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POLICY/POLITICS: California’s single payer bill, by Eric Novack

I don’t know why a bill that’s destined for a veto in a state he doesn’t  live in gets Eric Novack so worked up, but it does. So here’s his take on Sheila Kuehl’s single payer bill getting past the state Senate. And I won’t even mention that a Lewin study (all hail the mighty and authoratitive Lewin) showed that single payer would save California $353 billion over ten years (oops I just did!). So guess what’s Eric’s verdict is.

Many of you are aware that the California State Senate has just passed ‘universal health insurance’ for California.  The bill creates a single payer system with the details of funding to be worked out over time.  But it requires that all current Medicaid dollars and Medicare dollars (that’s all Part A and Part B) go into the pool.
 
It also creates an unbelievable bureaucracy—all unelected.  The new unelected health czar would be given control (along with an remarkably specific number of various board members—all appointed by the way) over nearly every aspect of healthcare delivery in the state.
 
The main beneficiaries – illegal immigrants, since the bill expressly states than anyone who resides in California is covered.  American citizens traveling in California—who will actually be footing the bill through federal tax revenues – would of course be billed for the cost of services provided in the state.
 
Fortunately, the Governor will likely veto this bill. For those of you who have a very strong stomach—read the bill yourself and marvel at the wishful thinking and special interest appeasement of a majority of California’s State Senate members.
But I do have to give you one gem of a quote from the KFF coverage: Chris Ohman, president and CEO of the California Association of Health Plans, said insurance companies can more effectively manage costs than the government  My Mr Ohman’s nose is getting very, very long!

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Matthew HoltBarry CarolEric NovackpgbMDTomH Recent comment authors
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Eric Novack
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Scott-
A compassionate doctor would have brought out the salt and ketchup from your break room!

Scott Robertson
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A little OT: I had a insulin-dependent diabetic eating a cheeseburger and french fries yesterday in my waiting room. Funny and sad.

pgbMD
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pgbMD

Correction. I will have to take Canada out of the economic failure column, but France, Italy, Germany and maybe Britain remain. Once oil drops back to $25 then Cananda will prob end up back in the dumps though.

Eric Novack
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pgbMD
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pgbMD

“How do you measure failure and for whom? And at what point in the oncoming unsustainable future of U.S. healthcare would you consider this system to be a failure? Would it be 80 million uninsured? Tax cuts/unending war/trade deficits/growing incompetent government/borrowing to stay afloat/global warming is a myth – these are signs of a successful government with a sustaining policy?” The only way to measure a nation’s failure/success as a whole is to look at GDP. Those numbers don’t lie. Canada, Britain and Western Europe are economic failures due to their craddle to grave entitlement programs. I don’t think many… Read more »

Eric Novack
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Peter- I enjoy the debate… Ask 10 of your co-workers how much their health insurance costs per month/ per year. Let me know how many know the correct answer. The reality is that few of us — other than those who pay for individual insurance — understand the cost of health insurance. We think of our SALARY + BENEFITS, rather than TOTAL COMPENSATION. Those on the left should really embrace the concept of TOTAL COMPENSATION as it protects workers from under the radar cost shifting. Those on the right should embrace it because disclosure about benefit costs explains to workers… Read more »

Barry Carol
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Barry Carol

If docs have some patients who rarely, if ever, take their advice, often don’t show up for appointments, don’t take their medication or take it inconsistently, etc., docs should diplomatically discharge those patients from his or her practice (fire them as customers). They should explain why they are doing this and, perhaps, offer two or three alternative referals within the community. For patients who are completely irresponsible, getting “fired” by your doc might be a useful way to convey the message that personal responsibility is important and counts for something. I also want to make it clear that I am… Read more »

John Fembup
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John Fembup

“Ok, so how do you police this decision making” Peter, why do you assume that personal health decisions must be “policed”? There are myriads of daily-living decisions that no one “polices”. You seem to assume that universal health care ultimately depends on some form of coerced behavior because you think too many other people are too ignorant to know what is good for them, and too unintelligent to figure it out. In that paradigm, policing is required, in order that these other people will be dragged, kicking and screaming, to the health care courthouse to be punished for making wrong… Read more »

Peter
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Peter

Posted by: Eric Novack | Aug 31, 2006 10:16:58 AM “In exchange for society paying for your healthcare, society expects you to make an effort. If you do not choose to play your part, the rest of us ought not be responsible for continually throwing resources at you.” “Not everyone can successfully lose 20, 50, 100 lbs. Not everyone can quit smoking. People do not choose cancer. But you can expect people to make real efforts and measure process” Ok, so how do you police this decision making process of, “George, I don’t think you are trying hard enough to… Read more »

Peter
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Peter

Posted by: pgbMD | Aug 31, 2006 1:25:57 PM
“Funny how a Canadian a Britain want to impose their failed socialized government run healthcare systems on us.”
How do you measure failure and for whom? And at what point in the oncoming unsustainable future of U.S. healthcare would you consider this system to be a failure? Would it be 80 million uninsured? Tax cuts/unending war/trade deficits/growing incompetent government/borrowing to stay afloat/global warming is a myth – these are signs of a successful government with a sustaining policy?

pgbMD
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pgbMD

“Meanwhile, Scott–if single payer passed, your income tax would go up but your payroll “tax” — the amount you spend on insureance for yourself and your employees — would go away! You can call that a tax increase if you like, but in terms of the difference in actual money, it’s neutral.”
I.E. we would be paying over 65% of our income to Uncle Sam like the Euros do. The neutral dream is complete BS. Smoke and mirrors. Just look across the Atlantic, I don’t like what I see.

pgbMD
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pgbMD

“So how come the universal gov insurance paid countries are doing it for less(about half) – rhetorical question – it’s because they control costs.” It is called severe rationing and cost controls. Last time I checked we live in a free society with Constituional protections. Currently we have Universal coverage and it is called the failed Medicaid/Medicare system. Bottom line, unlimited government guaranteed medical care will not work in this country, Americans expect more from their healthcare/physicians than the Europeans. No reason to expand a failed system. This cyclical argument keeps going round and round b/w why we should or… Read more »

Eric Novack
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Matthew — DM is important, but must have teeth for enforcement with consequences…
Every industry iis self serving… but remember that the malaria business, which kills millions of the world’s poorest men, women and children every year, is good, not because of some medical-industrial conspirancy, but rather because environmental activists in the USA would rather see those people die than let DDT be used…

Peter
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Peter

Posted by: pgbMD | Aug 31, 2006 5:15:22 AM “According to BusinessWeek, Finkelstein believes that consumers opt for more medical services if someone else pays for it. But more important, her research shows that the more significant effect on rising health costs may be that insurance guarantees a steady source of revenue for hospitals and health-care providers. “Such ready cash encourages them to build new cardiac-care centers and stock up on the latest high-tech equipment, knowing it will be paid for,” notes BusinessWeek.” So how come the universal gov insurance paid countries are doing it for less(about half) – rhetorical… Read more »

Eric Novack
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TomH– when it comes to substantive changes in the largest sector of our economy, discretion is the better part of valor. (I have now expended my one and only Shakespeare riposte). Your heartfelt sickness of “of magical thinking about the inherent superiority of the market-driven healthcare system” implies that we currently have a market driven system? You know, of course, that we do not. I can appreciate your experiences in low-income clinics. I spend a fair amount of time in emergency departments and caring for injured folks all along the socioeconomic spectrum. Vast exppansion of federally funded social programs are… Read more »