Author Topic: California’s single-payer plan costs $400 billion — twice state’s entire budget  (Read 14060 times)

Brad

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No system is perfect, but I know a lot of vets that get really good healthcare through the VA. 


All healthcare is rationed.  Right now we ration on the basis of price, ability to pay, and ability to secure insurance.  Single payer systems use a different set of criteria for rationing, things like: age, survival rate for given treatment, quality of life, etc.

As the US blunders around for the next 20 years, I expect medical tourism to explode both in country and out of country.

Example: a friend just priced out a yet another heart stent for her husband. $90K at a famous hospital in Chicago, where they had been referred, $45K at a local hospital 30 miles out of the city.  Surgeon fees extra.

The Amish, who do not believe in insurance, travel to Mexico for surgery for things like cancer.  I've heard of people traveling to India for hip replacements.  Someday somebody will put together something like Travelocity with ratings for medical tourism and it will explode.

Mackin USA

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Why don't the Amish believe in insurance?

Best Answer:  You are right. It is out of a Biblical sense of community providing for its own. Some may even consider insurance a form of gambling. You are betting you won't need to use it. Many Mennonites don't have insurance either. There is a general fund that communities can draw upon if needs exceed what the local group can provide. That's the closest to insurance they have. It seems to work well and fosters a better sense of interdependence between members.

Mennonites have several different varieties. There's Old Order that are horse and buggy like Amish. There's conservative or New Order which are what you describe. They drive, have electricity, and even cell phones but not TV, radio, movies, or use the internet (except limited business related). Then there is a more progressive, worldly group of Mennonites (mostly younger people) that aren't much different from mainstream society in dress or actions.

https://answers.yahoo.com/question/index?qid=20100804112904AAM2xdp
Mr. Mackin

Brad

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I learned about the Amish medical thing via an article about Amtrak.  The train the author was on had a group of Amish men aboard traveling to the SW United States and ultimately to a trusted hospital/clinic in Mexico.  They were helping one of their number who was going for cancer surgery.

The Amish know which hospitals in Mexico are good and take cash.

The Amish try to avoid entanglement or networking with the modern world, but exact interpretations are largely in the hands of the local bishops.  So for instance, one bishop might ban all telephones, while another might allow a phone for emergencies but it is wired to a poll out in a pasture, not to a house, because wiring to the house would be an entanglement.   Kind of the exact opposite of the Internet.

Certain exceptions are made for business purposes.

ergophobe

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All healthcare is rationed.

This is the piece that is generally lost on people. Or, perhaps, it is lost on them if they have good healthcare and someone proposing a different way of rationing.

ergophobe

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And... in related news

https://www.nytimes.com/2017/06/03/business/economy/high-end-medical-care.html

And yes, the subject is *that* John Battelle


ergophobe

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The Cato report says that Sanders "Medicare for all" proposal would cost $13.8 trillion over the first decade. That sounds exhorbitant (it's over double the total military budget of about $600b per year), but in the context of current healthcare expenditures of $3.35 trillion and rising at 5% per year (so $40 trillion over the next decade), that sounds like a bargain.

http://www.pbs.org/newshour/rundown/new-peak-us-health-care-spending-10345-per-person/

littleman

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Counter argument

Quote

The misleading figure of $404 billion that is often quoted is the cost under the existing fragmented, dysfunctional, for-profit insurance system. But a single payer plan like SB 562 has many cost-savings built in; among them hugely reducing the administrative costs involved in private insurance and bringing the weight of California to the table when negotiating with drug companies. Access to early and preventative care will cut down expensive emergency room visits. The real estimated cost of SB 562 is $331 billion, a savings of 18 percent over the $368.5 billion we are paying now to leave 2.7 million of our neighbors uninsured and another 12 million underinsured.

So where will that $331 billion come from? First, $225 billion of our total healthcare costs is already taxpayer financed through Medicare, Medi-Cal and subsidies to private insurers. With waivers we would shift these funds into the Healthy California system and according to the study, we could finance the remaining $106 billion with two new taxes. Yes, that dirty word “taxes.” But under this plan all businesses that currently provide health insurance would actually save money and so would very nearly all households. Businesses would pay 2.3 percent on gross revenues, with the first $2 million exempted, which would mean that the smallest businesses would pay nothing. The projected net savings for small businesses that currently provide health benefits is 22 percent, 7-13 percent savings for medium-sized businesses, and 0.6 percent for larger employers. This tax is projected to raise $92 billion.

The remaining $14.3 billion would be funded by a sales tax of 2.3 percent that would exempt spending on housing, utilities, food at home and other necessities. Since all premiums, deductibles, co-pays and out-of-pocket expenses for services that will be newly covered under SB 562 will be eliminated, low-income families can expect to save 1.2-5.5 percent and middle-income families 2.6-9.1 percent over what they are paying now. Only higher-income families will see a small increase of 1.5-1.7 percent


http://www.santacruzsentinel.com/opinion/20170617/commentary-california-can-afford-universal-healthcare