California Senate passes single payer health coverage

[Uncaripswife]

Have we talked about this?

www.thenation.com/article/california-senate-just-passed-single-payer-healthcare/?utm_source=facebook&utm_medium=socialflow

[Uncaripswife]

"The state Senate voted 23 to 14 on Thursday in favor of SB 562, a single-payer proposal that would guarantee universal health care to all Californians. “What we did today was really approve the concept of a single-payer system in California,” declared state Senator Ricardo Lara, a key advocate for the bill, following the vote."

I wish juliagulia were here.

[robot]

I know there's still a lot of hurdles to pass and details to work out but as someone who will likely live in CA again in the future and has a H who would like to consult but also can't be without health insurance, this is amazing news.

[fatpony]

miawallace

[Uncaripswife]

I really hope they can make it work. Then maybe the rest of the country will follow suit.

[miawallace]

I've been following this for a few months. I'm glad it's advancing forward.
I think the oppositions are saying it's going to bankrupt CA, but I don't know if that is actually true. It would be great though. Holy shit it would.

[Deleted]

Assuming it works, this is great news. I also think this is how it is going to happen. One state at a time and then eventually nationally.

[Uncaripswife]

Jun 3, 2017 11:56:47 GMT -6 miawallace said:

I've been following this for a few months. I'm glad it's advancing forward.
I think the oppositions are saying it's going to bankrupt CA, but I don't know if that is actually true. It would be great though. Holy shit it would.

I am curious about how financing would work. But I feel like California is so big, if that state can make it work then maybe it really is translatable to the entire US.

[dreadpirateroberts]

Jun 3, 2017 12:01:35 GMT -6 @ges072115 said:

Assuming it works, this is great news. I also think this is how it is going to happen. One state at a time and then eventually nationally.

Eta. Damn my gif won't work. 

[kitchen]

My family would probably pay (a lot?) more. It's absolutely the right answer (though on a federal level not by state). Because the cost and payment structures are so unclear it's hard to figure out what to think.

I did not know Kaiser was the largest employer. That is going to be tricky to navigate. The idea that somehow single payer would leave a lot of people unemployed seems laughable. Higher utilization of the healthcare system would hardly leave people without jobs (or am I off base with my thinking?).

[ktg]

kitchen maybe they mean in the insurance sector itself.

[Minerva]

Jun 3, 2017 13:57:06 GMT -6 kitchen said:

My family would probably pay (a lot?) more. It's absolutely the right answer (though on a federal level not by state). Because the cost and payment structures are so unclear it's hard to figure out what to think.

I did not know Kaiser was the largest employer. That is going to be tricky to navigate. The idea that somehow single payer would leave a lot of people unemployed seems laughable. Higher utilization of the healthcare system would hardly leave people without jobs (or am I off base with my thinking?).

It seems like it will be hard for them to pass single payer without figuring in Kaiser. In the part of NorCal I lived in, Kaiser runs more than a third of the hospitals and provide much of the primary care. People talk about themselves as Kaiser lifers. Many of the med students I know opted to work for Kaiser because their model of employment was more desirable than the Sutter practices or private practice. We had Kaiser for 3 years and loved both our doctors and the comprehensiveness of the system. I think the state will have a hard time getting widespread support if their plan dismantles the Kaiser system.

[thatgolfb]

Jun 3, 2017 15:48:20 GMT -6 Minerva said:

Jun 3, 2017 13:57:06 GMT -6 kitchen said:

My family would probably pay (a lot?) more. It's absolutely the right answer (though on a federal level not by state). Because the cost and payment structures are so unclear it's hard to figure out what to think.

I did not know Kaiser was the largest employer. That is going to be tricky to navigate. The idea that somehow single payer would leave a lot of people unemployed seems laughable. Higher utilization of the healthcare system would hardly leave people without jobs (or am I off base with my thinking?).

It seems like it will be hard for them to pass single payer without figuring in Kaiser. In the part of NorCal I lived in, Kaiser runs more than a third of the hospitals and provide much of the primary care. People talk about themselves as Kaiser lifers. Many of the med students I know opted to work for Kaiser because their model of employment was more desirable than the Sutter practices or private practice. We had Kaiser for 3 years and loved both our doctors and the comprehensiveness of the system. I think the state will have a hard time getting widespread support if their plan dismantles the Kaiser system.

I completely agree. Kaiser is pretty big down here, too.

[CurlieWhirlie]

Yeah I'm in NorCal and we love Kaiser. I wonder if Kaiser would be happy to be a part of the solution, though? I feel like the reason they are so successful is because they cut out the insurance companies. By becoming one, yes, but that isn't their primary focus.

[kitchen]

Jun 3, 2017 16:44:41 GMT -6 CurlieWhirlie said:

Yeah I'm in NorCal and we love Kaiser. I wonder if Kaiser would be happy to be a part of the solution, though? I feel like the reason they are so successful is because they cut out the insurance companies. By becoming one, yes, but that isn't their primary focus.

Kaiser is THE solution.  Well, government run Kaiser.  

[kitchen]

Jun 3, 2017 15:48:20 GMT -6 Minerva said:

Jun 3, 2017 13:57:06 GMT -6 kitchen said:

My family would probably pay (a lot?) more. It's absolutely the right answer (though on a federal level not by state). Because the cost and payment structures are so unclear it's hard to figure out what to think.

I did not know Kaiser was the largest employer. That is going to be tricky to navigate. The idea that somehow single payer would leave a lot of people unemployed seems laughable. Higher utilization of the healthcare system would hardly leave people without jobs (or am I off base with my thinking?).

It seems like it will be hard for them to pass single payer without figuring in Kaiser. In the part of NorCal I lived in, Kaiser runs more than a third of the hospitals and provide much of the primary care. People talk about themselves as Kaiser lifers. Many of the med students I know opted to work for Kaiser because their model of employment was more desirable than the Sutter practices or private practice. We had Kaiser for 3 years and loved both our doctors and the comprehensiveness of the system. I think the state will have a hard time getting widespread support if their plan dismantles the Kaiser system.

My dad was a family practice doctor - I cannot count the hours of angst he spent trying to hire doctors (he worked for Sutter) competing with Kaiser.  There was no way to compete with them. 

IFL Kaiser, but I feel like the things I love are the things that would be in a single payer system... easy connections between doctors, seamless payment mechanisms, etc.  Kaiser is going to be the key advisor for implementation of any system.  Or rather, the expertise of Kaiser would be.  The fact that somehow the profit mechanism would get removed is the sticking point.

[dc2london]

This is such fantastic news. California is, if I'm not mistaken, the world's 6th largest economy? And it really is its own little political ecosystem. So I'm not surprised that they can make single-payer work, but i am hopeful that they will and that it will inspire other states to follow suit.

[justkeepmoving]

This would be amazing if they could get this to work. I still have major doubts that red states or even toss up states would ever pass something like this but it gives me hope.

[Minerva]

Jun 3, 2017 19:33:25 GMT -6 kitchen said:

Jun 3, 2017 16:44:41 GMT -6 CurlieWhirlie said:

Yeah I'm in NorCal and we love Kaiser. I wonder if Kaiser would be happy to be a part of the solution, though? I feel like the reason they are so successful is because they cut out the insurance companies. By becoming one, yes, but that isn't their primary focus.

Kaiser is THE solution.  Well, government run Kaiser.  

Ha, yes! When I've imagined my ideal single payer system, it is basically government Kaiser.

[poppyc8]

I grew up in California but now live in Canada. I'm so excited they are taking this next step.

My sister in law is a family practice doctor affiliated with the UCLA medical group who was raised in Canada but is now practicing in California (for the higher pay check of course) and I'm curious to see her take on this

[crimsonandclover]

My only fear would be that everyone who has health problems and gets dumped by 45's massive healthcare cuts will decide to move to CA to get healthcare. Completely understandable, but when figuring costs they're going to have to factor that in.

[CurlieWhirlie]

Jun 3, 2017 22:45:03 GMT -6 crimsonandclover said:

My only fear would be that everyone who has health problems and gets dumped by 45's massive healthcare cuts will decide to move to CA to get healthcare. Completely understandable, but when figuring costs they're going to have to factor that in.

Even without universal healthcare this could happen! Except it's too expensive to live here.

[dc2london]

Jun 3, 2017 22:39:34 GMT -6 poppyc8 said:

I grew up in California but now live in Canada. I'm so excited they are taking this next step.

My sister in law is a family practice doctor affiliated with the UCLA medical group who was raised in Canada but is now practicing in California (for the higher pay check of course) and I'm curious to see her take on this

Interesting. Several of the doctors in my family have left the US to practice in Canada bc they feel the US system robs them of the ability to treat their patients properly.

[poppyc8]

Jun 4, 2017 10:49:19 GMT -6 dc2london said:

Jun 3, 2017 22:39:34 GMT -6 poppyc8 said:

I grew up in California but now live in Canada. I'm so excited they are taking this next step.

My sister in law is a family practice doctor affiliated with the UCLA medical group who was raised in Canada but is now practicing in California (for the higher pay check of course) and I'm curious to see her take on this

Interesting. Several of the doctors in my family have left the US to practice in Canada bc they feel the US system robs them of the ability to treat their patients properly.

She's a great doctor but also is motivated by money. I think she makes around 250K a year and according to her that wouldn't be possible at home with the hours she is able to work now.

We live in a rural part of Canada and their are tons of complaints here about the quality of care. Long waits, turning patients out quickly to save money. I hear in the larger cities that their are less problems with care.

[shadesofgold]

Jun 3, 2017 13:37:15 GMT -6 Uncaripswife said:

Jun 3, 2017 11:56:47 GMT -6 miawallace said:

I've been following this for a few months. I'm glad it's advancing forward.
I think the oppositions are saying it's going to bankrupt CA, but I don't know if that is actually true. It would be great though. Holy shit it would.

I am curious about how financing would work. But I feel like California is so big, if that state can make it work then maybe it really is translatable to the entire US.

Yeah, this is like a pilot for the U.S. I don't think success in CA means it could be scaled down, so I wouldn't necessarily expect it be a model for all other states. But if they can balance their risk and keep costs down that would be a great step for our national system. That cost piece is key though. I wouldn't be surprised if benefits have to be a bit more limited than the usual package, at least at first. So of course you'll have people wailing about rationing. Will be very interesting to see how it shakes out!

[Cnon]

Jun 3, 2017 11:52:06 GMT -6 Uncaripswife said:

I really hope they can make it work. Then maybe the rest of the country will follow suit.

And just HOW is CA going to be able to afford that; they're BROKE, people!

[lea]

A bit of a sidetrack, but there's a bill on the table to expand infertility coverage here and I broke Internet rule #1 and read the comments - a whole lot of "Who are they to tell the insurance companies they have to pay for that?" and similar comments. Mostly from men, no surprise, but some women, too.

I really wish for once they'd put some men's health care on the chopping block just to see the reaction.

[charlotte]

Progress! I hope they can take the time to really do it right so that with CA's success, other states may be encouraged to push forward toward this as well.

[shadesofgold]

Here is the full economic analysis of the proposal, for the wonky among you. From the abstract:

"The primary goal of Healthy California is to provide high-quality health care to all
California residents, including those who are presently either uninsured or underinsured. The
study finds that the providing full universal coverage would increase overall system costs by
about 10 percent, but that the single payer system could produce savings of about 18 percent.
The study thus finds that the proposed single-payer system could provide decent health care for
all California residents while still reducing net overall costs by about 8 percent relative to the
existing system. We propose two new taxes to generate the revenue required to offset the loss
of private insurance spending: a gross receipts tax of 2.3 percent and a sales tax of 2.3 percent,
along with exemptions and tax credits for small business owners and low-income families to
promote tax-burden equity. Within this proposed tax framework, Healthy California can
achieve both lower costs and greater equity in the provision of health care in California for both
families and businesses of all sizes. Thus, net health care spending for middle-income families
will fall by between 2.6 – 9.1 percent of income. Small firms that have been providing private
health care coverage for their workers will experience a 22 percent decline in their health-care
costs as a share of payroll. The small firms that have not provided coverage will still make zero
payments for health care under Healthy California through their gross receipts tax exemption.
Medium-sized firms will see their health care costs fall by between 6.8 and 13.4 percent as a
share of payroll relative to the existing system. Firms with up to 500 employees will experience
a 5.7 percent fall, and the largest firms, with over 500 employees, will experience a 0.6 percent
fall as a share of payroll relative to the existing system."

[Uncaripswife]

Jun 5, 2017 8:41:07 GMT -6 shadesofgold said:

Here is the full economic analysis of the proposal, for the wonky among you. From the abstract:

"The primary goal of Healthy California is to provide high-quality health care to all
California residents, including those who are presently either uninsured or underinsured. The
study finds that the providing full universal coverage would increase overall system costs by
about 10 percent, but that the single payer system could produce savings of about 18 percent.
The study thus finds that the proposed single-payer system could provide decent health care for
all California residents while still reducing net overall costs by about 8 percent relative to the
existing system. We propose two new taxes to generate the revenue required to offset the loss
of private insurance spending: a gross receipts tax of 2.3 percent and a sales tax of 2.3 percent,
along with exemptions and tax credits for small business owners and low-income families to
promote tax-burden equity. Within this proposed tax framework, Healthy California can
achieve both lower costs and greater equity in the provision of health care in California for both
families and businesses of all sizes. Thus, net health care spending for middle-income families
will fall by between 2.6 – 9.1 percent of income. Small firms that have been providing private
health care coverage for their workers will experience a 22 percent decline in their health-care
costs as a share of payroll. The small firms that have not provided coverage will still make zero
payments for health care under Healthy California through their gross receipts tax exemption.
Medium-sized firms will see their health care costs fall by between 6.8 and 13.4 percent as a
share of payroll relative to the existing system. Firms with up to 500 employees will experience
a 5.7 percent fall, and the largest firms, with over 500 employees, will experience a 0.6 percent
fall as a share of payroll relative to the existing system."

Cnon, here's your answer about how this will be paid for.