't find the money for it. Outside of California and New York none of the states looking at single payer would be able to pay for it.

You think California can pay for it? The state that has more debt than any other state, spends uncontrollably, and can't even handle its existing financial obligations?

which is why it's so important that when both states implement it that it's flawless

I mean, presumably in order for it to be "flawless" you would have to have some idea of how you would pay for it, right? Which they don't. Which ties into my first point, about how it's no wonder they are in so much debt when they just willy nilly do whatever they want without ever thinking about how to pay for anything
 
Oct 7, 2009
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You think California can pay for it? The state that has more debt than any other state, spends uncontrollably, and can't even handle its existing financial obligations?

Citation needed.

Edit- it looks like the debt statement is true, but I don't see much evidence that it spends uncontrollably or can't handle it's existing financial obligations.
 

GameAddict411

Member
Aug 4, 2013
5,494
0
0
They say established residency. What does that even mean for people on non immigrant status such as international students?
 

AmayaPapaya

Banned
Jul 20, 2013
692
0
0
California
The point of the bill was to get the ball rolling. Bills are often not feature complete, and obviously, if they are not specific about how it will be payed for, it's gonna have to be hashed out later. A bill that states California is moving to single payer is great because it's going to force the state to figure it out. Which it can. Most countries have single payer, and it is cheaper than what we have, not more expensive.

Discussion about regulating drug prices and closing tax loop holes would start to form, and the state would be better off for it. Make no mistake, if the bill was feature complete, Democrats would just find another way to close it down. All of a sudden, you get the Diane Feinstein's of the world complaining about the jobs in health insurance being lost, or they bring up how raising taxes is not the answer (even though it could just be about closing loop holes) etc etc...Passing the bill without specifics may have been the only way to actually pass it. As soon as you do get into details, donors and the lot all start to complain, and it may never pass. However, the discussion on how to pay for it changes rapidly when the state has to figure out how the hell it's gonna pay for everyone's health care in a year or whatever the guidelines are. You are never going to get discussion about regulating drug prices or closing tax loop holes to pay for health care before they are forced to figure it out.

The key is to look at who they are taking money from, and you will get what their answer is. No guy is going to betray the people who makes his election possible. It's just not going to happen.

I get people are uneasy about it, but just understand they are not stopping it because they are afraid it can't be figure out. They're stopping it because some guy who depends on the insurance industry is giving them money.
 

Kevinroc

Member
Oct 24, 2014
3,094
0
0
Anthony Rendon. Some of his top donors for election include Abbott, AbbVie, Sanofi, McKesson, and GlaxoSmithKline. The money he takes from the healthcare industry probably has nothing to do with his decision here.

This is why a lot of people think he's being disingenuous. It's not a good look even if he isn't disingenuous.