Current Events > Proposed Cali single payer bill has a $400 billion price tag and 15% tax hike

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voldothegr8
05/24/17 10:59:30 AM
#1:


http://www.latimes.com/politics/essential/la-pol-ca-essential-politics-updates-first-fiscal-analysis-of-single-payer-1495475434-htmlstory.html

A single-payer healthcare system in California — a galvanizing cause among the state's progressive flank — would cost $400 billion annually, according to a legislative analysis released on Monday.

The analysis, released in advance of the proposal's hearing in a key fiscal committee, fills in what has so far been the biggest unanswered question concerning the plan to dramatically overhaul California's healthcare coverage.

The analysis found that the proposal would require:

A total cost of $400 billion per year to cover all healthcare and administrative costs.
Of that, $200 billion of existing federal, state and local funds could be repurposed to go toward the single-payer system.
The additional $200 billion would need to be raised from new taxes.

The analysis proposes one scenario in which a new payroll tax on employers — with a rate of 15% of earned income — could supply the new revenue. But the measure itself does not contain a specific tax proposal, and therefore would not, at this point, need a two-thirds vote to approve a new tax.

This is what liberals want, the middle class on up being taxed to hell for "free" medical visits. Can you imaging how much single payer would cost for the whole country? Not that this will pass, but it's still sickening.
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voldothegr8
05/24/17 11:33:45 AM
#3:


Nobody cares?
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Balrog0
05/24/17 11:36:11 AM
#5:


Interesting!
Fully 1/2 of it would be covered by existing funds.

Payroll tax hike is an awful, awful plan though.

I wonder how they calculated the reduction in spending.
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Balrog0
05/24/17 11:36:42 AM
#6:


Spooking posted...
Wouldn't you need the whole country on board with single-payer as so you don't have companies moving out of state and to another?


the state would underwrite the risk itself

the whole point is to get rid of the insurance middle man, which is why insurance companies hate single payer
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Antifar
05/24/17 11:38:01 AM
#7:


http://mattbruenig.com/2017/05/22/californias-surprisingly-cheap-single-payer-plan/
There is coverage today of a new report from the California Senate Appropriations committee estimating the budgetary implications of a proposed single payer health plan for the state (Sacramento Bee, LA Times, Vox). I’ve not yet been able to access the report directly, but the coverage of it is pretty encouraging.

After the implementation of single payer, the report says, health expenditures in the state of California would total $400 billion per year, or 15 percent of the state’s GDP. This is 3 percentage points lower than the share of GDP the US overall spends on health care.

The reports indicate that, currently, government spending on health care in California is around $200 billion and employer spending on health care is between $100 billion and $150 billion. There is no indication of how much individuals currently spend on top of employers and governments on individual premiums and out-of-pocket expenses. Nonetheless, net of current government spending ($200 billion) and employer spending ($100-$150 billion), the single-payer plan requires an additional $50 to $100 billion of spending, or 1.9% to 3.8% of CA GDP.

For that extra 1.9% to 3.8% of GDP:

The state would pay for almost all of its residents’ medical expenses — inpatient, outpatient, emergency services, dental, vision, mental health, and nursing home care — under the plan, and Californians would not have any premiums, copays, or deductibles.


That’s an incredible deal for just 15% of GDP, which again is lower than the US as a whole already spends on health care.

Of course, there are challenges to implementing single payer on the state level. States have to deal with all sorts of federal laws like ERISA that could disrupt their plans. States have to hope the federal government will chip in the share they currently contribute to the state’s health care sector. States have to worry about rich people leaving to avoid tax to some degree. And states have to worry about what will happen during a recession when the state’s budget contracts in ways the federal government’s budget does not.

But if the plan would work like this report says it does and at the cost this report says it does, it is a no-brainer.

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Balrog0
05/24/17 11:41:12 AM
#8:


if they use a payroll tax the bigger problem is going to be an increase in working class people being squeezed out by taxes, particularly those without health issues
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Darkman124
05/24/17 11:41:47 AM
#9:


voldothegr8 posted...

This is what liberals want, the middle class on up being taxed to hell for "free" medical visits.


the middle class already pays through the nose for its healthcare

this would just change who they pay

it'd also be employer-friendly as it'd alleviate the need for companies to buy their employees' healthcare, which costs them thousands per person per year

this would potentially allow salaries to grow, or corporations to expand and hire more staff
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Balrog0
05/24/17 11:42:07 AM
#10:


also, we only spend 16% of GDP on healthcare I thought?

http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective

http://www.commonwealthfund.org/~/media/images/publications/issue-brief/2015/oct/squires_oecd_exhibit_08.png?la=en
cmon matt
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Questionmarktarius
05/24/17 11:43:31 AM
#11:


Good. Doing this at the state level first is very useful, to see how it works out before blindly jumping in nationwide.

Spooking posted...
Wouldn't you need the whole country on board with single-payer as so you don't have companies moving out of state and to another?

Did you just admit that the only way socialism can work is through centralized tyranny?
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Balrog0
05/24/17 11:44:23 AM
#12:


Darkman124 posted...
the middle class already pays through the nose for its healthcare

this would just change who they pay


I do wonder how this influences ESI, actually.

I dunno enough about medicaid and/or the individual marketplaces in california to comment on how the middle class are burdened by the current system there, though I assume its not great.

The big issue is that most private insurance is high deductible but with relatively low premiums, whereas the payroll tax is going to be a pretty noticeable ongoing cost
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Darkman124
05/24/17 11:45:07 AM
#13:


Balrog0 posted...
Darkman124 posted...
the middle class already pays through the nose for its healthcare

this would just change who they pay


I do wonder how this influences ESI, actually.

I dunno enough about medicaid and/or the individual marketplaces in california to comment on how the middle class are burdened by the current system there, though I assume its not great.

The big issue is that most private insurance is high deductible but with relatively low premiums, whereas the payroll tax is going to be a pretty noticeable ongoing cost


yeah, i think it's effectively a shift to everyone being on "good" insurance

but scaling it with taxes means nobody is unduly burdened vs how individual mandates tend to play out

this would be a lot cheaper per person if implemented on a national level though.

i wonder if the state will be rolling out personal health initiatives. my workplace gives pretty significant credits to our insurance if we meet basic health/fitness standards. that's the other nice way to reduce to cost of a pool--lower the risk level of the average member by incentivizing them to be lower risk
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Antifar
05/24/17 11:47:38 AM
#14:


I'd imagine one of the biggest beneficiaries here will be employers who currently pay (to varying degrees) for their workers' health insurance. That money can now go to wages/investment/executive bank accounts.
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Questionmarktarius
05/24/17 11:48:16 AM
#15:


Darkman124 posted...
this would be a lot cheaper per person if implemented on a national level though.

Why?
Historically, healthcare was least expensive when it was implemented in groups of roughly 50-100.
https://fee.org/articles/lodge-doctors-and-the-poor/
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Sativa_Rose
05/24/17 11:49:00 AM
#16:


$400 billion a year for only 40 million people?

$10k per person per year

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

Other countries are paying much less than that. Will this idea help bring the costs down to levels more in line with those other countries?

Also I don't like the idea of the payroll tax. It should be income tax based, not on payroll. I'm tired of this idea that progressives have that they can just keep raising payroll taxes. It's not a good idea. In a world where we want more and more hiring, we should not be continuously trying to make it more expensive to hire.
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EternalDivide
05/24/17 11:50:00 AM
#17:


OMFG! This is a horrible horrible plan. As CA resident, this is a nightmare. But it will probably pass given that those maniac leftist fucks have a super majority in the state senate right now.
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Darkman124
05/24/17 11:50:19 AM
#18:


Questionmarktarius posted...
Darkman124 posted...
this would be a lot cheaper per person if implemented on a national level though.

Why?
Historically, healthcare was least expensive when it was implemented in groups of roughly 50-100.
https://fee.org/articles/lodge-doctors-and-the-poor/


because old historical data doesnt really apply to modern insurance pooling

this isnt about 'implementing healthcare in 1930' but reducing the average risk level of paying for modern healthcare practices
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Balrog0
05/24/17 11:50:45 AM
#19:


Darkman124 posted...
i wonder if the state will be rolling out personal health initiatives. my workplace gives pretty significant credits to our insurance if we meet basic health/fitness standards. that's the other nice way to reduce to cost of a pool--lower the risk level of the average member by incentivizing them to be lower risk


I imagine that these exist in some form. Even here in Arkansas there are incentives for wellness visits on the individual marketplace, though they're too small to really be effective imho
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Sativa_Rose
05/24/17 11:51:15 AM
#20:


Darkman124 posted...
i wonder if the state will be rolling out personal health initiatives. my workplace gives pretty significant credits to our insurance if we meet basic health/fitness standards. that's the other nice way to reduce to cost of a pool--lower the risk level of the average member by incentivizing them to be lower risk


I hate how we've decided to make everything healthcare related through people's fucking employers. It drives me up the wall. It's something I think is terrible for this country.
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emblem boy
05/24/17 11:51:38 AM
#21:


So since companies won't be paying for employees insurance, the idea is they would then pay this payroll tax increase?
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Antifar
05/24/17 11:51:44 AM
#22:


Questionmarktarius posted...
Darkman124 posted...
this would be a lot cheaper per person if implemented on a national level though.

Why?
Historically, healthcare was least expensive when it was implemented in groups of roughly 50-100.
https://fee.org/articles/lodge-doctors-and-the-poor/

Why were the lodges able to charge such low fees? The answer to this question lies with several organizational strengths peculiar to the fraternal structure itself. The fact that lodges could entice doctors with a large and stable market left them well positioned, as one opponent put it, to purchase medical services at wholesale and sell at retail.


Think of the country as a huge lodge.
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HypnoCoosh
05/24/17 11:53:12 AM
#23:


California should be it's own country.
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The Admiral
05/24/17 11:53:47 AM
#24:


Nothing like enacting a massive entitlement bill like this at the height of the economic cycle. I can start writing my next book now entitled "How Liberal Economic Policies Completely Crippled a U.S. State."
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Questionmarktarius
05/24/17 11:54:40 AM
#25:


Antifar posted...
Questionmarktarius posted...
Darkman124 posted...
this would be a lot cheaper per person if implemented on a national level though.

Why?
Historically, healthcare was least expensive when it was implemented in groups of roughly 50-100.
https://fee.org/articles/lodge-doctors-and-the-poor/

Why were the lodges able to charge such low fees? The answer to this question lies with several organizational strengths peculiar to the fraternal structure itself. The fact that lodges could entice doctors with a large and stable market left them well positioned, as one opponent put it, to purchase medical services at wholesale and sell at retail.


Think of the country as a huge lodge.

And, much like the 1910s, there will probably be one doctor for the entire "lodge".
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Drpooplol
05/24/17 11:56:31 AM
#26:


The Admiral posted...
I can start writing my next book

Do you have a first book?
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Mal_Fet
05/24/17 11:59:04 AM
#27:


Inb4 all of silicon Valley moves to Utah
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Mal_Fet
05/24/17 11:59:43 AM
#28:


The Admiral posted...
Nothing like enacting a massive entitlement bill like this at the height of the economic cycle. I can start writing my next book now entitled "How Liberal Economic Policies Completely Crippled a U.S. State."

Was the first one about Illinois?
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Questionmarktarius
05/24/17 12:08:18 PM
#29:


The Admiral posted...
Nothing like enacting a massive entitlement bill like this at the height of the economic cycle. I can start writing my next book now entitled "How Liberal Economic Policies Completely Crippled a U.S. State."

Then let it fail, and we'll see how dumb an idea it was. Or, it'll actually succeed, and we'll have a working model to draw from.
The important part is a small scale experiment, instead of "this is how it's going to be" all at once.
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CruelBuffalo
05/24/17 12:30:05 PM
#30:


Mal_Fet posted...
Inb4 all of silicon Valley moves to Utah

Lmao. Engineers don't want to live in a conservative area with all those drinking restrictions
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Balrog0
05/24/17 12:30:49 PM
#32:


CruelBuffalo posted...
Lmao. Engineers don't want to live in a conservative area with all those drinking restrictions


that's why they're moving to texas?
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Questionmarktarius
05/24/17 12:31:55 PM
#33:


CruelBuffalo posted...
Mal_Fet posted...
Inb4 all of silicon Valley moves to Utah

Lmao. Engineers don't want to live in a conservative area with all those drinking restrictions

This is true. They'll relocate to Las Vegas, or more likely somewhere else in Nevada, where prostitution is legal.
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CruelBuffalo
05/24/17 12:36:36 PM
#34:


Balrog0 posted...
CruelBuffalo posted...
Lmao. Engineers don't want to live in a conservative area with all those drinking restrictions


that's why they're moving to texas?


They're moving to liberal Austin...because...guess why
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MangaFan462
05/24/17 12:37:13 PM
#35:


Cost of living needs to get even more expensive, lets do it!
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Balrog0
05/24/17 12:39:01 PM
#36:


CruelBuffalo posted...
They're moving to liberal Austin...because...guess why


what makes you think blue laws in utah are any worse than blue laws in texas? do you think austin gets a hipster exemption or something?
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Balrog0
05/24/17 12:40:12 PM
#37:


also most in-migration to texas from other states goes to DFW and Houston with Austin a distant third

Austin gets more transplants from within texas than from outside
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CruelBuffalo
05/24/17 12:43:00 PM
#38:


Balrog0 posted...
CruelBuffalo posted...
They're moving to liberal Austin...because...guess why


what makes you think blue laws in utah are any worse than blue laws in texas? do you think austin gets a hipster exemption or something?

1. You're over analyzing a non serious comment
2. They aren't the same drinking restrictions. Utah is among the most strict https://en.m.wikipedia.org/wiki/List_of_alcohol_laws_of_the_United_States
3. Which areas in Texas get the most engineers outside of the oil industry. What's the politics and environments like in those areas? Hmmm
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The Deadpool
05/24/17 12:43:49 PM
#39:


What percentage of people's current income is their insurance premium nowadays?

From all the complaints of it crippling the middle class Inwould imagine it'd be higher than the 15% proposed here...
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Balrog0
05/24/17 12:46:29 PM
#40:


if im over analyzing a non serious comment why are you doubling down on it in the same post lol
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CruelBuffalo
05/24/17 12:51:01 PM
#41:


Balrog0 posted...
if im over analyzing a non serious comment why are you doubling down on it in the same post lol


Because I wanted to show there is some truth that Utah laws suck, but it's obvious that's not the main factor high majority choos to move. Your response can also be "yeah you're right Utah laws are worse" and see that it's more City life and liberal areas in Texas that are getting more engineers.
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BLAKUboy
05/24/17 12:51:36 PM
#42:


Balrog0 posted...
also most in-migration to texas from other states goes to DFW and Houston with Austin a distant third

Pretty sure all three of these areas lean pretty heavily liberal anyway.
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QuantumScript
05/24/17 12:57:31 PM
#43:


This will bankrupt people, especially the people who are self-employed.
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Balrog0
05/24/17 12:57:33 PM
#44:


CruelBuffalo posted...
Because I wanted to show there is some truth that Utah laws suck, but it's obvious that's not the main factor high majority choos to move. Your response can also be "yeah you're right Utah laws are worse" and see that it's more City life and liberal areas in Texas that are getting more engineers.


BLAKUboy posted...


Pretty sure all three of these areas lean pretty heavily liberal anyway.


but the fact that the areas are liberal is just as important as the alcohol laws

no one who knows anything about houston or dallas would consider them liberal areas the way the major metros in california are anyway
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CruelBuffalo
05/24/17 1:00:20 PM
#45:


You're still harping on that even after I literally said most people do not base it on alcohol laws?

Btw San Francisco/Oakland are the only Uber liberal areas of California

San Diego is pretty moderate, Orange County leans right, and LA and San Jose are only moderately liberal compared to sf/oakk
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Balrog0
05/24/17 1:04:37 PM
#46:


bro you seem to be the one taking this too seriously

I'm not harping on anything

I'm just saying the vast majority of people moving to places care equally about the alcohol laws and the politics of the place they're moving (very little)

I'm from San Jose, and the only people who can say with a straight face that San Jose is only moderately liberal are people from California or other states where democrats have a trifecta in state government.

Like if San jose is only moderately liberal, DFW and Houston are straight up conservative. Lan Diep is a republican who would probably not even fit into the democratic party in texas honestly
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Balrog0
05/24/17 1:06:16 PM
#47:


im not being super srs here

i do think people should visit more of these places though to see how different the context for cities in different states can be
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sktgamer_13dude
05/24/17 1:06:22 PM
#48:


Love that Mal and Admiral shitposters once in this topic and since they didn't get any bites, they immediately left cause they add nothing to the conversation.
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Giant_Aspirin
05/24/17 1:11:33 PM
#50:


HypnoCoosh posted...
California should be it's own country.


imagine being so blindly conservative and butthurt over CAs electoral votes that you actually think this would be good for the nation.

p.s. you have Texas and it's guaranteed block of Red to counter the Blue from CA.
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CruelBuffalo
05/24/17 1:52:05 PM
#51:


Balrog0 posted...
Like if San jose is only moderately liberal, DFW and Houston are straight up conservative. Lan Diep is a republican who would probably not even fit into the democratic party in texas honestly

I've lived in Pennsylvania and Atlanta, stayed in Dallas and Amarillo, have friends in Austin. Trust me I have not only remained in California, I was also a consultant which had me flying to different parts of the country.
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