California Senate passes universal health care bill | Hacker News Reader

California Senate passes universal health care bill

sacbee.com

38 pointsfred25615 comments

Why is the level of conversation on this topic so low?

There's two top level comments here that effectively say: "Healthcare costs money! You didn't think of that did you, commie!".

And this is on a forum full of intelligent techies who are interested in business. I shudder to think what the opinion of the average Republican voter is. Some fever dream involving death panels no doubt.

This won't pass the house, the Property class won't let it. (Their two departments are the Democrats and Republicans.)

If it were possible, in a hypothetical sense:

Raise corporate taxes, they're much too low to be sustainable.

Care would need to be more efficient than Cuba or UK NHS in order to be cost-effective, this means preventative medicine and QALY will be front-and-center. The question will be how to pay for major operations and expensive, ongoing conditions without ending-up with Greece-style finances and IMF bailout austerity conditions. Even with cutting costs to rest of the world prices (1/4 of current prices), it would still be hundreds of billions per year. It's not impossible, but it would be an up-hill climb all the way and might not be very good with compromises, loopholes and back-room deals that will likely infest it.

Maybe there's enough rich corporations and wealthy people with taxes to raid, but their lobbyists on both sides of the aisle won't allow anything more than crumbs and getting back to sucking the blood money out of poor people.

Last I checked both houses were over 2/3 Democrats. Is this not the case now?

The bill does not include detailed language about how the state would come up with hundreds of billions of dollars to pay for health care coverage for nearly 40 million residents.

Perhaps they expect to go bankrupt and let the rest of the country bail them out?

You mean the red states that California have been subsidizing to help us out?

California is indeed a profit-center in the United $tates.

Turnabout is fair play.

> Perhaps they expect to go bankrupt and let the rest of the country bail them out?

No, like most states (and unlike the federal government) California has a Constitutional requirement for a balanced operating budget with limited exceptions, and so (even if authorized by legislation) a funding mechanism would have to be passed for this to actually be implemented.

What they expect is that the Assembly will amend and adopt a funding mechanism if it passes the bill (which will definitely send the bill back to the Senate and almost certainly require either a 2/3 vote or a referral to the electorate, possibly both, fot a couple of reasons). This is a step toward a real single payer law, but it is not one.

$400B a year with no way to pay for it.

$331b, not $400b. And the article talks about ways to pay for it. You just have to read to the end is all...

Instead of everyone paying insurance premiums, they pay through taxes. And no need to argue: almost every other first world country provides universal healthcare funded by taxes. It's both financially possible and prudent.

https://en.m.wikipedia.org/wiki/List_of_countries_with_unive...

> And no need to argue: almost every other first world country provides universal healthcare funded by taxes.

Almost every other developed country provides universal healthcare, but there's a mix of systems and all-public systems are not overwhelmingly dominant. Mandated-purchase with public safety net programs are not uncommon.

I think we're in agreement? There is a basic level of care in those UHC countries, but then private insurance/services/etc for above and beyond.

In some the model is very similar in outline (but superior in execution) to the US ACA model: everyone is required to buy insurance with certain minimum standards, with subsidies and/or a public fallback program for the indigent. In some there is a universal public baseline program that everyone is on that you may be able to supplement on top of, as you describe, but that's not at all generally true.

Apparently federal, state, and local government are already paying $200 billion for health care, and employers and individuals already pay $150 billion in premiums. Redirect that to taxes and you've got more than the $331 billion estimate needed.

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