Single-payer healthcare could cost $400 billion to implement in California

[Varitok]

http://mattbruenig.com/2017/05/22/ca...le-payer-plan/

Funny how that part was left out.

[Phookah]

That's a symptom of private insurance and only private insurance. Essentially what happens is a ridiculous billing and negotiation procedure between an insurance rep and the hospital charge master.

It starts out where the insurance rep tries to cut cost by denying payment on most of the charges. The chargemaster comes back going "well fuck you then, this bandaid that you agreed to pay is $90 billion". They do this dance back and forth until they eventually agree on the total sum in the middle. However, when you don't have people to negotiate these prices, simple things become insanely overpriced.

Exactly. I know a lot of people don't seem to understand that, and that's why everything hospital wise costs so much damn money.
Hospital does a knee surgery, sends the bill to your insurance for $25,000. Insurance says "F that, I'll pay $5000." and they go back and forth until a price is reached. Then the next time the hospital goes to send a bill to said insurance company they say "This knee surgery is $50,000" and insurance goes "F that, I'll pay $15,000" and so on, until getting a can of coke at the hospital costs you $34. Its ridiculous.

[Theinquisition]

The root of the problem isn't the government, but that almost half of the population consisting of Trump supporters seems to be incapable of setting aside their zealotry and hate of everyone who doesn't belong to their echo chamber to objectively weigh the pros and cons of having a good healthcare system.

Pospospos lecturing anyone about echo chambers is hilarious

[Draco-Onis]

California is a big market, somewhere around 15% of the population of the US. Changes there already have positive impacts across the country. I.e. emission standards, California has the strictest of all 50 states, and car manufacturers will make all cars to be sold in America up to those standards, so they don't have to make two versions. Now that isn't to say that hospitals and pharma companies won't try to gouge the state, but it is a massive market, and California would have a lot of power. They'd likely take a hit on their profit margins to make some money in the state, instead of throwing out all that potential revenue. Remember California is larger in population than Canada, Australia, New Zealand, the Nordic countries, many countries in Europe, all which have successful health systems.

If I was a ceo of those companies I would not just out of fear if California does well it will spread throughout the rest of the country. We are talking about an industry where they jack up prices 6000% because they can, California pales in comparison to the money they are squeezing form the rest.

[cuafpr]

"including those without legal immigration status." haha F-that noise, i feel sorry for the tax payers and its why i would never move there....

[Kellhound]

Oh unions, how wonderful they are...

Sorry but if voters vote otherwise (such as putting caps on retirement) then the unions can't really do shit other than sue.

1: The unions tend to get Portland to vote the way they want, and the Portland vote is all that matters.
2: The unions are likely to win a lawsuit against reducing retirement costs, even for those making more money in retirement than they did while working.

[God Save The King]

If I was a ceo of those companies I would not just out of fear if California does well it will spread throughout the rest of the country. We are talking about an industry where they jack up prices 6000% because they can, California pales in comparison to the money they are squeezing form the rest.

That is true as well. California could also talk to the our Northern Ally and potentially buy medicine from their vendor. I have no idea about the feasibility or legality of this, just an idea off the top of my head.

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"including those without legal immigration status." haha F-that noise, i feel sorry for the tax payers and its why i would never move there....

Well, there are a handful of reasons why it's being included.. If we excluded them from this program, we would need to verify identity before performing any life saving procedure (which could result in their death). And this doesn't just apply to illegals. Legals would need to naturally be verified as well. If you get mugged and stabbed half to death, and your wallet is stolen, how could we discern identity soon enough?

Secondly, at a federal level, we have to provide life saving services regardless of the ability to afford it. It's been empirically shown that preventive care is far cheaper and more effective than emergency care. So we can either deny preventive care and be responsible for emergency care (which is much more costly) or we can allow them to get preventive care. Personally I'd prefer stronger immigration controls and an easier path to citizenship, so we have less of an illegal population, but California can't enforce its borders, that is the responsibility of the federal government. We have to deal with the hand dealt to us, so it's better economically to provide preventive care.

[zenkai]

http://www.latimes.com/politics/esse...1&noRedirect=1

Interesting, even after applying money spent on existing healthcare systems, the cost would still be between 50 and 100 billion a year. That's a lot of money.

CA is CA and im all for states passing their own laws, I wonder what the mentality is behind spending tax payer money on illegal immigrants being covered under the single payer plan. Seems like a huge cost that wouldn't get paid back into the system.

What's funny is, republicans and democrats are trying to figure out how to cover the expensive of healthcare without trying to lower it's cost.

[I Push Buttons]

What's funny is, republicans and democrats are trying to figure out how to cover the expensive of healthcare without trying to lower it's cost.

Single payer addresses the inflated prices far more than the current method of doing absolutely nothing, friend.

Under a single payer system, there is only one customer, the single payer. If the single payer says "we will only pay $X for Y drug" (for example)... The company that makes Y drug can either take $X or they can fuck off and lose 12.5% of their business entirely (referring to losing California's business).

Which do you think they want? Making 90% of that 12.5% (by selling it for say, 10% less than before) or making 0% of that 12.5% (by refusing to do business with California)? Especially considering choosing the "fuck off" option, they would be vilified as evil greedy cunts and probably lose even more business.

[cuafpr]

That is true as well. California could also talk to the our Northern Ally and potentially buy medicine from their vendor. I have no idea about the feasibility or legality of this, just an idea off the top of my head.

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Well, there are a handful of reasons why it's being included.. If we excluded them from this program, we would need to verify identity before performing any life saving procedure (which could result in their death). And this doesn't just apply to illegals. Legals would need to naturally be verified as well. If you get mugged and stabbed half to death, and your wallet is stolen, how could we discern identity soon enough?

Secondly, at a federal level, we have to provide life saving services regardless of the ability to afford it. It's been empirically shown that preventive care is far cheaper and more effective than emergency care. So we can either deny preventive care and be responsible for emergency care (which is much more costly) or we can allow them to get preventive care. Personally I'd prefer stronger immigration controls and an easier path to citizenship, so we have less of an illegal population, but California can't enforce its borders, that is the responsibility of the federal government. We have to deal with the hand dealt to us, so it's better economically to provide preventive care.

you can specify life saving / stabilizing care.. this is way to general for me, then get proof of citizen ship, and/or bill them. and this wording specifically implies illegals not tourist/visitors. Everyone in the US should be able to prove their citizen ship either to the US or another country and their legal status here, once stabilized and able to communicate. If visiting and their ID's are stolen that's what embassies are for to assist on. If not here illegally stop care.

and lol at cali can't enforce its borders when its suing (or part of the suit) for the rights to have sanctuary cities..... they are encourging illegal immigrants to come to the state.

[Cyberowl]

Mostly people accepting feelings over economics.

They want everyone, illegal or not to benefit, yet want a minority group to foot the bill.

The irony.

It does not matter if some illegals get covered (unless you have some irrational hate like you do, apparently) if the result is still better for the majority. Single payer is both cheaper and better. You are the definition of the "Conservatives would eat shit if liberals had to smell it." meme, just replace liberals with illegals.

[zEmini]

1: The unions tend to get Portland to vote the way they want, and the Portland vote is all that matters.
2: The unions are likely to win a lawsuit against reducing retirement costs, even for those making more money in retirement than they did while working.

They are not immune. PERS is the big subject right now here in Oregon. Every time the dip shit State tries to increase taxes (that will help PERS) they camouflaging it with the children card. More and more people are starting to see the lies and even the democrats in PDX are tired of it. PERS can't sustain itself and will eventually collapse. Better to start fixing the holes now before the state becomes bankrupt. Best way to do that is through ballot measures and legislation putting caps on retirement. I would even go as far as removing assets from the retirees who benefited most form this - namely the ones who put PERS in place back int he 70s. They are probably dead now though.

How can the union sue if there isn't any money? It is like trying to sue a homeless person for a million dollars because he stole and totaled your car. I mean if god forbid the stats files for Bankruptsy, they will be protected.

[God Save The King]

you can specify life saving / stabilizing care.. this is way to general for me, then get proof of citizen ship, and/or bill them. and this wording specifically implies illegals not tourist/visitors. Everyone in the US should be able to prove their citizen ship either to the US or another country and their legal status here, once stabilized and able to communicate. If visiting and their ID's are stolen that's what embassies are for to assist on. If not here illegally stop care.

and lol at cali can't enforce its borders when its suing (or part of the suit) for the rights to have sanctuary cities..... they are encourging illegal immigrants to come to the state.

Legally states cannot enforce borders. That is left to the federal government, unless there has been some change over the last few years since I researched it?

Again if your identity is lost, it can take several weeks to replace it/verify your existence. What do they do in the meantime? Let you get worse? That'll be much more expensive in the long run. The smart thing to do is to provide care. And if you do determine that they are here illegally, what do you do? Let them get so sick that they come back in when they're about to die? That's a terrible idea not just from a humanitarian stand point, but economically it is much more expensive.

[Mafic]

That is true as well. California could also talk to the our Northern Ally and potentially buy medicine from their vendor. I have no idea about the feasibility or legality of this, just an idea off the top of my head.

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Well, there are a handful of reasons why it's being included.. If we excluded them from this program, we would need to verify identity before performing any life saving procedure (which could result in their death). And this doesn't just apply to illegals. Legals would need to naturally be verified as well. If you get mugged and stabbed half to death, and your wallet is stolen, how could we discern identity soon enough?

Secondly, at a federal level, we have to provide life saving services regardless of the ability to afford it. It's been empirically shown that preventive care is far cheaper and more effective than emergency care. So we can either deny preventive care and be responsible for emergency care (which is much more costly) or we can allow them to get preventive care. Personally I'd prefer stronger immigration controls and an easier path to citizenship, so we have less of an illegal population, but California can't enforce its borders, that is the responsibility of the federal government. We have to deal with the hand dealt to us, so it's better economically to provide preventive care.

The backbone of a universal health care system is preventive care which is why the US healthcare system is buckling. In fairness to health insurers when the risk pools are increasing because preventive care is being diminished it can't be all on the insurers. But insurers being stingy about regular doctor visits really hurts prevent health care and also hurts the insurance's bottom line in the long run.

The US healthcare system is under a disaster capitalist, short term mindset and not on a long term capitalist mindset or a socialist universal mindest. That has to change.

[Theinquisition]

What's funny is, republicans and democrats are trying to figure out how to cover the expensive of healthcare without trying to lower it's cost.

Well, the way I see it, the only way the price will go is up.

If supply of healthcare providers isn't increasing and demand is increasing (more people will use healthcare services if its free) there's no way price won't increase.

[Huehuecoyotl]

The problem is that as population increases there are problems (eg NHS)

That is completely wrong. As long as the spending on the healthcare increases in line with the population increases (and as long as they don't happen too fast) they can cope with higher numbers just fine. The per capita spend is the important thing. The reason the NHS has problems is that the Tories have been reducing the per capita spend over a number of years, so that they can point to it and say "look, it isn't working, we have to bring private providers into it". The NHS problems are actually part of a clear Tory plan to bring the UK healthcare more into line with the US. Which is, of course, fucking ridiculous.

[kail]

Well, the way I see it, the only way the price will go is up.

If supply of healthcare providers isn't increasing and demand is increasing (more people will use healthcare services if its free) there's no way price won't increase.

That's why healtcare doesn't tie well with Supply & Demand. The demand alone is hard to measure out.

[Lollis]

The problem is that as population increases there are problems (eg NHS) but also how the working population is distributed. Right now there are less workers under 25 than over 25 in the US and many Western countries. So, medicare, and social security face issues as a result of an inverted demographic pyramid and many of the universal health care system in the west face the same dilemma.

The NHS isn't having problems simply because there are more people. It is having problems because we have a party in government whose whole purpose is to reduce public spending. They cut education spending, they cut medical spending, they sell off publicly owned businesses.

The NHS needs increased funding to fight off inflation and an increasingly aging population. It isn't the system that is at fault, it is the cunts in charge of the system that are the problem.

[shimerra]

Well, the way I see it, the only way the price will go is up.

If supply of healthcare providers isn't increasing and demand is increasing (more people will use healthcare services if its free) there's no way price won't increase.

Pretty simple actually. ER visits are expensive. The same issue treated at an ER vs through a primary care physician is insane. Chronic conditions like diabetes can instead be managed because people have access to insulin instead of the much more expensive alternative of things like amputation and blindness, which also means a productive worker is taken out of the labor force. That alone will be a massive cost savings. Which is cheaper you think paying for my buddy who is a part time worker to get some basic primary care or the emergency care he had to receive resulting in a month long hospital stay with him hooked up to oxygen? Hint: primary car is a lot cheaper and giving people access to it reduces costs. And as others have said you're already paying for all these lazy uninsured and you're paying more to do it because of our jacked up insurance system and how they negotiate prices with hospitals. The exact market force employed at a small scale gets magnified with a single payer.


The literal only problem with it is the words government and taxes. Your fear of the evil money sucking immigrant/poor person and the idea that government does nothing right, even though programs like Medicaid and Medicare are generally ran well the issue is demographic changes, have caused you to accept a system where because of the limitations on denying emergency care and the weaker negotiating power of individual insurance companies than a single payer fuck you over harder than the demon your ideology tells you to fear.

Put more simply folks like you, orlog, and zenkai come across as the types who'd gladly pay higher premiums just to not pay taxes even if it means overall lower healthcare outcomes. Healthcare doesn't follow typical supply and demand rules and people need to stop acting like it does.

[Cthulhu 2020]

The irony.

It does not matter if some illegals get covered (unless you have some irrational hate like you do, apparently) if the result is still better for the majority. Single payer is both cheaper and better. You are the definition of the "Conservatives would eat shit if liberals had to smell it." meme, just replace liberals with illegals.

"It will save billions per year, increase access for a large portion of citizens, and improve quality of care!"

"But will illegals get to use it?"

"There's nothing stopping them I guess."

"FUCK IT THEN"