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Open thread June 30, 2017

Dan Crawford | June 30, 2017 8:24 am

Tags: open thread Comments (13) | Digg Facebook Twitter |
13 Comments
  • EMichael says:
    June 30, 2017 at 11:34 am

    Yeah, this is helpful

    Kevin DrumJun. 29, 2017 12:38 PM

    The single biggest proponent of SB562, California’s single-payer health care bill, is the California Nurses Association. But here’s something I didn’t know until yesterday: the CNA is aggressively using support for SB562 as a litmus test for being a true progressive. The bill is basically unpassable, but it’s being used as a way of whipping up the Bernie wing of the Democratic Party against traitors who fail to support it.

    Apparently this applies even to B-list bloggers. I got an email today from Chuck Idelson, communications director for CNA’s umbrella organization, National Nurses United. Here’s how it ended:

    Having seen two years of your hatred for Bernie Sanders, it’s not surprising you would be equally hostile to ideas he champions like single payer, but it would be nice if you were a little more honest with your readers, or maybe you can recommend the name of your magazine be changed from Mother Jones – who actually fought for working people – to Milton Friedman, which would better reflect your class sympathies.

    It’s good to see that progressive organizations are learning communications skills from the Trump administration. But I wonder if this kind of attitude is helpful in attracting and maintaining support for progressive causes?

    POSTSCRIPT: Just for the record, I’ve supported single-payer health care for at least the past 25 years. But for a variety of reasons, it needs to be done at the national level. No state has ever been able to make it work.”

    http://www.motherjones.com/kevin-drum/2017/06/i-get-letters/

    Still trying to find answers to this Cal single payer thing in terms of financing.

    “A legislative analysis found that California’s single-payer plan would cost $400 billion to implement, $200 billion of which would be new spending. Critics were quick to point out that this “hefty” price tag is twice the state budget. Furthermore, the bill did not include a funding plan (although the bill’s language ensured that Healthy California would not launch unless it was funded).

    However, a report by professors at the University of Massachusetts Amherst, commissioned in part by National Nurses United, estimated that after taking in the savings of single-payer, such as lower administrative costs and prices of pharmaceuticals, the actual cost of the plan would end up at around $331 billion. And, because 70 percent of the state’s current health care spending is covered by public programs like Medicare and Medi-Cal, California would only need to come up with $106 billion in new revenue, which researchers proposed could be done through two new taxes (a 2.3 percent gross receipts and sales tax), with exemptions for small businesses and tax credits to offset costs for low-income families. In exchange, nearly all of Californians’ medical expenses would be covered, doing away with premiums, copays, and deductibles…..

    But according to the Affordable Care Act’s Innovation Waiver, if a state comes up with a credible alternative to the ACA, the federal government is obligated to provide the funding. Pollin said that while it’s impossible to know in advance what the Trump administration will do, “you can also pass the bill, and obviously it has to be contingent on us continuing to get 70 percent of funding that we now get.” Pollin felt that Rendon’s objections were technical ones—they need to be addressed, but don’t raise any issues that can’t be worked through. “The concerns that they raised were pretty narrow. Nobody said this is crazy, we can’t do this,” he said.

    There are problems other than the fact that the bill did not include a specific funding mechanism. The biggest hurdle may be Proposition 98, a complicated California funding law that requires that around 40 percent of the state’s budget go to schools. This means that a huge portion of any increase in the state budget would have to go to education, so legislators would have to come up with almost double the money to cover the single-payer plan. To get around this, voters would have to first pass a ballot initiative.”

    https://newrepublic.com/article/143650/killed-single-payer-california

    I cannot find anything at all in the ACA’s Innovation Waiver that says Medicare funds can be used.

    “The 1332 waivers apply only to private health insurance coverage and the marketplace, not to public programs like Medicare or Medicaid. But states can seek multiple waivers from HHS at the same time. For example, they might ask permission to change their Medicaid programs under an 1115 waiver and their marketplace coverage under a 1332 waiver. However, the federal government will evaluate each type of waiver separately – an 1115 waiver must still meet all of the existing standards for Medicaid 1115 waivers, and a 1332 waiver must meet the requirements we describe below. To learn more, see How Could a 1332 Waiver Affect Medicaid or CHIP?”

    http://familiesusa.org/product/whats-new-federal-guidance-about-1332-state-innovation-waivers

    I cannot believe there is anything in Medicare law that would allow such a transfer, and it does not appear to me that there is anything in the ACA that even mentions using Medicare funds.

    Perhaps someone in here has more knowledge than I have been able to find, but I see no purpose whatsoever in this financing plan from Pollin that relies on funds that cannot be accessed. All this thing does is confuse the issue

    • run75441 says:
      June 30, 2017 at 1:47 pm

      EM:

      Interesting, you have surpassed me in drawing attention to a real issue in the nation today. How do you fund a healthcare system when the costs of the components (pharma, hospital supplies, hospitals clinics, doctors, etc.) are uncontrolled and the provision of the product or healthcare is fee for services. Both need to be regulated. It is also hard to believe that California can achieve a savings greater or equal to that of an entire nation negotiating costs. This has been my argument. The nation has to be the negotiator rather than a patchwork of states.

      Probably put you up later today.

  • EMichael says:
    June 30, 2017 at 1:52 pm

    Run,

    Are you aware of anything that would allow Cal to access Medicare funds?

    I cannot find anything that suggests that is true.

    • run75441 says:
      July 2, 2017 at 11:08 am

      Medicare is also means tested. If states like California (9th) who ranks in the top 10 for highest median income started to divert money from Medicare which is heavily subsidized by the federal government, other states which rank in the bottom 10 like McConnell’s Kentucky (46th) would suffer a shortage of funding which would have to be made up somehow. Higher ratio of people live in poverty and have little or no income. I know of no provision to divert Medicare or Social Security funds from the federal government to a state. http://247wallst.com/special-report/2016/09/15/americas-richest-and-poorest-states-4/3/

      Who are givers and who are takers?

  • Jay says:
    June 30, 2017 at 5:06 pm

    Someone opened fire in a NYC hospital. Wonder if PGL was there. They recently made a death threat over on Thoma’ s website. Fits the profile.

    • run75441 says:
      June 30, 2017 at 8:34 pm

      Jay:

      Oh please, quit spreading innuendo, supposition, and conjecture.

  • EMichael says:
    June 30, 2017 at 9:03 pm

    Jay is one of the worst people on the internet.

    Quite a high bar there.

    This was actually one of his nice posts, though it did lack any substance like every other one of his posts.

    Man needs a an application of prozac or a baseball bat.

  • ilsm says:
    July 1, 2017 at 7:55 am

    Run,

    The reason the US won’t fund health care is the same reason it blithely finds $30B a year forever to upgrade its ability to blow the world, the part more sane the US, away.

    The reason US won’t fund decent roads is the reason it funds al Qaeda in Syria, while it drone strikes them in Yemen.

    If big government is no good at doing safety net but unleashed on doing war…….

    It is immoral.

    • run75441 says:
      July 1, 2017 at 8:31 am

      Did you mean immoral

  • Jay says:
    July 1, 2017 at 12:36 pm

    Jay
    (not in our house. Murder ain’t edgy or funny)

  • ilsm says:
    July 1, 2017 at 2:07 pm

    Run

    Yes, the US is very negative in the moral dimension.

    • run75441 says:
      July 1, 2017 at 7:26 pm

      Fixed your comment

  • Lyle says:
    July 2, 2017 at 7:26 pm

    How single payer would work is Modeled on the Japanese way of setting pricing. It would likley be similar to the way medicare pricing is set, essentially the single payer says like it or lump it, this is what you will get. If national your option is to emigrate. (which of course hospitals can not do)

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