# California proposes UHC again, another empty promise to give false hope to their voters? **URL:** \ **Category:** Politics & Elections\ **Created:** [January 8, 2022, 7:03am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413 "2022-01-08T07:03:29Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [January 9, 2022, 3:37pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/21 "2022-01-09T15:37:45Z")
> [@Red\_Wiggler](#): > > Putting huge numbers of insurance company employees out of work is pretty unlikely and also the last fucking thing we should be worried about. There’s also a good number of people in the medical field whose whole job is to contend with differences in insurance plans (and many more who are exposed to it partially). I wouldn’t be surprised if half of the finance department of every hospital could go and 10% of the medical staff. During a boom, it might not matter so much. During the last recession, when unemployment was high, everyone was debating how much quantitative easing was needed, and at the same time trying to sell UHC - it was a bad moment to try and make the pitch. More importantly, politicians are going to get hit by big bucks to try and save all those jobs and they’ll take a big hit during their next election from that community, if they do it. ---
**Author:** ![DesertDog](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desertdog/32/11503_2.png) [@DesertDog](https://boards.straightdope.com/u/DesertDog)\ **Post date:** [January 9, 2022, 3:49pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/22 "2022-01-09T15:49:22Z")
> [@Horatius](#): > > And does anybody actually enjoy going to the doctor? [Munchausen syndrome.](https://en.wikipedia.org/wiki/Factitious_disorder_imposed_on_self) > … a [factitious disorder](https://en.wikipedia.org/wiki/Factitious_disorder) where those affected feign or induce [disease](https://en.wikipedia.org/wiki/Disease), illness, injury, abuse, or [psychological trauma](https://en.wikipedia.org/wiki/Psychological_trauma) to [draw attention](https://en.wikipedia.org/wiki/Attention_seeking), [sympathy](https://en.wikipedia.org/wiki/Sympathy), or reassurance to themselves. Granted, they’re (one hopes) thin on the ground, but they exist. ---
**Author:** ![Horatius](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/horatius/32/3572_2.png) [@Horatius](https://boards.straightdope.com/u/Horatius)\ **Post date:** [January 9, 2022, 5:24pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/23 "2022-01-09T17:24:39Z")
> [@Red\_Wiggler](#): > > Putting huge numbers of insurance company employees out of work is pretty unlikely and also the last fucking thing we should be worried about. [If only we had thousands of other businesses that were having trouble hiring employees who could pick up the slack…](https://boards.straightdope.com/t/the-nahployment-crisis/941117) ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [January 9, 2022, 6:22pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/24 "2022-01-09T18:22:13Z")
> [@Sage\_Rat](#): > > > [@Wesley\_Clark](#): > > > > 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’ll look it up. My understanding is in the 1990s, Taiwan wanted to develop a UHC system so they studied a wide range of systems and settled on the one they have now. I don’t know the details, but they rejected multi payer systems and found single payer more efficient, among other things. > **[Taiwan’s single-payer success story — and its lessons for America](https://www.vox.com/health-care/2020/1/13/21028702/medicare-for-all-taiwan-health-insurance)** > > The first in a Vox series on how countries around the world achieve universal health care. [https://www.politico.com/news/agenda/2019/11/25/health-care-economics-072145](https://www.politico.com/news/agenda/2019/11/25/health-care-economics-072145) [https://www.nytimes.com/2017/12/26/upshot/the-leap-to-single-payer-what-taiwan-can-teach.html](https://www.nytimes.com/2017/12/26/upshot/the-leap-to-single-payer-what-taiwan-can-teach.html) ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [January 9, 2022, 6:40pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/25 "2022-01-09T18:40:30Z")
> [@Wesley\_Clark](#): > > My understanding is in the 1990s, Taiwan wanted to develop a UHC system so they studied a wide range of systems and settled on the one they have now. I don’t know the details, but they rejected multi payer systems and found single payer more efficient, among other things. The Vox article, at least, doesn’t seem to single it out as special compared to most other countries. It seems pretty copy-paste from Europe. If the entire US wants to go single payer, besides solving the issue with misuse of the medical system, you also need to deal with the problem that the US is pretty universally the only country that funds R&D and trials new technology. Everyone else skates by on our work, after we prove (or disprove) the efficacy of the treatment. It’s like the corporate tax rate. If we raise it on our own then all the big businesses simply leave the US and set up shop in Ireland or wherever. You have to first go out to the other countries and form an agreement that you’ll all raise the tax rate together. Similarly, here, before you can drop US spending and, effectively, tank medical R&D, you need to go out and get every nation’s version of the NHS to start spending on exploratory, cutting edge, and “luxury” procedures, to coincide with the change in US policy. (I’ve also argued that we should add a “under FDA review and safety testing” extension that can be put into medical patents.) ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [January 9, 2022, 6:43pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/26 "2022-01-09T18:43:52Z")
> [@Sage\_Rat](#): > > If the entire US wants to go single payer, besides solving the issue with misuse of the medical system, you also need to deal with the problem that the US is pretty universally the only country that funds R&D and trials new technology. Do you have a cite for this? Because on it’s face, it sounds like an absolutely ridiculous assertion. ---
**Author:** ![Red\_Wiggler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/red_wiggler/32/13190_2.png) [@Red\_Wiggler](https://boards.straightdope.com/u/Red_Wiggler)\ **Post date:** [January 9, 2022, 7:04pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/27 "2022-01-09T19:04:30Z")
R&D might, _might_, slow down with the implementation of a UHC but that’s a fair trade-off for the increased accessibility and lower national costs. Pharmas will still develop new products to sell Americans. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [January 10, 2022, 5:54pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/28 "2022-01-10T17:54:29Z")
> [@Miller](#): > > Do you have a cite for this? Because on it’s face, it sounds like an absolutely ridiculous assertion. [https://www.policymed.com/2011/01/pwc-medical-technology-innovation-scorecard-us-falling-behind-in-the-race-for-global-leadership.html](https://www.policymed.com/2011/01/pwc-medical-technology-innovation-scorecard-us-falling-behind-in-the-race-for-global-leadership.html) > **[The Most Innovative Countries In Biology And Medicine](https://www.forbes.com/sites/matthewherper/2011/03/23/the-most-innovative-countries-in-biology-and-medicine/?sh=4074bcd21a71)** > > Is the U.S. really losing its edge in biology and medicine. > **[United States: #4 in the 2020 World Index of Healthcare Innovation](https://freopp.org/united-states-health-system-profile-4-in-the-world-index-of-healthcare-innovation-b593ba15a96)** > > America’s leadership in health care choice, science, & technology is marred by a fiscally unsustainable system of government-run care. The first link notes that the US is 40% of global medical device sales. If you could single out newer innovations, I’d venture to guess that the US would be an even larger percentage. And let’s look at how much we’re spending above Europe. Using a sample breakdown of “where the money goes” from Wales (good enough for a ballpark): > **[How much does NHS Wales spend?](https://www.bbc.com/news/uk-wales-30951803)** > > Economics correspondent Sarah Dickins looks at how money is spent in the NHS in Wales. Last I checked, salaries in the US for medical workers were relatively similar between the US and Europe - maybe a little higher, like 10-15% or something - drug prices are doubled, and I’m not entirely sure on medical devices, premises, and the other things. (Unfortunately, many of [my cites on the question](https://publius2point0.wordpress.com/2010/01/06/the-cost-of-health-care-part-4/) are now dead) You have to make that chart cost twice as much without expanding the Staff slice by more than 10-15%. Do we spend more, per capita, on public health and social services than an average European territory? Probably not and our spending on drugs on indicates that we’re ready to throw down for tangible assets; we had multiple vaccines ready to go before anyone else; and you can clearly see that US hospitals are far more decked out with tech than European ones: UK: > **[NHS hospitals face record levels of 'bed blocking'](https://www.theguardian.com/society/2014/jan/25/nhs-hospitals-bed-blocking-figures)** > > New figures show total number of bed days lost because of delayed transfers of care hit 70,124 in December 2013 > **[Some Facts About British Hospital Care](https://oanapetrache.medium.com/some-facts-about-british-hospital-care-17718bca2417)** > > Happy New Year, everyone! 2019 started off in style for me… with a visit to the Pembury Hospital which resulted in an appendectomy and my… US: [https://www.axios.com/coronavirus-hospital-bed-crunch-capacity-18e22c81-006b-4654-a74c-40ff86488431.html](https://www.axios.com/coronavirus-hospital-bed-crunch-capacity-18e22c81-006b-4654-a74c-40ff86488431.html) > **[‘Nursing Is in Crisis’: Staff Shortages Put Patients at Risk (Published 2021)](https://www.nytimes.com/2021/08/21/health/covid-nursing-shortage-delta.html)** > > “When hospitals are understaffed, people die,” one expert warned as the U.S. health systems reach a breaking point in the face of the Delta variant. By process of elimination and grouping things that seem more similar to one another (things vs. people vs. coverage differences), it’s likely that the grand majority of the double-spend value of the US versus other countries comes down to physical objects like medicine, medical devices, and cool looking, futuristic hospitals with big fountains out front. If the EU’s percentage of money spent on tech is roughly 15% of the total and that totals say $30u (arbitrary unit) per twerk (arbitrary time frame) that would say that their total spending is $200u per twerk and consequently that the US’s total spending is $400u/t. If 67% of $200u/t of that is for staff and we can only pay them 15% more, then our staff cost is $154u/t, 18% of $200u/t is for non-object spending ($36u/t) if we’re assuming similar costs to European, and the remainder of the $400u/t is for stuff. The US ends up spending $210u/t for tangible objects vs Europe’s $30u/t. Some of that will be for making cooler, fancier looking hospitals and that money goes to the construction industry instead of to drug and medical equipment sellers and some of it will go to non-innovative tech like gauze and band-aids (and maybe the US does buy and use things like that in a more wasteful way than Europe, I can’t say). But it seems difficult for me to believe that we’re not spending many times greater than Europe on innovative technology and buying the lion’s share of first gen tech. How much of a hit the medtech center would take, if the US started buying second and third gen, I can’t say precisely with the numbers that I’ve been able to find but I’m sure that it would be a pretty strong gut punch to the industry. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [January 13, 2022, 4:56am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/29 "2022-01-13T04:56:51Z")
So I’m not sure how the California legislative process works, but single payer in California passed out of the committee. I’m assuming it now needs to be passed by the CA state assembly, then the CA state senate, then signed by the governor. Then the voters have to approve the tax hikes in 2024. > **[Single-Payer Bill Leaps First Major Hurdle in California](https://www.commondreams.org/news/2022/01/12/single-payer-bill-leaps-first-major-hurdle-california)** > > Committee passage was heralded as "big news," but an uncertain path forward remains. Of course even if it does all that, they could still cancel the bill. Vermont passed single payer in 2011, then retracted it after passing it into law. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [February 1, 2022, 3:12am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/30 "2022-02-01T03:12:07Z")
Empty promise. Go figure. > **[Single-payer healthcare proposal fizzles in California Assembly](https://news.yahoo.com/single-payer-healthcare-proposal-fizzles-002131281.html)** > > Assembly Bill 1400 by Assemblyman Ash Kalra (D-San Jose) did not have the necessary votes to move forward ahead of a key deadline Monday. ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [February 1, 2022, 11:39pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/31 "2022-02-01T23:39:26Z")
Well, they promised to look into it. The same way my dad promised “I’ll think about it” when we bugged him to go to Diary Queen. (narrator: They never went to Dairy Queen) ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [February 2, 2022, 12:00am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/32 "2022-02-02T00:00:20Z")
> [@Sage\_Rat](#): > > 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. Extending health care to everyone is precisely how you lower those costs. > [@Sage\_Rat](#): > > 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. We have an an entire industry dedicated to denying people health care. That industry should be trashed. Most of the reason why healthcare is so expensive here is because we’re paying an awful lot of people to deny healthcare. The people actually providing healthcare still get paid well in a sane system, so they have no reason to leave. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [February 2, 2022, 12:23am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/33 "2022-02-02T00:23:37Z")
This is a bad idea… to do by state by state. It has to be nationwide. ---
**Author:** ![DesertDog](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desertdog/32/11503_2.png) [@DesertDog](https://boards.straightdope.com/u/DesertDog)\ **Post date:** [February 2, 2022, 1:30am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/34 "2022-02-02T01:30:04Z")
Eh. Women’s sufferage happened state by state before 19th amendment passed. Granted, it’s an imperfect comparison – it being more expensive to provide medical coverage than simply allow someone to vote – but it’s a start. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [February 2, 2022, 3:01am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/35 "2022-02-02T03:01:58Z")
> [@DrDeth](#): > > This is a bad idea… to do by state by state. It has to be nationwide. I believe places like Canada and Australia passed UHC on a provincial level before going national. Also California has a population and GDP higher than Canada and most other nations with UHC. They seem to have the resources to build a UHC system considering that many nations with a tiny fraction of Californias population and wealth built working UHC systems. I don’t think there will be an influx of people into CA for UHC who have expensive conditions, as many/most people with expensive conditions are already on medicaid or medicare. I think a lot of people who move to CA will be fairly healthy, just attracted to the sense of security that UHC gives. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [February 2, 2022, 5:21am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/36 "2022-02-02T05:21:44Z")
> [@Wesley\_Clark](#): > > . I don’t think there will be an influx of people into CA for UHC who have expensive conditions, as many/most people with expensive conditions are already on medicaid or medicare. I am not worried about that, but will my CA health insurance cover me in another state? ---
**Author:** ![Smapti](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smapti/32/17938_2.png) [@Smapti](https://boards.straightdope.com/u/Smapti)\ **Post date:** [February 2, 2022, 5:30am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/37 "2022-02-02T05:30:48Z")
> [@Wesley\_Clark](#): > > Empty promise. “They couldn’t get enough votes” != “empty promise”. ---
**Author:** ![Slight\_Off\_Hand](https://avatars.discourse-cdn.com/v4/letter/s/f08c70/32.png) [@Slight\_Off\_Hand](https://boards.straightdope.com/u/Slight_Off_Hand)\ **Post date:** [February 2, 2022, 11:20am UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/38 "2022-02-02T11:20:34Z")
> [@Wesley\_Clark](#): > > I believe places like Canada and Australia passed UHC on a provincial level before going national. In Canada the healthcare is provincial. The provinces get federal money based on their following the guidelines of the Canada Health Act but the system is not a federal system. It is managed province by province. note: this is the best of my understanding as a Canadian. I’m not an expert and have never really looked into it. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [February 2, 2022, 5:08pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/39 "2022-02-02T17:08:30Z")
> [@Smapti](#): > > “They couldn’t get enough votes” != “empty promise”. They had no problem getting enough votes when they knew Gov Schwarzenegger would veto it. ---
**Author:** ![Red\_Wiggler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/red_wiggler/32/13190_2.png) [@Red\_Wiggler](https://boards.straightdope.com/u/Red_Wiggler)\ **Post date:** [February 2, 2022, 5:13pm UTC](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413/40 "2022-02-02T17:13:26Z")
With some big policy changes, you just have to keep kicking at the door. “Never give up! Never surrender!” [Previous page](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413.md?page=1) [Next page](https://boards.straightdope.com/t/california-proposes-uhc-again-another-empty-promise-to-give-false-hope-to-their-voters/957413.md?page=3)