Senate passes 'Medicare for all', 59% of voters approve

[Genx87]

Not quite true. http://www.socialsecurity.gov/history/tally.html

Damn facts biting Craig in the ass again.

 

[EagleKeeper]

1) They are proposing something - GOOD
2) They are defering on how to pay for it - BAD
3) The government will be controlling/coordinating it - Questionable

CA is already having budget problems. They have used smoke and mirrors for a couple of years - eventually they will run out of options.

Even if they raise taxes; will the people tolerate it?

If one has a decent plan through the employer that costs them $250/month (as example) they will question why they need to pay an additional $200/month for something that they will not use?

You will have people that are not contributing to the tax roles that are using the benefits - that will force others to take on the load. And those that take on the load will now be paying triple (their original coverage costs, the proportional added costs for the new system and the proportional added costs of those that are not paying in to the system).


If it is for all; does that mean anyone inside CA borders?
Will the coverage be accepted out of state?

Much more details are needed to form an positive opinion. At present, it seems to be a lemon - looks good; but underneath - it may not be what it seems.

 

[BoberFett]

I'm glad to let California do this. The article at once states that this type of system costs half while creating 2.6 million jobs. That's a nice trick.

Anyway, let them be the guinea pigs.

You've seen Jay Walking, haven't you? Californians truly are stupid and would believe that kind of math.

 

[RyanPaulShaffer]

No, you misrepresent what I said.

I reported they passed it. I like the goal. I think it's likely they addressed this.

You are being an offensive person yourself - slanderous.

Back off of your error.

No, the problem is that they passed this massive program without resolving the fundamentally vital issue, which is "how do we pay for this beast?"

If you can't see that, I don't know what to tell you. It should have never even gotten to the voting state until this critical problem was solved. Them voting on it before they know how the heck they will pay for all of it is actually much, much worse than doing nothing.

 

[WHAMPOM]

All I can say is right now, I wish my state had a "Medicare for All"...funny how major life events can change your perspective.

The problem with the "Medicare for All", of course, is that anything the government touches always ends up being completely inefficient and grossly over budget. Such is our conundrum.

Oh, and you can't keep increasing spending while cutting taxes. That doesn't really work out. IOUSA is a pretty decent documentary that shows how our spending problem is out of control, and both parties are at fault.

Craig, I can't believe I'm saying this, but I agree with you. I wish my state had "Medicare for All", and that the public option was back on the table. However, the massive costs that such programs would incur need to be sufficiently addressed before any such plan is considered. I have the sneaking suspicion that they are not...which is the big problem.

You dear misinformed boy, other countries spend half what the US does per person, cover everyone and provide better care. But there, Corporate Interest does not trod Public Good into the mud like the US does.

 

[Jaskalas]

This is great.

Hope it pisses off every Republican in California so bad that they not only leave California but leave the country since they are already in moving mode.

I hope you're in CA when it sinks.

 

[Craig234]

No, the problem is that they passed this massive program without resolving the fundamentally vital issue, which is "how do we pay for this beast?"

If you can't see that, I don't know what to tell you. It should have never even gotten to the voting state until this critical problem was solved. Them voting on it before they know how the heck they will pay for all of it is actually much, much worse than doing nothing.

How do you know what they did? Did you follow the legislative hearings?

 

[woolfe9999]

I'm glad to let California do this. The article at once states that this type of system costs half while creating 2.6 million jobs. That's a nice trick.

Anyway, let them be the guinea pigs.

While this is good from a national perspective because we get to use Cal as a laboratory for single power, I am skeptical that single payer can achieve anything like the quoted savings when done on a statewide, as opposed to a national, level. Accordingly, we may not be able to properly generalize from an experiment here in Cal to what single payor would achieve if done nationally.

- wolf

 

[PokerGuy]

Fair question; my guess based on the history of them is they have answered them better than you suspect.

But neither of us can answer them until doing the research.

Based on their history you think they've answered the question on how to pay for this stuff? LOL again :biggrin: You do realize they are 20 billion in the hole, right? The only history they have is deficit spending.

 

[JS80]

unicorns and rainbows for all!!!!!!!!!

 

[Craig234]

Based on their history you think they've answered the question on how to pay for this stuff? LOL again :biggrin: You do realize they are 20 billion in the hole, right? The only history they have is deficit spending.

You haven't read any of the discussions on this? You don't have a clue of the role of prop 13, of the Republicans, who like children cut their thumbs and put their blood on a statement in crayon saying no new taxes no matter what, can block any taxes to pay the deficit down with a 1/3 minority? THe bad economy? Other factors? It's not that they say darn, we knew we forgot something, paying the bills.

You sound like yuou're spouting ideology to make up the reasons for the big deficit (and by the way, we have a constitutional requirment for a balanced budget).

 

[Doc Savage Fan]

Will it be the republicans fault if this program does not work out well?

Of course...and don't forget the corporatist Democrats as well.

 

[RyanPaulShaffer]

How do you know what they did? Did you follow the legislative hearings?

You said that you have no idea how they're going to pay for it!

Fair question; my guess based on the history of them is they have answered them better than you suspect.

But neither of us can answer them until doing the research.

A guess <> cold, hard facts!

Good grief man, if you put the harsh ideology down, you'd actually make some salient points.

Do YOU know how they are going to pay for it? No? Then why are you blindly supporting it?

"my guess based on the history of them is they have answered them better than you suspect."

What history? The ~$20 billion budget deficit California is suffering from?!

 

[Craig234]

Of course...and don't forget the corporatist Democrats as well.

It's always fun to try to figure out where the idiots get all that straw.

 

[EagleKeeper]

Referring to opposition arguments about supposed ballooning costs under the bill, Sen. Leno pointed out that a single payer system would simply redirect current spending on healthcare, away from insurance overhead and towards a more direct and efficient way of providing care.

They want to direct it from insurance overhead. Government overhead instead.

Additionally the bill would not go into effect immediately; the current SB 810 creates a system to propose revenue streams that would then go back to the legislature for final review.

They do not have a way to pay for it yet. If they can not pay for it; what happens?
Presently, they can not pay their current bills - yet they want to undertake a massive undertaking.

 

[Jaskalas]

I think it's good to have experiments like CA. It'll either be a lessen of how to succeed or how to fail.

 

[PokerGuy]

You haven't read any of the discussions on this? You don't have a clue of the role of prop 13, of the Republicans, who like children cut their thumbs and put their blood on a statement in crayon saying no new taxes no matter what, can block any taxes to pay the deficit down with a 1/3 minority? THe bad economy? Other factors? It's not that they say darn, we knew we forgot something, paying the bills.

You sound like yuou're spouting ideology to make up the reasons for the big deficit (and by the way, we have a constitutional requirment for a balanced budget).

Yes, I've seen all the BS about prop 13 etc. Bottom line: huge deficit, which means they spend more than they bring in. Saying they have a history of figuring out how to pay for stuff before implementing is ridiculous, clearly they do not.

 

[PokerGuy]

They want to direct it from insurance overhead. Government overhead instead.


They do not have a way to pay for it yet. If they can not pay for it; what happens?
Presently, they can not pay their current bills - yet they want to undertake a massive undertaking.

Yeah, and we have so many examples of how efficient the government is at running large programs, I'm confident they'll have almost no overhead and it will be streamlined. Heck, I'd love to have my health in the hands of the same kind of people I encounter at the DMV, the post office, the TSA and the like.

 

[Hayabusa Rider]

While this is good from a national perspective because we get to use Cal as a laboratory for single power, I am skeptical that single payer can achieve anything like the quoted savings when done on a statewide, as opposed to a national, level. Accordingly, we may not be able to properly generalize from an experiment here in Cal to what single payor would achieve if done nationally.

- wolf

California plans to do everything a nation would, like negotiate drug prices. They would be a fair sized European nation too. This is about as fair an experiment as can be. If it passes or fails, it won't be because it's not big enough.

 

[RyanPaulShaffer]

California plans to do everything a nation would, like negotiate drug prices. They would be a fair sized European nation too. This is about as fair an experiment as can be. If it passes or fails, it won't be because it's not big enough.

http://en.wikipedia.org/wiki/California#Economy

"As of 2007, the gross state product (GSP) is about $1.812 trillion, the largest in the United States. California is responsible for 13 percent of the United States gross domestic product (GDP). As of 2006, California's GDP is larger than all but eight countries in the world (all but eleven countries by Purchasing Power Parity). However, California is facing a $26.3 billion budget deficit for the 2009&#8211;2010 budget year.[41] While the legislative bodies had appeared to address the problem in 2008 with the three-month delayed passage of a budget they in fact only postponed the deficit to 2009 and due to the late 2008 decline in the economy and the credit crisis the problem became urgent in November 2008. One problem is that a substantial portion of the state income comes from income taxes on a small proportion of wealthy citizens. For example, in 2004, the richest 3&#37; of state taxpayers paid approximately 60% of all state taxes.[42] The taxable income of this population is highly dependent upon capital gains, which has been severely impacted by the stock market declines of this period. The governor has proposed a combination of extensive program cuts and tax increases to address this problem, but owing to longstanding problems in the legislature these proposals are likely to be difficult to pass as legislation.

State spending increased from $56 billion in 1998 to $131 billion in 2008, and the state was facing a budget deficit of $40 billion in 2008.[43]"

Forget "fair-sized European nation"...if California truly was the People's Republic of California, it would be one of the biggest nations in the world.

Look at the spending at the end...ouch.

What is happening in California is a good testbed for what would happen to the rest of the nation if we all adopted California policies, since California is so huge.

 

[Craig234]

Yes, I've seen all the BS about prop 13 etc. Bottom line: huge deficit, which means they spend more than they bring in. Saying they have a history of figuring out how to pay for stuff before implementing is ridiculous, clearly they do not.

Darn, you didn't fall for it. There's no such thing as prop 13, it's BS.

 

[Hayabusa Rider]

You dear misinformed boy, other countries spend half what the US does per person, cover everyone and provide better care. But there, Corporate Interest does not trod Public Good into the mud like the US does.

That's an awesome statement.


Can you show us some facts as to precisely (not saying "profit profit") why there is the cost difference. Statistics please.

Start with 2.2 trillion dollars and divide that in half. Tell us where that 1.1 trillion evaporates.

No, "profit profit profit" won't work. Show us Corporate Interest stashes it.

Good luck.

 

[Hayabusa Rider]

Well looking through the bill, one thing is clear. The most powerful person in CA will be the Commissioner. He or she will be in charge of everyone's lives, as he has the authority to run medicine.

Good luck CA.

 

[woolfe9999]

California plans to do everything a nation would, like negotiate drug prices. They would be a fair sized European nation too. This is about as fair an experiment as can be. If it passes or fails, it won't be because it's not big enough.

It isn't the size that is concerning. Single payor can work in a country with 3 million people or 300 million. The trouble is you need to have only one payor in the entire system to realize the admin savings. Does this mean we are going to can the state Medicaid program and fold everyone into a state system? Not feasible, because the federal government pays for half of that program and we can't afford to lose those federal dollars. And if we don't can it, we end up with two payors, which means an itemized billing system. Getting rid of itemized billing is where the real cost savings are.

Also, I don't want them trying to realize additional cost savings by doing things like lowering doctor's salaries. I have a friend who moved to Canada from the U.S. two years ago, and he raves about the healthcare system there, but even he admits that they do get some "brain drain" as good Canadian doctors will often relocate to the U.S. because they can make a lot more money here. I don't want to see a brain drain of doctors moving out of California to other states, which would actually be less of an uprooting (and no immigration restrictions) than moving from one country to another and therefore easier and even more probable. If we did this nationally, we probably wouldn't see a big brain drain, because other developed countries already have lower doctor salaries than we do.

Single payor is a great idea, but it has to be done correctly. Which generally means you don't go for the maximum cost savings possible because the tradeoffs are unacceptable. It remains to be seen if California can get this right.

- wolf

 

[Hayabusa Rider]

It isn't the size that is concerning. Single payor can work in a country with 3 million people or 300 million. The trouble is you need to have only one payor in the entire system to realize the admin savings. Does this mean we are going to can the state Medicaid program and fold everyone into a state system? Not feasible, because the federal government pays for half of that program and we can't afford to lose those federal dollars. And if we don't can it, we end up with two payors, which means an itemized billing system. Getting rid of itemized billing is where the real cost savings are.

Also, I don't want them trying to realize additional cost savings by doing things like lowering doctor's salaries. I have a friend who moved to Canada from the U.S. two years ago, and he raves about the healthcare system there, but even he admits that they do get some "brain drain" as good Canadian doctors will often relocate to the U.S. because they can make a lot more money here. I don't want to see a brain drain of doctors moving out of California to other states, which would actually be less of an uprooting (and no immigration restrictions) than moving from one country to another and therefore easier and even more probable. If we did this nationally, we probably wouldn't see a big brain drain, because other developed countries already have lower doctor salaries than we do.

Single payor is a great idea, but it has to be done correctly. Which generally means you don't go for the maximum cost savings possible because the tradeoffs are unacceptable. It remains to be seen if California can get this right.

- wolf

If physician salaries are significantly lowered, why spend a significant portion of your life not earning income and acquiring debt, assuming huge responsibilities, getting little thanks (indeed much scorn from some) when you are smart enough to do something else? Because one is a martyr?

You'll have less incentive, loss of control, less income and fewer going into health care meaning longer hours.

That's what's being asked for, and CA can have it. If the US adopts that same stance, it can keep people hostage with no where to go, but they'll either have to lower standards to get more people in, or accept fewer workers.

What you are saying is that the system will invoke hardship on people and if they can escape it they will.

No, CA wants single payer and they are welcome to try it. Extending it to all 50 states won't fix many problems. It will just create new ones.

The fallacy about government run medicine comes when comparing it to socialist nations where the government controls most aspects of industry and society. It's Craig's utopia. Well here, our system is not the same and therefore it's an attempt to graft a socialistic nations way of doing things into a capitalistic system (granted that socialist and capitalist is relative).

Besides, CA seems to disagree with you. It feels that your concerns aren't relevant, not that it really cares what we think.

This is entirely on them, win or lose.