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Should California Pass Single Payer?

Should California pass Single Payer?

  • Yes! SH will work great!

    Votes: 7 15.6%

  • Yes! Let California be a test case for the nation.

    Votes: 27 60.0%

  • No - SH would break the state budget.

    Votes: 8 17.8%

  • No - other (explain, but "national single payer" isn't an option)

    Votes: 3 6.7%
  • Total voters
    45
Try it out. Let's see how it goes. It's never been done before in the US across all age groups, so this would be some new territory for healthcare.
 
Don't see how it would work. Seems like it would attract the sick for "free" healthcare, and drive away those expected to foot the bill to states where they could get better care for less money.
 
Tanngrisnir said:
No. Not because I'm opposed to it philosophically, but because it would be better done at a federal level.
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An option explicitly denied to you, because it is a cop-out.
 
cpwill said:
FOR THIS POLL, ASSUME A FEDERAL SINGLE PAYER IS NOT AN OPTION.

California likes to point out that it is the 5th largest economy in the world, making it larger than Great Britain, which has a Single Payer Healthcare System.

Should California enact a Single Payer Healthcare System, as has been proposed?
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Sure; it would be an interesting test case if backstabbing Democrats that serve as representatives of insurers and pharma (rather than constituents, whether party or state) like Anthony Rendon, would:

A: Let the requisite legislation pass.

and

B: Not try to sabotage it during implementation (you just know some big pharma/insurer shill politico is going to try to add language that kills, restricts or retards the ability of the state to negotiate prices, or alternately, directly throw said negotiations).
 
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Tanngrisnir said:
No. Not because I'm opposed to it philosophically, but because it would be better done at a federal level.
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cpwill said:
An option explicitly denied to you, because it is a cop-out.
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Tanngrisnir definitely has a point; federal level SP would have more clout and negotiating power than a single state, even one as big and economically powerful as California.

That said, I certainly feel that it is within California's raw capacity to make SP work, and that they should certainly try; better to have SP now than on the 12th of never or some unspecified point in the future, even if it wouldn't be as good or cost effective as a nation wide equivalent.

That all said, there is certainly risk in the implementation that could undermine the entire project per lobbyist and donor sourced corruption. I am terrified of bought politicos and other such dishonest actors moving to sabotage this endeavour so they and their sponsors can spin it as 'evidence' of SP's 'unviability'.
 
cpwill said:
FOR THIS POLL, ASSUME A FEDERAL SINGLE PAYER IS NOT AN OPTION.

California likes to point out that it is the 5th largest economy in the world, making it larger than Great Britain, which has a Single Payer Healthcare System.

Should California enact a Single Payer Healthcare System, as has been proposed?
Click to expand...
Absolutely!

States are the laboratories of democracy. Let them be the test case. We can get some real-world American data.

But I do have reservations as to how it will work, since Cali has no immigration provisions against citizens of other states! I fear a flood of uninsured, poorly insured, and financially compromised sick people from around the nation relocating to enjoy the healthcare.

But yes, if Californians desire to try this route, by all means they should not be hindered - particularly by Washington!
 
Its very difficult for a state to have single payer because a state cannot easily borrow money during economic downturns to pay for it. Healthcare needs are unrelated to economic growth. Just because a state is in an economic recession does not mean there will be less cancer patients or less heart attacks.

Just the same, California already has the best HMO in the country with Kaiser Permanente that provides more affordable coverage and gets better outcomes than just about any other insurer in the country. That would go away if they went to a single payer system. There are other market innovations in some California markets with hope of controlling health care costs in the future as well like Reference Pricing. That would go away as well with a single payer system.

The problem with going with a single payer system, aside from it being politically impossible, is that you lose some good with the bad. Health insurance is expensive because many providers are charging exorbitant prices. Your health premiums on the individual market for a family can be 20k a year because you have orthopedic surgeons billing more than 800k a year, anesthesiologists double billing for their nurse, hospitals charging over 400 dollars for a 22 dollar metabolic panel because they bill for each result individually even though its just one test, plastic surgeons charging tens of thousands of dollars for a couple of stitches in an emergency room after trauma, Neurologists charging 5k to spend a couple of minutes glancing at a CT scan result. Specialists doing 2 minute drive-bys with patients for no reason other than they can bill a couple of grand each time they do it. The list goes on an on, its a racket and we would call it fraud if it were any other industry.

Going to a single payer system doesn't fix any of that by itself. It just changes who pays for it. Neither party ever really talks about healthcare costs themselves (other than drug prices which is only 10 to 15% of over all health spending), they just talk about insurance premiums which are just a symptom of the problem. The closest either party gets to talking about curbing actual healthcare costs is when you have them pushing high deductible "consumer driven" plans which put the expense of routine care on patients rather than insurers. The idea being that you will then shop routine and ancillary care based on cost. The problem with that is that routine care and ancillary care are not the problem in terms of overall healthcare costs, seeing your GP for a yearly wellness is not that expensive to begin with. You will spend more in a 2 day hospital stay than you would in a lifetime of routine care. It is chronic and catastrophic healthcare costs that are the problem (which would still be paid for by a catastrophic plan), and no one in either party ever talks about doing anything to curb those costs.
 
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Surrealistik said:
Tanngrisnir definitely has a point; federal level SP would have more clout and negotiating power than a single state, even one as big and economically powerful as California.

That said, I certainly feel that it is within California's raw capacity to make SP work, and that they should certainly try; better to have SP now than on the 12th of never or some unspecified point in the future, even if it wouldn't be as good or cost effective as a nation wide equivalent.

That all said, there is certainly risk in the implementation that could undermine the entire project per lobbyist and donor sourced corruption. I am terrified of bought politicos and other such dishonest actors moving to sabotage this endeavour so they and their sponsors can spin it as 'evidence' of SP's 'unviability'.
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California is larger than Great Britain, which has had Single Payer for decades (ie: since it was much smaller). The "they're not big enough" claim is BS, which is why the poll doesn't allow it - It's a cop-out, designed to protect a policy goal from being implemented when and where it can still prove whether or not it would be a failure.
 
cpwill said:
California is larger than Great Britain, which has had Single Payer for decades (ie: since it was much smaller). The "they're not big enough" claim is BS, which is why the poll doesn't allow it - It's a cop-out, designed to protect a policy goal from being implemented when and where it can still prove whether or not it would be a failure.
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It is also not a country with a border
 
SouthernDemocrat said:
Going to a single payer system doesn't fix any of that by itself. It just changes who pays for it. Neither party ever really talks about healthcare costs themselves (other than drug prices which is only 10 to 15% of over all health spending), they just talk about insurance premiums which are just a symptom of the problem. The closest either party gets to talking about curbing actual healthcare costs is when you have them pushing high deductible "consumer driven" plans which put the expense of routine care on patients rather than insurers. The idea being that you will then shop routine and ancillary care based on cost. The problem with that is that routine care and ancillary care are not the problem in terms of overall healthcare costs, seeing your GP for a yearly wellness is not that expensive to begin with. You will spend more in a 2 day hospital stay than you would in a lifetime of routine care. It is chronic and catastrophic healthcare costs that are the problem (which would still be paid for by a catastrophic plan), and no one in either party ever talks about doing anything to curb those costs.
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Actually yes, progressive Dems certainly do talk about healthcare costs and what a racket they are, both in terms of the pharmaceutical and provider end.

SP helps combat exorbitant provider prices both by substantially reducing administrative costs (i.e. you don't need a sprawling department of people trawling through myriad different insurers and their cacophony of plans), and using economy of scale negotiating clout to reduce and disinflate healthcare costs at both the provider and supplier level. A recent study found savings of $37 billion after expansion of coverage to all remaining uninsured:

Single-payer health plan would save Californians $37 billion and cover more people, study finds
 
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vegas giants said:
It is also not a country with a border
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So? Neither is Britain under the EU. Nothing stops California from providing care to Californians.

Sent from my XT1526 using Tapatalk
 
cpwill said:
So? Neither is Britain under the EU. Nothing stops California from providing care to Californians.

Sent from my XT1526 using Tapatalk
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Uh....yes it is.
 
vegas giants said:
Uh....yes it is.
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Okedoke. Tell us about the border control measures Britain has that keeps non-British citizens out in such a way that they can have Single Payer, but California can't :)

Sent from my XT1526 using Tapatalk
 
cpwill said:
California is larger than Great Britain, which has had Single Payer for decades (ie: since it was much smaller). The "they're not big enough" claim is BS, which is why the poll doesn't allow it - It's a cop-out, designed to protect a policy goal from being implemented when and where it can still prove whether or not it would be a failure.
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I agree that any claim which says that California is not 'big enough' is largely disingenuous.

But he is right that it would be better at a national level assuming the rollout and implementation were done in good faith.

Speaking of, good faith is precariously hard to find in government these days. The threat of undermining in a variety of ways, most likely/prominently those related to price negotiation via pharma and insurer sponsored politicos, is very real and my leading concern.
 
Surrealistik said:
Actually yes, progressive Dems certainly do talk about healthcare costs and what a racket they are, both in terms of the pharmaceutical and provider end.

SP helps combat exorbitant provider prices both by substantially reducing administrative costs (i.e. you don't need a sprawling department of people trawling through myriad different insurers and their cacophony of plans), and using economy of scale negotiating clout to reduce and disinflate healthcare costs at both the provider and supplier level. A recent study found savings of $37 billion after expansion of coverage to all remaining uninsured:

Single-payer health plan would save Californians $37 billion and cover more people, study finds
Click to expand...

Healthcare costs are one of the most common topics discussed on NPR shows and I never hear any Democrats or Republicans talk about provider costs on them. Perhaps its because healthcare providers spend more on lobbying than anyone else.

Sure, single payer would be less expensive and cover more people. However, it is politically impossible. Progressives would be far better served by focusing on what is remotely possible like true price transparency with providers, requiring providers to provide a good faith cost estimate for a procedure at the time of consent, lowering the Medicare eligibility age down to about 55 or so, breaking up provider monopolies (half of all healthcare markets are a monopoly where one health system owns everything), reference pricing, promoting physician cooperatives, and much stronger insurer regulation.

Finally, California already has a model healthcare system with Kaiser Permanente, why would we throw that away and go to single payer when we ought to figure out a way to build on that model and expand it. Kaiser Permanente Is Seen as Face of Future Health Care - The New York Times
 
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cpwill said:
An option explicitly denied to you, because it is a cop-out.
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I don't think it's a cop-out. It's a practical consideration. A couple decades ago many cities in California found out the hard way that, when they handed out uber-attractive benefits to homeless people, all of a sudden homeless people from all over the country started migrating there and the programs became unsustainable. I think the same would happen here.

Because of this practical consideration, I would have to vote 'no'... though it would be interesting to watch to see if it could work elsewhere in the US. (I don't always buy that what works in other cultures would automatically work here... that's why they're defined as "cultures".)
 
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