Looking Ahead to Wednesday's Hearing on California Health Care Bills

AB 8 was pretty bad. It was obvious to many of us before the special legislative session that any compromise with Ahnold would be even worse. We were right. Wright's article sets out one of the main reasons why the compromise that has emerged should be rejected: By reducing the required employer contribution, it will impose greater costs on large numbers of middle income Californians. Employers will cut down on what they kick in for their employees' health care; 6.5% will become the norm. Employees will have to cover the rest. Because insurance companies will still rake off their bloated admninistrative costs and profits, the total from emplyer and employee contributions (and other sources) will fall far short of what is needed to furnish comprehensive coverage for most Californians. So a scimpy package of benefits will become the norm. To expand insurance companies' profits, moderate income workers would be forced to suffer a substantial de facto pay cut in exchange for junk insurance.

The government caused the problem with health care in America by over socializing (with mandates) medicine to the extent it is not completive, and we want to exacerbate the problem? U.S. Capitalism refers to an economic system in which the means of production are all owned and operated for profit, and in which investments, distribution, income, production and pricing of goods and services are determined through the operation of a market economy. It is the right of individuals and groups of individuals acting as "legal persons" or corporations to trade capital goods, labor, land and money (see finance and credit). See http://www.InteliOrg.com/

The Governor wants a plan that "Guarantees that every Californian can get insurance."

What this means is he wants to guarantee that all his friends in the insurance industry keep control of our healthcare and can continue to profit off the backs of Californians. INSURANCE IS NOT HEALTHCARE! What about guarantee every California get HEALTHCARE! SB840 SINGLE-PAYER insurance will guarantee this. Why are we not rushing to pass this bill?

In response to Dr. Coles.

I am a stronger believer in free-market competition for consumer goods. But health care is not a market commodity. F.A. Hayek, an Austrian Economist, is considered one of the founding giants of free-market economics. Milton Freeman described Hayek as his inspiration. Hayek’s writings are imbued with an immense fear & distrust of government power. For him, the main defense of individual freedoms is a strong market economy with minimal to no government regulation. His extreme market approach can be partially understood given his having experienced the horrors of Nazism & Stalinism during his formative years. Few have ever written stronger condemnations of socialism & government power than Hayek. Yet, even Hayek recognized that there exist public goods, goods & services, that markets do not apply to, that trying to fit into a market model only result in market failure & reduced societal welfare.

In one of his seminal works, “The Road to Serfdom,” Hayek writes: “Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance—where, in short, we deal with genuinely insurable risks—the case for the state’s helping to organize a comprehensive system of social insurance is very strong.”

Single-payer is the social insurance that Hayek speaks of. It is not socialized medicine since delivery of care would be in the private sector.

And I would like to add that Kuehl's SB 840 is the best plan and the plan that most in California would prefer. If only our governor would listen to the people of California instead of the insurance lobby.

For the first time in the history of America. The life expectancy of today's children is less than that of their parents. This is catastrophic. And our infant mortality is equal to that of a third world country. Current U.S. adult life expectancy is down from #1 to #42. And dropping fast. These facts are what is known as EXTINCTION! indicators. These are the early signs of the final phase of the EXTINCTION of the American people.

You have to take the profit motive out of health care delivery. The profit motive does not work with health care. Or any other essential public service like police, and fire. The sooner everyone faces this truth. The sooner you will be able to adopt a real solution to the problem. The days of paying for health care out of pocket are at an end. Just like the mob days of paying for protection out of pocket came to an end.

HR 676 is the way to go. Single payer Universal National Health Care For All. Medicare for all. Accept no substitutes. The sooner you face this. The sooner you begin to heal the Cancer of private for profit medicine that is destroying this entire society. Other developed countries realized this years ago. It's a no-brainer now. See sickocure.org

Money, greed, and the profit motive has just decimated health care in America. And killed, and injured millions needlessly. Just for profit. But that is what large amounts of money, greed, and a lust for power always does. No one is immune from this corrupting power. The smart ones know this. And avoid letting them-self be put in compromising positions. But that is easier said. Than done. And very few succeed.

Most in the US go into medicine primarily to become wealthy. That is who the medical schools mostly choose. Most of the medical schools faculty are in bed with the drug companies, and others. And like the story of Dr. Faustus. They end up selling their souls. One compromise at a time. Until Lucifer owns them.

In medicine. Compromised care means. Injury, disability, and death. It's sad really. But HR 676 can fix this disgrace. Like it has in other developed countries. The only question is. How many more millions will be hurt, injured, and killed. And how many more of your children will die before their time. Before we fix this disgrace of private for profit health care in America.

I realize there will be a few people that have what they believe is good health care coverage. Who will want to opt out of a single payer system like HR 676. But let me remind you we rank # 37 in quality of health care for all. Down from #1. Never the less. A few opting out is not a problem. As long as all other Americans are automatically covered at birth through life. Unless they choose to opt out of HR 676. The government takes out 1.4% from your paycheck now for Medicare. All they have to do is substitute for HR 676 what they now take out of your paychecks for private health insurance. Remember, we already spend more on health care than any other country in the world. Right Now. We are being ripped off. And raped.

The SCHIP program is a desperately needed program for Americas children. But with the impending EXTINCTION of Americas children. And their current catastrophic health care condition. SCHIP needs to be extended to cover all of Americas children, immediately. Parents should have no hesitations, or financial worries about seeking medical care for their children. Whenever they have any concerns about their children's health. Especially in the richest country in the world. I would submit that any President, or politician that fails to do this for the children. Betrays their most solemn oath to protect the American people. Especially when you consider that all other developed countries have done this. And that we are the richest country in the world.

So get on it America. Get it done. You have been doing great over the past several months. Keep it up. And step it up. You have to force it, and take it. It's the right fight, and the right thing to do. Now is the time... Take no prisoners.

You are Brilliant! Sally Hampton. Thank you. The tide has turned for single payer universal health care for all. Thanks to the persistence of Brilliant! people like you. Getting the message out. And setting the record strait. Keep it up. Step it up. It is starting to happen. :-)

In response to Randy Silverman:

* I would have preferred the higher minimum employer contribution in AB8, but it's important to recgonize that in the status quo, there is nothing right now.

Setting a minimum employer contribution for health care is of similar significance to the setting a minimum wage 70 years ago. And nobody thinks that setting a minimum wage makes those folks that have higher wages drop down to that amount: it simply sets a much-needed floor for workers to bargain up from. Like the minimum wage, it directly helps those at the bottom, but actually has positive impacts for all workers.

* AB x1 1 would provide more help to more people than AB8 (much more expanded public programs, for example), so it's hard to see it as a compromise, but a new version.

* I do not think there is a conflict is advocating for both single-payer solutions like SB840 and HR676, and other efforts that also expand group coverage, like the SCHIP expansion, AB x1 1, and other proposals. These are complementary efforts to get to the goal of quality, affordable health care for all.

Why in politics does the single-payer system or solution have to be considered as the extreme measure of fixing the health care crisis? I don't understand the logic the opponents are using for linking a single-payer system of health care to a social type of system - it doesn't add up. It's sick and twisted.

In response to Anthony Wright. How can one compare a healthcare plan like AB X to a real solution like SB 840, single-payer? Any plan that retains private insurance companies retains the problem; wasted dollars and their profit incentive which must, by law, continue to put stockholder profits before patients. We must control costs and make health care truly affordable for all residents.

Stop pandering to the insurance companies! AB8 was a bad bill and so is AB X - designed to keep the middlemen in business. Enough already! The people of California spoke at CA Speaks. And they want SINGLE-PAYER SB840.

Mr. Briz has obviously has his head in the sand about the truth about SB840. It is a bad bill. It will not guarantee quality healthcare for all Californians. It will raise taxes every year because there's no competition and since it will be under the budget umbrella--if the budget is not passed on time like it has been just about every year, doctors (like vendors who deal with the State) will not be paid and they will leave California. And if there's any budget shortfalls, guess which program will get hit hard first--healthcare. And that will all be under SB840.

Re: health reform and single payer, to expand on Anthony Wright's comments. As a strategist over the years on single payer, and someone who helped design the financing for SB 840 in SB 1014 (Kuehl), I think you have to see this health reform step as the next incremental one. The problem we have faced with single payer over the years is how do you get from here to there?

Strategically, AB 1X 1 takes a major step by requiring that all employers pay in, including those who have completely ignored any responsibility for health care, plus it puts additional hospital dollars on the table. Since the financing of single-payer is going to have to be payroll, like Medicare and Social Security, PLUS other income (capital gains, dividends, pensions, up to a certain amount), an advance which requires payroll payments opens the door (and lessens the opposition) to getting a far more efficient system in which everyone pays in and then the health purchaser buys health care for all.

I'm also encouraged with the strategies put forward at the federal level. Medicare for All, which includes the incremental ability to buy into a Medicare policy, is clearly being understood as the way to make progress toward single payer. The devil is in the financing, but our numbers in California show it's workable.

Thank you Sally Hampton! As an economist dealing with the same issues, surely we can go as far as Hayek, with social insurance as a non-market good.

In response to Darrell, my guess is he works for the insurance or drug industry or has been terribly misinformed.

SB840 in CA or HR 676 (nationally) will save money and make healthcare more affordable for everyone, including businesses. Many have already strongly endorsed single-payer reform and to read how businesses will benefit and about their coalition in favor of single-payer reform see: http://blog.myspace.com/index.cfm?fuseaction=blog.view&friendID=144312962&blogID=266185786

Doctors and nurses are also in strong support of SB840 and single-payer reform. Go www.guaranteedhealthcare.org (nurses) and www.pnhp.org (15,000 doctors) to find out what they say about single-payer and SB840.

With all due respect, I strongly disagree that ABX could be viewed as any type of incremental or meaningful reform leading us to the real reform, single-payer which is embodied in SB840 (Kuehl). Any plan that keeps private insurance at the table will allow them continued control, plain and simple. And history has proven that insurance companies can not be legislated to behave themselves and will, if left in control, continue to deny and reduce care for profit and continue the very practices exposed in the LA Times article yesterday. (http://www.latimes.com/business/la-fi-insure9nov09,0,3065397,full.story?coll=la-home-center ) Private insurance is not and will never be in business to provide healthcare but is and will always be in business to make profits and that is the problem. Sally Hampton is correct, healthcare is not and can’t be a market based commodity and the sooner we get to that, the better off we will all be.

ABX is another Trojan Horse for insurance companies and will simply expand their business. The reason they are trying to “rush” ABX is because it will effectively kill future efforts for single-payer reform that puts them out of business. (just follow the money behind every group that is pushing ABX and you will find insurance and drug industry dollars.) You can bet that if ABX is passed that the insurance industry will do everything in their power to ensure this. ABX will NOT lead us to Single-Payer reform and it is naïve for those who have supported SB840 to believe otherwise.

FYI: The CA Nurses released a strong statement today opposing ABX. And for good reason. The REAL reform and the real grassroots reform is SB840. And the people of California are catching on real fast.

SB840 is dead, Kuehl will be termed out.
Ms. Clinton will be President and does not support single payer.

The entire proposal is rather sad because it builds a welfare program, financed partially by a sin tax and does nothing to help employers lower the cost of insurance unless they drop private coverage and opt into the state pool. Employees would be forced to limit their income to qualify for the state pool, and telling people they must limit their income for health insurance is bad public policy. We should belly up to the bar and pool our resources through a public agency that would be available to everyone just like Medicare. We finance public works this way, public money pays private contractors. Experience shows it would work for health insurance too.

Privatizing health insurance has failed all of us and is killing us sooner than we would like to anticipate here in California and the rest of the United States. Private health insurance systems have to go. Since WWII (short fifty years) the average life expectancy for Americans has declined five years (78 years of life vs 83 years of life)from elsewhere. Patient's denied health services by private health insurance companies is a bad deal in California. Denied care and access to health care happens all the time, sadly Sacramento legislators know it and should not be promoting more of the same insurance and pharmaceutical company sponsored special session legislation for producing television sound-bite commercials for next year's elections. As a Pharmacist, I beg you, Sacramento take another look at Senator Sheila Kuehl's bill SB840 and see you can make her California Universal Health Care Act of 2007 work.

Why is health insurance linked to employment? Someone please tell me why it should be? Insurance companies brag to employers that if they buy in and increase the size of the risk pool, the cost will be lower per employee. Well, DUH!! That is the whole idea behind single-payer! If everyone pays in according to their ability to pay, we can cover everyone and have this mess fixed ASAP.
Kuehl may be term limited out of the Senate, but she is not term limited out of politics. Everyone knows we have to do this one day---but we keep pretending the insurance companies are giving us a service, when in fact they add no value whatever to the system---just money changers and paper pushers. I thought conservatives hated that; so why do they support it in the insurance industry?

Let's pass SB840 and do something real for Health Care Reform in California. It is the only proposal that will work for all Californians. If SB840 is instituted in California, we will be a model for the rest of the country, and we will once again have something to feel proud of living in California.

No, Jeff, SB 840 is not dead, it picks up more support every year and just keeps coming back stronger. When Senator Kuehl is termed out, as she told me, she is handing the bill off to someone else; there are several possible legislators who are enthusiastic to take it over, and get it passed again under a better Governor. And meanwhile the mass movement supporting single-payer in California just continues to grow.

Senator/soon-to-be-President Clinton is irrelevant to this. We have to make single-payer work here in California first, then the rest of the nation will want to join us.

Single-payer: Accept no Substitute!

Single payer like Medicare?
The one that is projected to go broke by 2019.

Just google Medicare troubles and see how much OVER budget the government is. See how the healthcare cost are out of control. Is all sound great now but when you add 20+ million illegals. What is going to happen then? Get Medicare under contol first!

Medicare? The one that only the rich and government employees can keep seeing their own doctors?
Medicare part b costs 93.50 + supplemental 210.00 + Part d 35.00. Almost 350.00 a month vs HMO Sucure Horizons they only charge the 93.50. The average guy is getting forced into a HMO.
2008 if you saved you money and have a income over 80K you are going to be charged more. Take Take Take don't turn contol over to the government.

Jeff,

You are confused or work for the insurance industry based on your support of Secure Horizons.

Regardless, let's look at facts. The traditional non profit Medicare program has been one of the most efficient and economical government programs there is---far more so than our present for-profit privately run for-profit system. It utilizes a very small work force administering a plan for 43 million seniors, a fraction of that of our present, privately run system. Ironically, since private companies have been managing Medicare (under the push for privatization under the Bush administration) we have had many more problems and costs have gone up. The New York Times reported ( see: http://www.nytimes.com/2007/10/07/us/07medicare.html?_r=1&ref=health&pagewanted=all&oref=slogin ) Medicare Audits Show Problems in PRIVATE Plans -- Quote from article "Tens of thousands of Medicare recipients have been victims of deceptive sales tactics and had claims improperly denied by private insurers that run the system’s huge new drug benefit program and offer other private insurance options encouraged by the Bush administration, a review of scores of federal audits has found." ------ And as Don McCanne said in his quote of the day, “Not only can the private insurers not be trusted, but they waste resources that should be redirected to health care. And we all pay for that waste, directly or indirectly. When is enough enough?”

So, yes, the drug benefits part (Medicare-D) is a joke but let’s ask ourselves why? It was designed to guarantee increased profits to the Pharmaceutical Industry, not to benefit seniors and the Louisiana Congressman who ensured that Medicare couldn't negotiate drug prices left Congress to work at a high paid job in industry.

Ironically, AARP helped to push through Medicare-D, selling out the very seniors they claim to advocate for. So, it is no surprise that, to ensure their continued profits in their health insurance business, are supporting ABX and hope to rush it through before more people are educated to single-payer. One only has to check out “It’s OUR Healthcare” to see they are funded by AARP.

SB 840 is still the best solution.

Jeff,

How much do you think private insurance would cost someone 65 (even without a preexisting condition)? And assuming a private insurance company would even extend coverage to someone over 65.

Medicare growth is no higher than private insurers (many years lower) but the private sector just increases premiums, deductibles and co-pays. And Medicare is at an unfair disadvantage because unlike private companies are not allowed to negotiate drug prices down - thanks to Medicare Part D. And, as Doug points this was pushed through by AARP and Former Republican Congressman Billy Tauzin who commenced work as the head of the Pharmaceutical Research and Manufacturers of America (PhRMA) in early January 2005. Tauzin is also registered as a lobbyist for PhRMA. So, Part D was not in the interests of seniors but the drug companies.

In addition, I would like to give proper credit to my friend J.A. Harrison for the comment I posted on the Austrian economist, F.A. Hayek above. J. A. Harrison is the brilliant one who found the quote and e-mailed me the comment. I have encouraged him to sign up to post himself and hopefully he will do so soon.

Follow up to the above comment I made. Actually everyone else is allowed to negotiate drug prices except Medicare, including VA and Medicaid, and, of course, all private insurance companies.

Doug,
What part of the average guy is getting forced in an HMO makes you think I like them?
I'm saying Secure Horizons and other HMO's are the worst. Many on medicare get forced in to them. They can't afford to stay on straight Medicare.

If you are lucky enough to stay on Medicare there are no cost controls. Medicare is running out of money.
Did you google troubles? We have a serious problem. The consumer must some how take more responsibility. Diabetes is out of control, people are over weight and cost are out of contol. I just saying Medicare cost are out of control and Jamming the middle class in a HMO is not the answer. We don't need 30 million new beneficiaries in california until we can contol cost. That simple!

Sally,
You said "Medicare growth is no higher than private insurers, but the private sector just increases premiums". Sure Medicare does the same thing by cutting payments to doctors. Ask your doctor how they like Medicare. Private insurance must pick up the slack.
Google: doctors payments medicare cuts

I'm not an expert I just google, use common sense and don't drink the cool aid. Try it!

Comparisons using National Health Accounts data cannot prove the superiority of one model of cost containment over the other.
http://www.heritage.org/research/healthcare/wm250.cfm

I'm not saying the insurance companies are the best answer. I'm saying giving everyone medicare without cost controls is far worse. I like what someone posted on another site.
If you think healthcare is expensive now wait until it is free.

Jeff, it's an illusion health care will ever be free except for Gulf states swimming in oil. We can pool our resources through a public agency, much like State Fund has done for worker's compensation since 1915 or traditional Medicare since 1965. Governor Wilson tried to privatize State Fund in 1995, much like Reagan did with Medicare. The business community blocked Wilson. I'm sorry they didn't stand up to Reagan because HMO's are more expensive to operate and siphon some of our premiums for profit, money that is no longer available for health care and the main reason the business community blocked Wilson. People have already mentioned the prescription giveaway Bush introduced, the principal reason Medicare is in trouble today. Medicare is forced to pay 3-10 times more than the VA for the most common drugs used by seniors. Coincidentally, private insurance can leverage bulk purchases while Medicare cannot.

I'm on a citizen oversight committee in Merced and found the City and County of Merced could save up to $14.5 million in health care premiums every year if we pool our resources and enact SB 840. So you see, we can reduce the cost of insurance and manage health care so it is equitable, comprehensive and less expensive.

To Jeff -

In 2005, Medicare paid HMOs an average of $772 per member. Rather than saving money, this cost Medicare 112% of the average cost for patients in traditional Medicare. Despite this bribery to HMOs, they have continued to cherry pick healthier seniors (also when seniors become ill, they often switch back to traditional Medicare so they can choose their doctors) and some have just closed shop forcing seniors to scramble to find alternative sources of health care.

In 1966, when Medicare began, doctors could charge their usual, customary, and reasonable fees. Within a year, Medicare had gone way over budget, but the number of senior citizens getting medical care had not increased significantly (William Shonick, “Government and Health Services”). Two things were responsible for this: 1. Usual, customary, and reasonable fees went up; and 2. Doctors began charging Medicare the full amount for patients who had previously received either free care or care on a sliding scale. Doctor’s incomes went up substantially. Gradually more and more seniors did gain coverage from Medicare.

Currently, the U.S. ranks at the top in international comparisons of life expectancy for those who make it to 65. Anyone care to guess what one major contributory factor is? Medicaid came into being at the same time as Medicare and paid the same. For several years, until it was stopped; doctors would visit nursing homes, walk from room to room and bill Medicaid for a lot of “office visits.” Surgical procedures that when first developed took several hours in hospital that have now become outpatient procedures are still being billed at the same rates. A few years ago, a group of experts developed the Resource-Based Relative Value scale. Using a combination of education, training, skill, stress, etc., they developed a point system for every medical procedure. They found that surgeons often charged way too much, yet diagnosticians received far too little. Medicare adjusted its fee schedule accordingly, but protests lead to its being watered down. An internist who spends several hours examining and evaluating a patient earns far less than someone performing out-patient cataract surgery that may take 30 minutes or less. Finally, Medicare pays for all residencies which has lead to our having too many specialists.

Perhaps Medicare is underpaying for some procedures, but on the whole, doctor’s incomes are significantly higher that they would have been if Medicare had not existed and many of our specialists would not have gained their specialty training, so part of the reduction in fees is just reasonable adjustments. Of course, doctors got used to the higher fees, but that doesn’t necessarily mean they were right. With Single-Payer, doctors’ office overhead will go down substantially. Years ago a study found that American GPs grossed 200% of what Canadian GPs did, but their net income was only 130%. In other words, overhead costs were much higher (it wasn’t malpractice insurance differences). Most plans do not encourage preventive medicine because people change plans and so the preventive efforts would benefit another plan. This leads to higher medical costs. For instance, currently, most plans have high deductibles for a colonoscopy, but preventing colon cancer is very cost-effective. In a Single-Payer system, since everyone will be in the same system, it will be cost-effective to invest in and encourage preventive medicine, as well as catch developing problems at earlier stages. With one data-base for the State of California, for instance, researchers will be able to look at patterns of both over-treatment and under-treatment, something impossible to do in our current fragmented system. Even trying to adapt various systems to look for early indications of a pandemic breaking out are currently problematic. Not only will this improve the quality of life for many people, but worker productivity as well. Medicare covers seniors citizens, regardless of pre-existing conditions, people with AIDS and End-Stage Renal Disease. Go to the website of any private for-profit company and check their premium rates by age. Some actually will offer coverage to those few 65 and older who do not qualify for Medicare, if they don’t have any pre-existing conditions and if they can afford the exorbitant rates. For doctors who complain about Medicare payments, how many would even be in business if we abolished Medicare?

As for comparing National Health Accounts not being able to prove the superiority of one model, I strongly disagree. When France and Germany have more hospital beds and doctors per capita, can see a doctor within a day, can get 2nd opinions at will, have similar survival rates for heart disease, cancer, have lower infant mortality, longer life expectancy (except for those making it to 65), and a host of other measures, costing almost 50% less than health care in the U.S. and virtually covering everyone, I think those stats say a lot. If one can’t use such stats, then why quote stats comparing HMOs to fee-for-service? Why resort to any stats? Get real! Obviously, you aren’t an expert, and insulting people with statements like “don’t drink the cool aid!” doesn’t increase the credibility of your argument. As for googling for info, the Heritage Foundation is a right-wing think tank that gets a lot of its funding from industry. I can google for the Flat Earth Society. One can find anything on the web.

Keith and J.A.,
You both make some good points. I sure your city may save some money great! Why does it have to be all or nothing? Take the Medicare shoe print and make it work for your city. I have a distrust of government they have no cost controls and spending is out of control. No one can say no. What about all the illegals do they get this great plan too? How do you stop people south of the border from getting it? They will be coming in masses and now the sick ones will be coming! Will we run it like the DMV or the post office how about the county hospitals, VA hospitals. Walter Reed. Healthcare is just to big to turn over to the Goverment.
Make them earn it, if it works companies will come along.
I did not know Heritage foundation was right wing. Still there is a lot of information out there. Did you google medicare problems? What about medicare going broke not controling costs? You still have Bush and his part D. There is alway some reason why it cost more that expected. I am just a tax payer that is sick of paying more money. The schools always want more and the education keeps going down. The rich get to put their kids in private school. The average guy gets forced in an HOM and the rich get their Medicare Supplements. Just once I would like to see the goverment stay on budget? Thanks for you input.

Hi Jeff,

I can understand your concern about the government, but government can provide excellent services if we demand accountability and transparency. All the irrigation districts in California are public agencies. Public utilities in LA and Sacramento weathered the 'energy crisis' a few years ago much better than private utilities. In spite of bad press the VA received because of our inept president, they are ranked the best run health care organization in the country.

The government does negotiate and control costs. I renegotiated a government contract over the last two weeks and price was a major issue. My firm submitted a bid along with 5 other companies to the U.S. Embassy in Congo. I'm sorry you had bad experiences with the DMV and Post Office but both organizations are well run in Merced.

We're better off pooling our resources through a public agency like State Fund. Local school districts are forming partnerships with other districts to reduce the cost of insurance. Public insurance would leverage the largest group, namely everyone in California. Only 25% of the residents in Merced County have health insurance through employment, so private insurance plays a small part here.

I don't believe illegal residents should qualify for public insurance. I called the consulates for Canada, France, Belgium, Germany and Spain and asked about whether they cover illegal residents. All of them laughed at the question and said no.

We're taking a beating in international markets because our reliance on private health insurance makes our products more expensive than our competitors. I attended an international trade conference last year, and the keynote speaker said they are struggling to keep their creative team in Burbank instead of moving them to Belgium. I asked why and he said health insurance was their biggest challenge. Belgium finances health insurance through social security and is much less expensive than California because their premiums are progressive and based on an employee's income. Toyota chose Canada over Alabama for their newest facility in North America because of Canada's national insurance.

SB 840 or HR 676 will create a public health insurance agency not a government run health care system like Canada. The measures will insure every resident with no requirement people remain poor for health insurance, a plight 65% of Merced County residents face. Public insurance will be accountable to us much like credit unions are accountable to their members.

I went to the site Dr. F. Cole sent us to and found that he is (according to the search on his name) "a graduate of Southern Methodist University, Dallas, Texas, with a B.A. in Psychology and a Master of Theology from the Perkins School of Theology, SMU. He also has a Doctor of Ministry in Homiletics from United Theological Seminary, Dayton, Ohio."
I thought he might be a medical doctor. However, with a degree in theology one would expect more compassion for the disadvantaged---as Jesus taught. Perhaps if "Dr. Cole" learned more about Single-Payer he would support it, since it is the system most in accord with Christian principles and the Golden Rule.

I understand you may not want to cover Illegals but you know they are goint to try. They tried to add then to Healthy Families! We need to conrol our borders and contol costs, SB840 will not save money until that happens.

Jeff,
I am not in disagreement about our borders but this is a seperate issue. And tax payers already pay for them NOW, only we pay MORE because it is far more costly when care is provided via our ERs which are struggling to maintain. Providing primary care clinics is far less expensive and more efficient way to handle the illegal population and uninsured (common sense also dictates that we can't allow sick people to run around - you want TB or bird flu?). For example a twelve-year-old boy died of a toothache after tax payers spent close to $250,000 for emergency brain surgery. A routine, $80 tooth extraction might have saved him. If his mother had been insured. If his family had not lost its Medicaid. If Medicaid dentists weren't so hard to find. see: http://www.msnbc.msn.com/id/17372104/?GT1=9145 - All these problems solved by a single-payer plan like SB840.

EMERGENCY MEDICAL CARE FOR THE UNINSURED:

Federal law requires hospital emergency departments treat emergency conditions of all patients regardless of their ability to pay. The Institute of Medicine estimated 18,000+ people die yearly in the U.S. due to lack of medical insurance, including ca 1,400 people with high blood pressure, 400 to 600 with breast cancer & 1,500 diagnosed with HIV. Their report Care Without Coverage: Too Little, Too Late states: "Many Americans believe that people who lack health insurance somehow get the care they really need. . . .examines the real consequences for adults who lack health insurance. . . . findings in the areas of prevention & screening, cancer, chronic illness, hospital-based care, & general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection & AIDS, heart & kidney disease, mental illness, traumatic injuries, & heart attacks. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care & receive it too late; be sicker & die sooner; & receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash." Among the study's findings comparing uninsured with the insured: Uninsured people with colon or breast cancer face a 50% higher risk of death; Uninsured trauma victims are less likely to be admitted to the hospital, receive the full range of needed services, & are 37% more likely to die of their injuries. About 25% of adult diabetics without insurance for a year or more went without a checkup for two years. That boosts their risk of death, blindness & amputations resulting from poor circulation.

Being uninsured also magnifies the risk of death & disability for chronically sick & mentally ill patients. In addition, emergency care is far more expensive than prevention & treatment.

To Jeff:

Currently, to be eligible for Medicare, one has to have paid into both Medicare and Social Security for at least 20 quarters and be either a citizen or legal immigrant. Single-payer bills will cover ALL citizens and LEGAL immigrants. Both current law and humanity dictate that emergency medical care be given to anyone regardless of their standing legally. If Jeff were to get sick in any EU country, they would treat him first, then ask about his insurance. Even if a few undocumented aliens managed to get coverage, should we reject a system that will benefit the American people? Some undocumented aliens use our school systems and libraries, would Jeff want us to close them down or privatize them completely? As for Medicare going broke or not controlling costs, again I remind Jeff that Medicare covers senior citizens, regardless of pre-existing conditions, people with AIDS, and those with End-Stage Renal Condition. Without Medicare, the vast majority of these people would be without health coverage, including our grandparents, etc. And without Medicare, many doctors and hospitals would have to close shop. In a Single-Payer system, the costs will be spread by including young and healthy together with the old and infirm. With everyone in the same system, people will be more motivated to make sure it works properly. Currently, different groups are played off against each other. The administrative savings alone will more than cover everyone currently not insured. By focusing on health care rather than profit, we can increase preventive medicine efforts and catching disease processes at earlier stages which will save money, improve quality of life, and increase worker productivity. Health services research to improve care will be much better since all data will be available for evaluating care. Side-effects and serious problems with medications will be spotted earlier. As for the VA, I suggest people read an article by Phillip Longman, “The Best Care Anywhere” [http://www.washingtonmonthly.com/features/2005/0501.longman.html]. The VA is actually one of the best health care delivery systems in the world. And it isn’t just American researchers that think so. With the wars in Afghanistan and Iraq, the Bush Administration failed to increase funding enough to cover the increased load. Any system, regardless of how good it is, will break down if underfunded and overloaded. As for Walter Reed, again the Bush Administration failed to increase funding enough and began outsourcing to private for-profit companies which led to a flight of qualified personnel. See article, “Bush Administration push for privatization may have helped create Walter Reed ‘disaster.’” [http://www.rawstory.com/news/2007/Bush_Administration_push_for_privatization_may_0303.html] As for schools, our system is far better than the critics would like us to believe. There are powerful forces representing either anti-government ideologies and/or business models that like sharks smell blood if they can undermine government’s credibility. Our test scores are partially down internationally because more students are taking them than previously. If we look at the same percentage of any age cohort taking the ACTs as 40 years ago, we don’t do so badly. For those open-minded enough, try finding at your local library or book store, David C. Berliner, “The Manufactured Crises: Myths, Fraud, and the Attack on America’s Public Schools.” I remind the reader that many of the nations surpassing us economically educate their students in mainly public schools. Because of cultural myths, it is easy to convince Americans that government doesn’t work. Just a few examples that spurred the economic growth of this nation: 1. Federal government paid for transcontinental railroad; 2. Federal government in 1956 built the interstate highway system; and 3. Federal government built the internet. No private corporations even considered doing any of the above. The National Institutes of Health and Centers for Disease Control, despite Bush’s decrease budgets, are the foremost centers for medical research and public health in the world. Our government has problems, but the solution is to strengthen the public’s control of government, to take it away from the wealthy corporations. There is definitely something wrong when one Congressman keeps Medicare as the only health care entity not able to negotiate drug prices and then gets a job with the Pharmaceutical Industry. It would be insane to reward the Pharmaceutical Industry by further weakening government. By the way, the average guy gets forced into HMOs by their employers as well.

If a Illegal immigrant gets brain cancer today what happens? He goes to a hospital they say you have brain cancer he goes home and dies. When he get this great SB840 health insurance and has brain cancer. He goes to the hospital they do exploratory surgery, Chemotherapy and other work to the tune of 300K and send him home to die. J. A you are full fo crap on the school and the VA, but you have a good point on the employers jamming the HMO on people and the Pharmaceutical companies screwing us. Thanks for your imput, I am rethinking this SB840, I just hate free anything muchless free to Illegals, drug addicted, unhealthy, smokers, boozing, every day fast food eaters. They see no value in it and just going to drive my cost up.
I still see no incentives for the people to stop doing what they are doing. High deducibles and HSA make people think.

To Jeff:

Telling me I am “full of crap” certainly indicates the scope and power of your wisdom and strengthens your arguments? I’m impressed! Using your absurd logic of the rare possibility that we would spend $300,000 to treat an illegal immigrant’s brain cancer, we should close down anything and everything that could be remotely misused or abused. Since restaurant inspectors can be bribed, we should stop restaurant inspections. Since bankers have embezzled money, we should keep our money under our mattresses. There are approximately 300 million people living in this country, at least 280 million are legal. Do you really want to hold everyone hostage to the possibility that the system wont be perfect? I would rather focus on how the system will benefit the vast majority of those living in the U.S. legally, of how it will give us cost-effective, timely access to quality care and form a basis for improving care, preventive, secondary, and tertiary. As for the VA system, try reading a recent article in one of our premier left-wing journals (just joking), Business Week, “The Best Medical Care in the U.S. How Veterans Affairs transformed itself -- and what it means for the rest of us”
[http://www.businessweek.com/magazine/content/06_29/b3993061.htm?chan=top+news_top+news]. I recommended a book on our so-called school crisis, try reading it. Do you deny that countries like Sweden, Germany, France, China, and India are surpassing us and part of the reason is their public education systems? Try reading T.R. Reid’s, “The United States of Europe,” which among other things relates how the EU is producing far more scientists and engineers than we are. As for high deductibles, numerous studies have shown that they do reduce immediate use of medical services, but the reduction, especially for lower income people, included needed care resulting in more costly care later. Doctor visits don’t cost that much. The French see doctors more than twice as often per year as Americans. If every man, woman, and child in the U.S. were to add two visits per year, say at $40 per visit (in single-payer doctors overhead would be much lower), it would add $24 billion to our current $2 trillion costs, but single-payer will save over $350 billion in wasted administrative cost. In return, though many of the visits will be wasted, many will catch medical problems at earlier stages where they can be successfully treated, including infectious diseases that put us all at risk.

I just said you are full of crap because I was lazy and it was late. If you think the public school system is better than private and the VA and county hospitals are better run then private, we disagree. If you think that we don't have the best hospitals in the world we disagree. If you don't think giving free healthcare to every sick person who jumps the border and asks for it is going to drive up cost we disagree. You can find books and studies that say anything. The fact of the matter is we have the best Hospitals, Doctors and system in the world and putting the government in control is not going to make it any better.

To Jeff:

You conflate county hospitals with the VA. However, with that said, in my home town, the county hospital is one of the teaching hospitals for the UCSD medical school. And for severe injuries (gun shot wounds, but also automobile accidents, etc.), many county hospitals are excellent. As for having the best hospitals, the best doctors, etc. We do have excellent facilities and excellent doctors, but so do other countries. For instance, Stockholm has the world famous Karolinska Institution. As for doctors, in every country they are the best of the best, the brightest. Medical schools in Sweden, Germany, France, Canada, etc. teach the same materials, require the same experiences. In fact, Sweden requires longer residencies than in the U.S. You still miss the point that it is absurd to design a system because of the possibility it may be abused by illegal immigrants. As for your disagreeing with me, that's your right, but I can cite not a few statistics, but hundreds of peer-reviewed articles from dozens of different journals, by researchers in different countries. It is pure arrogance, typical American mythology, to claim we are the best, we have the best doctors, the best hospitals, etc. Just for bypass surgeries, Canadian, French, Swedish have the same outcome statistics as we do, though American heart surgeons make considerably higher incomes. Disagree all you want, but come up with actual data, not patriotic cant. And do read the articles I mentioned on the VA and the book on education. Do you always dismiss something that disagrees with you without looking at it? Who knows, you might learn something?

AB x 1 1 is not going to improve what we have now.
Massachusetts has already tried 'mandated health insurance' and it has not worked.

Health insurance does not necessarily provide health care. Given the high cost of insurance, many citizens will opt for a high-deductible, low-cost one, that they will try not to use. This does not give them access to health care.

SB 840 is the only plan that will improve on what we have now.

Forgive me - but all these comments are debatable side-issues.

The sad truth is that Western European countries have better health coverage for their citizens and yet spend a lower proportion of their GDP on healthcare than the United States.

If you are happy with defending the inferior product we get for our dollars then oppose any and all reform. - I trust that you, personally, are adequately covered yourself and expect to stay that way.

How many Californians file for bankruptcy each year because of unanticipated medical costs? How many uninsured Californians were treated at emergency rooms for conditions that could have been handled at a fraction of the cost by a GP? How many hours are lost at workplaces because someone on the staff is sick and unable to see a doctor because they cannot afford the premiums charged by their employer?
What time and energy is wasted every year while insurance companies argue with doctors about whether a procedure is covered or not?

Do we argue against housing laws that require that a habitable dwelling have clean, potable running water? Somehow we accept "socialized water" as being a necessary part of a modern society but we canot grasp the need to have medical coverage provided to everyone?

Post a comment