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

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.

Munchausen syndrome.

… a factitious disorder where those affected feign or induce disease, illness, injury, abuse, or psychological trauma to draw attention, sympathy, or reassurance to themselves.

Granted, they’re (one hopes) thin on the ground, but they exist.

If only we had thousands of other businesses that were having trouble hiring employees who could pick up the slack…

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.)

Do you have a cite for this? Because on it’s face, it sounds like an absolutely ridiculous assertion.

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.

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):

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 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:



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.

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.

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.