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Author Topic: California’s single-payer plan costs $400 billion — twice state’s entire budget  (Read 14106 times)

Mackin USA

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #15 on: May 24, 2017, 12:22:53 PM »
As funded levels have declined and overall fiscal pressure for states has increased in recent years, many
states have implemented some level of pension reforms in response. The majority of these changes 
have been mandated increases or implementation of employee contributions, changes to formula calcula-
tions, and extending vesting periods. The details of these changes and the projected impact on the 
state’s liability, if available, will be addressed in the upcoming pension reports for the applicable states.
Pension reforms continue in the latter portion of calendar year 2012, including two of the most 
populous states with sizeable liabilities: California and Ohio.

http://media.navigatored.com/documents/StateofStatePensionsReport.pdf

INTERESTING GRAPHS
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Mr. Mackin

rcjordan

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #16 on: May 24, 2017, 12:41:43 PM »
Quote
The flood insurance program was originally intended to be self sustaining — funded through policyholder premiums, not taxpayer dollars — and for much of its history, it was. But the catastrophic hurricanes Katrina in 2005 and Sandy in 2012 caused so much damage that the program could not pay for it all. After Hurricane Katrina, Congress increased FEMA’s borrowing authority from $2 billion to more than $20 billion. They increased it again, to $30 billion, after Hurricane Sandy. The program’s debt to the U.S. Treasury is now $23 billion.

In recent years, FEMA has been accused of inadequately supervising that money, as well as the private insurance companies that dispense it.

http://www.pbs.org/wgbh/frontline/article/can-femas-flood-insurance-program-afford-another-disaster/

I rest my case.
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littleman

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #17 on: May 24, 2017, 05:02:40 PM »
I've been looking for verification on the current cost of insurance premiums in California.  That $100-$150 billion seems low to me.  I would be interested in knowing what the total out of pocket and employer contributions are currently in California.

I do agree that a co-pay would be a good idea, even if it were a small one, say $25, or variable depending on income.  This would help eliminate frivolous doctor visits.
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Mackin USA

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #18 on: May 25, 2017, 10:21:41 AM »
"A sweeping measure that would establish government-run universal healthcare in California cleared its first legislative hurdle Wednesday as scores A of supporters crammed into the Capitol to advocate for a single-payer system. The Senate Health Committee approved the measure on a 5-2 vote after a nearly three-hour hearing, but Democrats and Republicans alike signaled unease with the major question still unanswered in the legislation: how the program would be paid for. The bill, SB 562, would establish a publicly run healthcare plan that would cover everyone living in California, including those without legal immigration status. The proposal would drastically reduce the role of insurance companies: The state would pay for all medical expenses, including inpatient, outpatient, emergency services, dental, vision, mental health and nursing home care. The measure says the program would be funded by "broad-based revenue," but does not specify where that money would come from."

https://townhall.com/tipsheet/guybenson/2017/05/23/surprise-californias-singlepayer-healthcare-plan-would-cost-400-billionper-year-n2330456
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littleman

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #19 on: May 25, 2017, 05:18:58 PM »
Universal health care is no doubt very expensive.  In contrast, if AHCA goes through it looks like $330 billion would be reduced from the deficit in the next decade.  I've also read that 23 million people will lose health insurance and 50 thousand people will die annually.  So, that's 500 thousand lives for $330 billion dollars.  Or, $660,000 a life.


The F-35 program is projected to cost $1.5 trillion.  So that's the equivalent of 2,272,727 lives in taxes, but it sure is a sexy plane.
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ergophobe

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #20 on: May 25, 2017, 08:15:20 PM »
And thus my despairing comment at the beginning ("Oh my people.")

People are very poor at evaluating risk. If a mountain lion is loose in the city, it's a 911 situation. Get the SWAT teams out and take it out. Entire city blocks go into a lockdown. During which time, two people will die on the highways.

There are enough people who believe that the US military has become weak that you can build will for the F-35, but not for health insurance. Forget that by most accounts the largest three air forces in the world are all US (USAF, USN, and US Army). Some people say that the next three are the Marine Corp, the Air National Guard and the Air Force Reserve. We must protect the nation.

I remember when that plane crashed off Long Island and they had to pull the parts up from deep water at a some huge cost, like $125,000,000 for a projected savings of a couple of lives per decade. When asked if it was too expensive, the investigator said no, "Are you prepared to make that decision to let people die to save that money?"

Of course, littleman would say "Yes, that's 189 lives I can save if I spend that money on health insurance," and I would agree, but as my wife is always reminding me when I got on that particular broken record, people only pay attention to "interesting" ways to die.

Oh my people!

[BTW, "Oh my people!" is a refrain in Billy Lynn's Long Halftime Walk, an absolutely brilliant and funny book]
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Mackin USA

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #21 on: May 26, 2017, 10:35:07 AM »
"if AHCA goes through it looks like $330 billion would be reduced from the deficit in the next decade.  I've also read that 23 million people will lose health insurance and 50 thousand people will die annually."

That piece of $HIT is not doing anywhere.

The Senate will start over and something DIFFERENT will pass or Obamacare will implode and...
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Mr. Mackin

rcjordan

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #22 on: May 26, 2017, 10:49:45 AM »
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Brad

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #23 on: May 26, 2017, 12:02:24 PM »
I remember seeing charts showing how the cost of healthcare started rising with the start of Medicare.  Seems to me we can't give any industry a direct feed into the US Treasury without it running wild over time.  Medicare has to be able to control costs and use its buying power to negotiate lower prices.  The VA can and does do this, but Medicare can't and the power for it to do so was removed from past legislation at the behest of the medical lobbyists.

All I can say is that the system was broken before ObamaCare.  Obamacare is flawed in large part because it does not contain costs.  The proposed "replacement" for Obamacare sounds worse, IMHO, and in the meantime the middle class, the people that provide the stability and backbone for the nation, are finding it more and more difficult to pay for the most basic medical needs and that inability to pay keeps spreading higher up the food chain.
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Mackin USA

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #24 on: May 26, 2017, 12:05:35 PM »
"any industry a direct feed into the US Treasury without it running wild over time."

Take higher EDUCATION as an example  >:(
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Mr. Mackin

ergophobe

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #25 on: May 26, 2017, 04:58:46 PM »
Part of the inability to constrain costs in govt healthcare in the US is

1. medical/insurance lobbyists who got the laws crafted in such a way that the govt was not allowed to negotiate (basically Brad's point)

2. completely disconnecting those who receive services from the actual cost of those services

3. a complete unwillingness to recognize that as a society we are always rationing healthcare. The question is whether to do it based on ability to pay or based on projected outcomes. This is a main reason why US healthcare is so expensive. If you have the money, you can get prohibitively expensive care to add 6mos to a year to your life, while someone of lesser means is unable to access care that would add decades. This both drives costs up and life expectancy down, which is why we have the highest cost system and some of the worse outcomes on a population level.

Without dealing with those three things, the rest is window dressing and costs will never be contained in my opinion. Without dealing with those issues, you can't "tech" your way out of it.
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grnidone

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #26 on: May 26, 2017, 06:00:44 PM »
Quote
Medicare has to be able to control costs and use its buying power to negotiate lower prices.  The VA can and does do this, but Medicare can't and the power for it to do so was removed from past legislation at the behest of the medical lobbyists.

BAM.  If there is only one change in our health system, this one would be the one that would do the most good.
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grnidone

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #27 on: May 26, 2017, 06:16:48 PM »
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>2. completely disconnecting those who receive services from the actual cost of those services

Exactly.  Republicans tell us that a free economy system will help contain costs.  The problem with that is, nobody is going to compare costs of medical treatments when they need it.

IE

If you need medical treatment, you're not going to call different hospitals to see how much a bag of blood is going to cost or how much it will cost to get a bone set.  You're just gonna go to the nearest hospital or go to the doctor you know to get treatment.  

I remember on Oprah once, there was an insurance person saying that you could help contain costs by calling ahead to find what the prices were on bone marrow.  

She yelled back at her guest,"IT'S BONE MARROW!  You're not going to compare costs for bone marrow!  You're just gonna get it."

And, how do you compare costs for medical procedures if you don't know what procedure you need?

There are a few procedures that you know about in advance:  having a baby is one where you might be able to compare costs -- assuming there are no issues that come up -- but honestly, if I'm having a baby, I want to go to the doctor I know and trust even if the doctor isn't the cheapest one out there.  I'm going to the one I feel the most comfortable with since, well, he/ she is gonna be deep up in my business.

Free economy just doesn't work for a lot of health care.
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Brad

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #28 on: May 26, 2017, 09:26:34 PM »
25 plus years ago, in a past life, I processed bankruptcy cases for a law firm for filing with the court.  9 out of 10 bankruptcies were because some unforeseen medical need came along and put them under.  Most of these had good, employer funded health insurance.
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buckworks

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Re: California’s single-payer plan costs $400 billion — twice state’s entire budget
« Reply #29 on: May 27, 2017, 04:41:52 AM »
>> some unforeseen medical need came along and put them under

That's a lot less common in Canada. I'm not saying it doesn't happen, but I've never heard of someone being bankrupted by medical expenses ... unless they got sick or hurt while travelling in the US!

>> completely disconnecting those who receive services from the actual cost of those services

There's often a big difference between the actual cost of a medical procedure and the cost that is charged after administrative bloat is factored in!

Canada spends a significantly smaller portion of its GDP on health care than the US does, yet on average we live longer. One big reason is that more of our costs go to actual medical care and less to administrative overhead. Another reason is that people can seek medical help while problems are still small, there's no incentive to wait until the thing is desperate.

>> good, employer funded health insurance

Canada's Medicare coverage doesn't depend on our employment status. There are many benefits to that, including removing a huge paperwork burden from employers.

-----

Years ago someone we knew was injured in a farming accident - his foot got caught in a grain auger. The doctor who looked after him said later that it would have been cheaper to just amputate the foot, but he truly valued not having to restrict his medical decisions on the basis of what the individual could afford at the time. Our friend was left with a limp, but the foot was saved and he was able to return to work. How to measure society's ROI on something like that?
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