California proposes UHC again, another empty promise to give false hope to their voters?

I don’t know. I get tired of states proposing universal health care, then doing nothing. You can’t even blame republicans for this, because California has 80 seats in their state assembly, of which 60 are held by democrats. The California senate has 40 seats, of which 31 are held by democrats. And the governor of California ran on supporting single payer. When the democrats control 3/4 of the legislature seats and the governor ran in supporting UHC, you can’t blame anyone but the democrats when it fails.

I just get tired of all these false promises to distract voters and give them false hope that ‘this time’ they’re actually going to pass laws that make rich people mad. I’m sure this bill will die like all the others in all the other blue states.

“When” it fails?

UHC should either be an all or nothing thing - all 50 states or none at all. Otherwise, this invites unfair exploitation of free Californian healthcare by non-Californians.

We are wayyyyy overdue for total single-payer healthcare in America.

That being said, if it must be that way, then better UHC in California than none at all. I still argue, though, that it is better to charge a very low deductible than nothing at all, because people tend to treat something like trash when it’s totally free.

As long as I pay less for the same services, I don’t really care who I pay whether it’s the fed or state or the insurance co. But moving from AL to CA two years ago (and as a pretty left leaning guy), I don’t think I’m getting my money’s worth here presently so I don’t have high hopes if CA decides to do this. In fact, it would probably make my exit from this state more haste.

Democrats in the California Legislature aren’t a monolith. Some of them will support this universal health care bill, but others won’t. (And according to this report, the proposal requires tax increases, which a full two-thirds of the Legislature must approve.)

I don’t see where pro-UHC legislators are making false promises or otherwise acting in bad faith. They have a lot of support but not a decisive majority, so they’re putting the issue on the agenda and looking for ways to get it passed. I assume they’re playing the long game. (What else can they do?)

Why would California “propose” UHC, when UHC is already a highly-successful company?

UHC in this context is Universal Health Care

You have to be “a resident of California” to take advantage of it. (Note that the law specifically includes “undocumented persons” as residents.) Besides, it is paid for only by people who live or work in California - specifically:
(1) 2.3% on the gross receipts in excess of $2 million of all businesses in California;
(2) 1.25% on all wages or other compensation paid to employees who reside in California by any business that employs at least 50 residents of California, increased to 2.25% on amounts in excess of $49,900 per year (note this is a payroll tax, so it comes out of each employee’s paycheck);
(4) An income tax increase, starting at 0.5% on incomes in excess of $150,000 and going as high as 2.25% for incomes in excess of $2.5 million.

Most Europeans are covered by systems that are not single payer. They still manage to have universal health care systems that function well.

Why should we limit ourselves to only systems that are single payer when crafting a replacement?

I feel like democrats like to pretend they’re going to reform health care, without passing anything into law. It helps keep their base motivated and energized, and they hope their voters never catch on that its all just an act. I feel like these laws are designed to fail.

Yes, exactly. Deriding UHC as “Free healthcare” that will be exploited so much that it will collapse into bankruptcy almost immediately is a pretty standard scare tactic for those opposed to it, which completely ignores the reality of how it works almost everywhere else in the world.

Here in Canada, our “free” healthcare is actually an insurance system, it’s just run by the government, not a for-profit company. If you don’t have an Ontario Health Insurance Plan (OHIP) card, or its equivalent from other provinces, you’re expected to pay for any care you receive.

The big difference is that we don’t have to worry about “being out of system” or “co-pays” or “coverage denied” or all that other crap. Since no one makes a profit out of denying coverage, decisions are made based on actual medical need. I’ve never heard of anyone being denied coverage for routine healthcare.

There are some complaints about some specific treatments not being covered, but those tend to be edge cases that are few and far between. Plus, if such cases begin to affect enough people, then they begin to affect things like elections, so the system is probably more responsive than a for-profit system that can just deny you a policy if they think you’re costing them too much or causing too many hassles.

universal health care systems usually start as regional systems before going nationwide. I believe that is how UHC started in Canada and Australia, a province developed it first then it eventually went nationwide. This never caused mass migration to collapse those systems.

Also MA has had an ACA style plan for years long before the ACA went nationwide. It didn’t cause people to move to MA and collapse the system.

Also, if there ever was an issue with mass migration to live in a state with UHC all that does is prove how badly the US needs UHC. Thats like saying a state making the minimum wage $20/hr would cause massive amounts of people to move there, and somehow that shows why a $20/hr wage is a bad idea. It shows the opposite.

Not the experience in Canada. When we started medicare, doctors were permitted add a small extra fee, at least in Ontario (not in Quebec). Few did. To set up a billing system for a few bucks a patient wasn’t worth the effort. But I never heard that people were seeing doctors unnecessarily because it was free.

On the Republican side, Roe v Wade was passed by a Republican court and, without interlude, the court has remained majority Republican in the half century since that point.

Swearing up and down that you want what the voters want and then not doing that is a tried and true tradition that provably works. They keep voting for you. After all, the alternative is to vote for those other people.

That said, usually when something is obviously good and yet the government refuses to do it even when in a good position to do so, it’s because it’s actually a bad idea and/or overwhelmingly complicated to do - and thereby impossible to come to an agreement on how to implement.

In the case of health care, last I looked, everything costs about twice as much in the USA as the next most expensive country. When that’s true, extending health care to those who can’t currently get coverage - and who are at an ever higher risk of needing care - means we all have to spend even more than we do now, when what we’re paying now is already ridiculous.

But probably the reason for the expense is that we standardized on a system of pairing health care with employment and have employers a tax discount for offering health insurance. They can offer more to entice potential employees at a tax discount by offering them “better” health care. Your average, working age person’s idea of good care is, is that the hospital looks cool, has space age equipment, and will see them fast. Neither the prospective employee not the employer is running the numbers to charge the value in years of life per dollar that you’re getting from having TVs in every room and CAT scanners, and employers are just in a bidding war against each other to attract employees, so they’re willing to dump money into healthcare, whether it’s rational to do so or not.

Ultimately, this means that it you go to single payer:

  1. You’ve trashed an entire industry and laid off a good part of the workforce.
  2. By removing employment-based systems, the state of California will start forcing health spending to match the value of treatment, dropping the amount of money in the system by half. This means that a) all the medical professionals of the land will leave the state to one which pays better, and b) lots of people (especially the poor, with medical issues) will start moving into the state. Which will effectively force California to maintain the same going prices as the rest of the country in order to keep things from going insane, and to retain the medical workers that they need.
  3. The (perceived) quality of care will drop as our hospitals start turning into concrete bunkers and all our fancy equipment starts to rot and not be replaced.
  4. People will start to complain that the hospitals are being used like they are in Europe, Japan, Russia, etc. with people heading over to take naps because of bad digestion (and to avoid work/school), all on our dime.

Migrating to a better system than we have today, really, requires a multiple stage transition that plans out a sequence of smaller changes over a course of decades. Anything less will be chaotic. Ideally, as well, you arrive at an answer different than Europe and Canada went for, correcting for their mistakes. It’s difficult to do that when everyone just wants to copy those systems wholesale and bluff around the downsides.

Yeah, that’s something that I’ve always wondered: aside from hypochondriacs, who are all these people that are supposedly going to be going to the doctor all the time, just because it’s “free”? Firstly, it isn’t actually “free”. At a minimum, there’s a base investment of your time, to get there, sit in the waiting room, and come home. Honestly, that’s the single biggest factor that makes me not want to go to the doctor; I hate waiting and they’re always behind schedule. And then there’s travel costs, like bus fare and maybe parking.

And does anybody actually enjoy going to the doctor? Even if it were perfectly free, I don’t like getting poked and prodded unless I have to, and having the doctor tell me yet again that I should lose weight and stop drinking beer.

My understanding is Taiwan already did that, designed a UHC system from the ground up based on what worked and didn’t work in various countries. Taiwan has supposedly one of the best run and most cost effective systems out there.

I don’t think the issue is designing a well run system. That seems like the easy part. The hard part is implementing it since any genuine improvement in the health care system will cut costs and increase efficiency, both of which will cut into the business model of trillion dollar industries who won’t take it lying down.

Putting huge numbers of insurance company employees out of work is pretty unlikely and also the last fucking thing we should be worried about.

That would be true if you insisted on just doing more of what you are currently doing. i.e. if it is an expensive system now, it’ll be x more expensive to include the x more people who are currently missing out and deliver healthcare in the same way.

The point with UHC is that you’d do it very differently. It wouldn’t be just more of the same.

There is absolutely no reason why a system of UHC in the USA would be more expensive that what you currently have.

I’ll look it up.

That is addressed in my post. If the nation did it, the price would go up and then drop. If California did it, it would go up, drop, and then go back to the higher value (I expect).