"Doable" but not profitable enough for the medical extortion complex ((MEC).
Oh, how I wish I still lived in West Hollywood. This is amazing and mar-
velous. Go, California! To hell w/Trump & the godawful, power-hungry, money-
"These savings are in addition to the benefits that the residents of California will gain through universal access to healthcare."
Wished Mr. Pollin had expanded that thought into at least three or four sentences to emphasize the win-win that could be. To go along with his concise and effective economic discussion.
The numbers he and colleagues offer sound reasonable; not too large, but not insignificant either. Especially so when added to the mental relief of the entire population of California. The uncertainty and tension being caused by this one national issue, could very well be purposeful, by a scurrilous industry and a vengeful political party. Calculating that a desperate and high-anxiety nation will acccept anything, no matter how toxic, just so this confrontation goes away.
California is courting a young and hopeful partner, and the national GOP is pimping a wrinkled and stingy service kept in circulation with joint implants, pills, and Depends.
I'm sincerely hoping there are enough serious and dedicated Cal representatives to do this right, and get it done. The pressure/resources from the opposition will be massive. Hope all of Cal can defiantly say "No, we won't be intimidated or fear-mongered this time."
California needs to add single payer to its a "WWII style mobilization" to deal with climate change, addressed in another CD article.. Starting a 12 step program for corporate money addicted politicians whose only skills are pushing fear and greed buttons, and winning hearts and minds of the electorate will be key.
The D-party pragmatist establishment commenters should be along soon, broadcasting their 'can't do' attitude.
Here's the problem with Single Payer developed state-by-state. What happens when the federal government threatens to withdraw its funding, which provides about 2/3 of the dollars? Litigation will tie up Single Payer for decades unless the state just rolls over,
State-by-state Single Payer will require full state funding financed by massive tax increases on the rich and corporations. While Caly has an economy strong enough to do this, does it have the political will? And the vast majority of states just don't have strong enough economies to even ask these questions.
The U.S. is not Canada, constitutionally or culturally. It's gonna be federal Single Payer for All or the shit we now have. Or even worse shit.
I'd predict worse. The R-Party might damn well pass this, it rolls out slowly, many Americans--otherwise known as frogs on slow-boil--will be too busy hating immigrants to notice their coverage ebbing away.
About half of California's single payer funds rely on federal moneys. Once the Republicans kill Medicaid expansion and block grant the rest of Medicaid, single payer is dead in California. The discussion has centered on a 15% payroll tax increase for funding right now, there's no way in hell doubling that's even close to passable via popular ballot. Mitch McConnell knows what he's doing, sadly.
That's why I advocate for a federal program, and for politicians with the guts to put it on the table.
Also, just a reminder to everyone reading this: Trump and the R-Party--in power across the board--ran precisely and unapologetically on repealing and replacing ObamaCare. Now, with far smaller numbers than the D-Party had when they passed ObamaCare, they'll run roughshod over the whole thing.
I mention this to compare a party who keeps promises and wields power without qualms, to a party who's chief mission is to offend no one.
I think a federal program is the best way too. If California finds a way to pull it off, I'm not saying no though.
Assume California uses Medicaid as the "base" and the state pays the entire cost. Medicaid in California (including seniors in nursing homes) about $5000 a year per capita. So covering the 40 million that now live in California would cost about $200 billion. States license medical providers so the state really has a lot of power. Ditto with insurance companies. As far as I know, states can "replace" MD's with nurse practitioners and physician assistants. Both of whom have the legal right to write prescriptions. So primary care coverage isn't a problem.
The thing is, California is limited on its power to control drug prices and nobody thinks the state is going to get better than market rate for doctors. If physician assistants replace doctors as the go-to care providers, they are going to want comparable market rates as well. Moreover, if Medicaid gets slashed, there goes a big portion of the money the legislature is counting on for coverage. The discussion is a 15% payroll tax at the moment with federal funding as it is currently. What will it be after Medicaid cuts kick in?
Not trying to be a downer here, but the Republican healthcare bill is going to make things more difficult, not less. I am very happy to be wrong though.
Atlas Shrugged WAS a warning - a warning that an appalling, cold-hearted and hypocritical bitch named Ayn Rand could write absolute drivel that would be spread by right-wing apologist assholes like mcsandberg.
"There are two books that can change a bookish 14 year old's life - "The Lord of the Rings" and "Atlas Shrugged". One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs."
Also, remember that idiots like mcsandberg who push the crap of Ayn Rand conveniently forget to tell you that Rand was a big supporter of a serial killer named Hickman. She thought of him as some kind of superior man because he was so outside the moral order of the little people that she liked to call "takers" and "parasites". This is part of the foundation of "thought" that is championed by these assholes.
This is part of the political will that I'm talking about. The kind of restructuring that you describe makes alot of sense. And there are many other things that can lower real medical costs. And Single Payer itself saves billions in administration, does not require marketing, etc. California certainly has (or can raise) the money to do this independent of the feds. But all of this will require state-mandated structural (and cultural) changes. Increasing taxes on the rich will be required and many people and institutions that have been ripping off the system will be forced to give up their scams. There is more than economics involved here.
You're not trying to be a downer here but that's your job. You are here in every single payer health care discussion to try to convince us that single payer is just too difficult so we might as well quit trying.
The problem with your argument is the entire rest of the developed world have figured our how to remove profit from their heath care systems resulting in greater efficiency and equal or greater results.
Because the Senate healthcare bill is going to make things easier? Here's a better breakdown of why it will make it harder to do for California:
When you've got an answer for that, let me know. Otherwise, I've called my Senators already and protested locally to stop this stupid bill so California has a chance to maybe make single payer work.
I hate to say this as a California resident who is pro single payer, but I also anticipate if we can enact this change that a significant number of very sick under or non-insured people will come from other states to live here (maybe not in the most expensive locales, but when medical costs are trumping rent costs it's the logical move). We should have estimates of this number in our plans to make sure the numbers still work out.
I saw the author's study linked here in another article weeks ago, and I was quite happy to see serious research into funding mechanisms that don't involve the payroll tax which has got to be the stupidest idea for funding that I've heard so far (when Josh Barrow of Left Right Center made the payroll tax comment last week and Katrina didn't push back, I cringed). In fact, I'd like to eliminate the payroll tax altogether (as would many Republicans). Why would you want to disincentivize a company to hire a worker? It's like we can't shed the concept that health insurance is tied to your job.
It's because a payroll tax, say15% split between employer and employee, is a relatively stable and less complicated funding mechanism than other proposals. The thing is, and as I indicate above, it's likely moot anyway if the AHCA passes since that 15% number is based federal funding as it is currently. That 15% was going to be a lift, it's tough to see anything going forward if that number goes up more. But maybe the backlash to the Republican plan to cut taxes for massively wealthy people will face some backlash.
Ayn Rand was a sociopath without empathy or any normal human feelings. This hypocrite signed up for Social Security and Medicare in her declining years. Randites and libertarians are the worst scourge on this earth. They believe in social Darwinism and corporate supremacy. They are useful tools for the plutocrats and oligarchs. F$$$ the Randians and libertarians.