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.
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.
A lot of people who would like to retire before 65 are delaying their retirement only because they can’t afford health insurance without their job. A single payer plan could create a huge number of jobs as an additional benefit, when large numbers of people feel secure in the ability to retire early.
Seems like the CA Assembly isn’t as sanguine as the author. Quoting from the Sacramento Bee:
"Assembly Speaker Anthony Rendon put the brakes on a sweeping plan to overhaul the state health care system Friday, calling the bill “woefully incomplete.”
Rendon announced plans to park the bill in Assembly Rules “until further notice” and give senators time to fill in holes that the bill does not currently address. Senators Ricardo Lara and Toni Atkins, who introduced the proposal, described the bill as a work in progress when it passed out of the Senate earlier this month without a funding plan.
“Even senators who voted for SB 562 noted there are potentially fatal flaws in the bill, including the fact it does not address many serious issues, such as financing, delivery of care, cost controls, or the realities of needed action by the Trump Administration and voters to make SB 562 a genuine piece of legislation,” Rendon said"
Guess the bill isn’t all it’s cracked up to be.
The Health-Care bill written by the GOP is a horrible disaster.
(I supported the GOP until they recklessly put togather their so called health-care bill that supports putting corporate greed before the health and safety of the American people.)
This bill strips health-care from millions of people and puts an end to health-care for people with pre existing conditions.
I support and DEMAND single-payer Health-care for everyone.
HEALTH-CARE IS A RIGHT, NOT A PRIVILEGE
I will not vote for any lawmaker IN ANY PARTY who will be running in any future election who voted for this monstrosity bill.
I will continue to make donations to organizations dedicated to unseating any of these politicians who obviously only care about putting corporate greed over the health and safety of the American People.
Health care is not a “right”. Anything that someone else has to give you is _not _a right. __
I think there’s a solution to that issue of whether the Federal Government continues to contribute along the lines of current estimates to California (i.e. in the neighborhood of $200 to $225 billion):
I suggest creating a progressive “Federal Cutback Tax” on incomes in the top 10% that is set at a rate to make up for any difference between current and future Federal heath care contributions to California. If the Feds cut back more, the taxes on the rich go up more. If the Feds continue paying California their share, the tax is not activated. Most importantly it should be clearly labelled as a Federal Cutback Tax on every tax bill and the California Treasurer should provide an accounting to those taxpayers affected of how the Feds have cut back and caused their taxes to go up.
The people that generally love Rand? Conservatives and Libertarians.
Guess everyone else just didn’t accept the Me, Myself, and I philosophy of Objectivism, and the “screw everybody else” ideology, including the 45% of Medicaid recipients that are children, and it serves 1/5 of all Americans.
So essentially the Aynn-Rand-Sycophants-for DJT’s-Love-GOP wants to screw kids of 1/5 of the American public. That’s what I call “rape,” but on a really massive scale.
The 2 following books, Orwell’s 1984 and Atwood’s_The Handmaid’s Tale__ are more read than ever since Jan. 2017 because of parallels to the authoritarianism, alternative facts (aka lies) scandal, prejudice, hate mongering, more perpetual war (which if we stopped those trillions being thrown away to billionaires we could pay for every bit of healthcare and education we all would need.)
Is “national security” not about the health and education of the nation? Or is it only achieved by bombing brown innocent civilians in the Middle East and beyond?
“Earlier this year, sales of Nineteen Eighty-Four surged (and the novel became an Amazon bestseller) after Trump’s advisor Kellyanne Conway used the Orwellian term “alternative facts” in an interview. Meanwhile, Margaret Atwood’s dystopian novel The Handmaid’s Tale (1985), a novel that was written as a direct response to Orwell’s influential text, has similarly seen a dramatic boost in sales since the Trump administration came to power.”
BTW, this source is not MSM, or liberal or conservative, but a site merely for writers, about writing.
Not a bad idea, but I fear that we’d just see rich folks list their residencies in other states to avoid it. Either way, worth looking at.
The whole idea of rich flight from high taxes in the United States is a complete right wing fabrication that they attempt to back up with a few anecdotes. The real data say that just isn’t true. Have a look at the number of millionaires per 100,000 people across states. This type of data comes out every year. For example, here’s an interactive map from 2014:
Knowing that millionaires can basically live where they choose, you’ll see that they generally choose to live in high tax areas with high levels of public services.
I am very aware of that data, especially here in California where am radio constantly goes on about businesses leaving for Nevada. It’s just not true. That said, I wouldn’t mind seeing some modeling of this idea before making assumptions about it either. We have a very progressive income tax here in California and it’d be something worth examining adding more on top.
On a personal level though, I am not against the payroll tax being discussed. In the spirit of FDR’s famous line on it, in terms of politics, it ensures everyone has “buy-in” into the system. I think a successful single payer system is going to need that, at least to some degree, and the stability the tax would bring.
I can only speak to it on an anecdotal level. I work with a double handful of companies in CA. Of those, I know three that have made all their expansion outside of CA - in TX, NV, and off shore. I know two that have specifically expanded their Bay Area operations, because they can most easily find the people they want there. The others are a mixed bag - most of their expansion is outside CA, but there is some in CA. I also know one company that explicitly move their HQ out of CA so that the executives are not subject to CA taxes.
On that basis, I’d have to say that the tax rates have some impact, It may be more opportunity cost than a drop in revenue for the state, but at least some percentage of high earners will vote with their feet.