Blue Mass Group

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California Senate passes Medicare for all single payer health care bill

By

CommonDreams (unsurprisingly, a story that is hard to find in the traditional media):

SB 810, The California Universal Healthcare Act, authored by Sen. Mark Leno and sponsored by the California Nurses Association/National Nurses United (CNA/NNU), with broad support among many healthcare, community, and labor groups, will now proceed to a vote by the Assembly, which has passed similar legislation in the past.  The bill would establish a single-payer system in California, modeled on the healthcare systems flourishing in virtually all other industrialized nations, where better patient outcomes are achieved at a fraction of the cost of the U.S. system.

If California can do it, why not Massachusetts? Lower costs, better health care. What’s not to like.

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  2. If California can do it, why not Massachusetts?

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    p>As a function of percent of the population, how many people live outside CA but within 100 miles of the border?  Now, for MA?

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    p>MA has a lot more neighbors to MA relative to our size.  Folks coming across the border would be a much bigger burden for MA.  Now, if we could get a few other states to join in at the same time (say RI, CT, and ME) we’d have a better chance at it methinks.

    • In an area of geographic density of population like New England that makes sense.  I don’t think I have seen that concept mentioned, let alone developed.   Excellent idea to investigate.

      • It’s an issue of freeloading.  How many people could cross the border?  There aren’t that many non-Californians living 100 miles or less from the CA border, relative to the number of Californians.

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        p>Alaska is by far the least dense — one fourth as dense as Wyoming, and it could work well in Alaska too — it’d be hard to freeload.  Roughly speaking, all of the following cold pull it off as a “region”:

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        p>HI, AK, CA, WA, OR as individual states.  They could regionalize of course, and then welcome their border states — Idaho, Nevada, Arizona.  From there, you could do Montana, Wyoming, Utah, and from there Colorado.  If you add New Mexico you get El Paso, so be prepared for dealing with that.  Add Kansas and you get Kansas City MO.  Omaha NE is just about 100 miles from the tip of SD, etc.  Each state you add at this point lands you the potential for a “freeloading” city nearby.

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        p>Maybe Texas?  Texas is big, but is it big enough to absorb the freeloaders of LA, AK, and OK?

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        p>The point is, at some point you get to the situation where you ask a freeloading state to join the group, which means that it’s now on the perimeter and has to absorb all of the freeloaders.  At that point, you’ve just got to go national.

        • I like the idea of regionalization on so many fronts not just health care.  

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          p>As for “free loaders” how would Canada impact new England and Mexico California.  Is it possible that patients from other countries could also impact the system?

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          p>I like the thoughts as I had not heard the region argument before and wonder if it could work on this and other issues.

          • I don’t think it’s a big problem w.r.t. Canada — after all, the difference between Canadian health care and Maine health care under a single payer wouldn’t be anywhere near as dramatic as, for example, Mexico and California.

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            p>So, if you’ll take, with respect to this issue, “Canada will be so little a problem we can ignore it” I’ll also offer “Mexico is quite a substantial problem, and I don’t know how to deal with it.”

            • and has been quickly moving towards improved results.
              http://wapedia.mobi/en/Health_…

              According to the site http://www.internationalliving.com, health care in Mexico is described as very good to excellent while being highly affordable, with every medium to large city in Mexico having at least one first-rate hospital. In fact, some California insurers sell health insurance policies that require members to go to Mexico for health care where costs are 40% lower. Some hospitals are internationally accredited. Americans, particularly those living near the Mexican border, now routinely cross the border into Mexico for medical care. [9] Popular specialties include dentistry and plastic surgery. Mexican dentists often charge 20 to 25 percent of US prices, while other procedures typically cost a third what they would cost in the US. The http://www.internationalliving.com site states that on average, an office visit with a doctor-specialists included-will cost about US$25, an overnight stay in a private hospital room costs about $35, and a visit to a dentist for teeth cleaning costs about $20. Some 40,000 to 80,000 American seniors spend their retirement years in Mexico with a considerable number receiving nursing home and health care.

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              p>Actually the US currently ranks #1 in medical tourists traveling abroad for health care.

    • If people move to MA and start paying MA taxes that’s fine.  We could easily require proof of MA residency to take advantage of these services.

      • it’s no difference for signing up for health insurance after you’ve come down with cancer.  Moral hazard.  Even if those people stayed and paid taxes, they simply wouldn’t ever catch up to their added cost (in aggregate).

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        p>As for requiring proof, it’s not hard for me to rent a $400/month slum apt in A-B if it means a free $10,000+ medical procedure.

      • if business moved to Massachusetts to take advantage of the cheaper health care costs. The State that accomplishes this first is the biggest winner.

    • You could make it a system where you have to show residence. The easiest way to get other states involved would be to create the system to begin with.  

  3. Medicare’s Origins Lie In Saskatchewan

    The origins of Medicare date back to 1947 in Saskatchewan. Premier Tommy Douglas passed the Saskatchewan Hospitalization Act, making healthcare free for much of the population. A decade later, Prime Minister Louis St. Laurent introduced a national hospital insurance program despite an outcry from the medical community, and insurance companies.

     

    • Namely HI, AK, WA, or OR.  They could join a regional pact, or do it their own.  In either case, the more states which joined on, the easier it would be to make the case to expand that system.

  4. If you’re tempted to chalk it up to corporate conservatism that makes no sense.  I’ve always thought the business world should be first in line to support this because it would let them off the hook regarding employee benefits and make them more competitive globally.  I’d love for someone to point out the flaw in my logic here.

    • Businesses would almost certainly pay significantly less to provide insurance than they do now, but they’d almost certainly have to contribute something to make this viable. For reference, the way the medicare-for-all bill in the House proposed funding was a 3% tax on employees and employers. That’s much, much, much less than almost anyone pays for insurance, including employer contributions, but it’s still not a free lunch.  

      • Then it’s still a bargain all around compared to status quo, right?  You’re right about there not being a free lunch, of course, but the basic logic to my argument still stands, doesn’t it?

        • a huge, huge bargain. I just think it’s important we recognize that it’s not free, because it’s actually important to realize how something like this would be funded so people don’t think it’s a gimmick.

        • Would this entail a shift in employee / employer contributions?

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          p>While this might result in a shift from employees to employers in the private sector under what would seem to be a 50 / 50 split based on Ryan’s example would this also entail a shift from the municipalities to their employees where the splits generally are more in the 60/40 – 85/15 range?

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          p>If this is the case, I could see how this would benefit CA.  Not only would the State benefit from the potential for presumed decreases in costs but they would also be bearing a smaller percentage of the overall cost of the plans.  In fact, it would seem to push for a common cost allocation between employee and employer regardless of union vs. non-union or public vs. private.

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          p>Interesting concept and will continue to look for additional updates.

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          p>Thanks

    • Single payer is a silver bullet through the heart of the health insurance industry, and because of that, it also has a dramatic impact on the large and extraordinarily profitable health care provider conglomerates (the executives and share holders, not the providers themselves).

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      p>The health insurance industry, not surprisingly, attracts lots of investment (including pension) dollars. The change we’re talking about would move those pension dollars somewhere else. It threatens to even — be sure you’re sitting down here — leave them in the pockets and wallets of consumers.

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      p>The media tend to low-key stories that drive away advertising revenue. Success in this area has the potential to drive away a lot of advertising revenue. That’s why they’ll be reluctant to report this.

  5. huge amount of free care and bad debt they incur is probably a big factor.   I would bet that a lot of hospitals are also lobbying for a universal system – single payor or not.  

  6. Leno’s bill would create a commission to recommend a financing plan for the health care system. The plan would go before voters for approval before it could take effect.

    Symbolic Action?
    Although SB 810 is moving forward in the Legislature, Gov. Arnold Schwarzenegger (R) has pledged to veto it if it is sent to his desk. The governor has rejected two similar single-payer proposals in the past (Thompson, AP/Los Angeles Times, 1/28).

    Lawmakers also would need to work out numerous details before the state could implement a government-run health care system.

    Senate President Pro Tempore Darrell Steinberg (D-Sacramento) said, ,“Let us stipulate that single-payer is a long way off” (Herdt, Ventura County Star, 1/28).

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    p>Because your post seems to imply something rather different.

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    p>http://www.californiahealthlin…

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    p>

  7. This bill passed two times before, the Gubernator vetoed it. And even if Maria convinces him to sign it before he goes out as a lame duck, it still won’t pass since CA voters hate paying for anything. Not to mention they don’t have the money to implement it.

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    p>So your shocked major media outlets didn’t report a piece of legislation that has no chance of facing the voters, no change of getting it approved if the voters do see it, and no chance of being implemented in any way shape or form?

      • You tell me what realistic chance this has of affecting anyone’s health care outcome’s in California and then I will stop being cynical. Sorry if universal healthcare, which I support and want, ever gets passed in this country, then that’s a story. But if a Democratic supermajority couldn’t do it I don’t see how it can happen in a tax averse, fiscally insolvent state with a Republican governor.

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        p>I thought this was supposed to be a reality based community Bob?

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