California 2 votes away from passing single payer in state senate--get on their asses!

I already emailed the 5 senators saying HELL NO to socialist medicine!!!

Correction:

It is not socilist medicine. It is just medical insurance. It is single payer health insurance. Not a take over providers or doctors or whatever.

The market can still provide what it doesn't. And if you don't like it, quit your job and earn your money through capital gains...you won't pay anything.

So Mr. Avenger, you like paying overpriced premiums to scum corporations like Anthem Blue Cross who pay their piggish execs way too much and deny health care to many subscribers?  Your day has passed.  We live in a new world now, one for the people not the money junkies.

I hate to say this, but I don't think this will pass the senate nor will the governor sign it. We just came out of a budget shortfall of $42 billion a while back. If we go to this single payer system now we will be over $40 billion in the hole (even with individuals and corporations paying into the system). An analysis of the bill as of last week (1/26/2012) showed that initially the program would cost $210 billion per year (presumably $167 billion actually spent on health care and the remainder on the transition). Even at 12% I do not belive we could get enough revenue from the more $865 billion in income of state residents and corporations combined to garner that amount (at least not at 12%). Although this could show a savings over a 10 year period, it is the short term that everyone (especially the right wing media) will be looking at and harping on. If this passes, a possible scenario could be a massive campaign to recall the governor once the public sees the large short fall. Expect to see state assemblymen and senators to lose their seats as well. I am all for a single payer system, but the only way this is going to work is if someone can show that this can pay off right away from the start before we implement it. That way there can be no argument that it doesn't work.

dnno1, I suppose you are correct although I hope not. This program needs to be paid for from the beginning so that voting for it will not be a political liability.

Conservative Avenger, it seems to me that if anyone has a mental disorder, it is conservatives, not liberals. If you tell me your qualifications to make judgments about peoples' mental disorders, I will certainly tell you mine.

As for socialism, we cannot get by as a society without it. We are all socialists to one degree or another. Anything which involves our common resources or working for the common good is socialist. Just get a dictionary and look up the definition of socialism. It says socialism is anytime the means of production or distribution are in public hands as opposed to private. Anything the government does is socialist by definition. Without government, we wouldn't have much of a society. Things like cooperatives and unions are socialist too. Schools, the postal service, the military, our public roads and parks, etc. and even the internet, are all socialist, and health care should be too.  

 Well said NL, that's a nice paragraph. It's amazing how
 the conservative news media, and the Rightwing Blowhards
 take words with beautiful meanings like Liberal and                   
 Socialism and make them sound dirty to the point where
 people are afraid to be associated with or even use them.

 I remember Michael Dukakis cowering like a beaten dog
 after old man Bush called him a Liberal during a debate
 in the 88 prez. campaign. He should have jumped down the
 old bastards throat and declared, "Damn straight I'm a
 Liberal!"

Thanks anti-Republicon, and your reply is well-stated too. I am a Social Psychologist, which I believe gives me a broad perspective on what socialism is.

I went to Mark Leno's homepage on the California Senate website, which alleviated my budget concerns about the bill enough to prompt me to call the 5 Democratic Senators who abstained from voting on it last time. Somehow, I remembered all of their names, got their phone numbers, and called in my support. I will make it easy for anybody else who wishes to do so, as the vote is coming up later today.

Here are the phone numbers:

Alex Padilla: 916-651-4020

Ron Calderon: 916-651-4030

Michael Rubio: 916-651-4016

Juan Vargas: 916-651-4040

Roderick Wright: 916-651-4025

It was extremely easy to call their offices and they were extremely efficient. The phones were answered immediately, before they even rang, and they took my information and the fact that I support the bill, then said "thanks for calling." I think they were getting a lot of calls about this bill, and most must have been in support of it since some of them guessed that I called to support it -- either that, or my voice just sounds progressive. This was the first time I had called any legislators. I also sent a message to my state Senator, a Republican based in Riverside, named Dutton, for what it's worth. The website would not allow me to send messages to any other Senators, but we can call them.

Senator Leno's website said that California state government already spends about $200 billion per year on helath care, an amount which I am sure is increasing. I don't think it would take very much to make up any budget shortfall in terms of implementing this bill.

This is a message from Senator Leno:

http://www.pdacommunity.org/california/1029-message-from-senator-leno-sb...

As it turned out, although SB 810 did not get the votes to pass the senate last Thursday, it did get enough votes to be reconsidered (which in essence nullified the votes made on 1/26/2012). If you watch the Senate floor session for yesterday, you would see that Senator Leno passed on the item when it was time for it to be read (look at 28:04 minutes into the session). I believe that he either felt that there would not be enough votes to pass the legislation out of the senate or there just wasn't enough time to get back to the bill (I want to believe that it was the former). There were a number of senators who were not present at the floor session to vote and this is the reason why I believe it was never read the third time. Now, because it was not voted on yesterday, it can not be considered again this year. That doesn't mean that the bill can not be presented again next year.

It didn't pass again last night either.  But the timing was bad as the announcement came out yesterday that California may be bankrupt in March.  Sort of hard to pass a bill that requires a lot of funding when you tell the public that.  And as Thom pointed out his morning the abstaining politicos were ones from the districts of the corporate health care firms.

@captbebops, I don't know too much about the districts being ones where health care firms are, because they don't actually vote. Senator Rod Wright, who was one of those who did not vote is from CA Senate District 25 which covers cities like Gardena, Hawthorne, Lawndale, and Compton. Although they have hospitals there these cities do not house the corporate offices of health insurance companies. Senator Juan Vargas is in Senate District 40, which is in San Diego County. He is a devout Catholic (even formerly a member of the Jesuit order before he started his political career). You would think that the man's conscience would tell hem to vote for universal health care, but he just didn't vote. In fact all of these senators hail from more rural or urban districts where the residents would benefit from universal health care.

Because Ca does not have the money to pay for Single Payer, Californians have to continue to pay much more for health insurance.  I love the logic.

Thom may have been assuming that because companies like Anthem Blue Cross are in SoCal that's why they didn't vote.  Just before walking out the door for my walk this morning I happened to hear the start of the discussion that Ronn Owens had on KGO about the California financial problem.  Two solutions on the table is to raise sales taxes which is bad because that will discourage spending which is needed to keep the economy going and the other is taxing the rich more which is the most logical solution.  But too many Californians believe that rich will get mad and take themselves and their business out of the state which is highly unlikely.  And listening to callers on Owen's show is often irritating because so many of them are one dimensional morons who want to blame the "liberal left".

Personally I don't think there is any solution and the state will collapse into anarchy which is just a cycle before regrouping and rebuilding.  It may well take the rest of the country with it.

Sad but true, captbebobs.  And, if we have a structure to 'regroup' with, the question needs to be asked--and answered:  Is medicine 'a right for all'--or 'a privilege for all'?--and go from there...

I just don't think that medical should be all that expensive.  It didn't used to be!  It only is now because there are all these expensive tests that doctors feel they'll be sued for malpractice unless they have you do them.  I've used alternative medicine for 40 years to stay healthy.  It's not easy because there is so much crap in our water, our air and our food.

But our health care is sick because our economy is sick.  Capitalism has become unbalanced by a bunch of unevolved materialistic thugs who care only about material gain.  In other times that would have been seen as inappropriate and unsocial behavior but they've managed to train a lot of human animals to believe that such greed is good to support them.

Today, Wednesday Feb 1, I did not hear Thom say that the districts represented by the senators had  Healt Ins Companies.  What he did say, was that Jacob noticed the Health Ins companies provided large contributions to the campaigns of those senators.

I also notice that any mentioned of the vote is hard to find on California news outlets like www.sfgate.com etc.

There is all sorts of reasons why medicine has gotten more expensive.   I think that it got its start in escalating in price with the passage of Medicare and Medicaid along with the extension of insurance companies and health care--in other words, a coordination of third party payment structures supplying most of the costs of medical care (instead of primarily depending upon the payment of those directly receiving the services).   This works on an economic scale by having government cover most of the costs of what generally works out as the most expensive patients (the elderly and the poor) while insurance companies can, then, capitalize on the others that generally are less expensive for their profits.   You may have heard me mention that Obama wrote in his book, The Audacity of Hope,  that 20% of the population takes up 80% of the medical budget.  And, of that 20%, government covers for most of their costs--leaving the other 80% that take up 20% of the budget for insurance companies to capitalize on.  However, I have never seen Obama (or anyone) mention these figures in any national discussion on health care--and I think it is fairly obvious why not.   If they did, I think that a good question that could be asked would be, "If the government already pays for most of the most expensive patients, why isn't the government going ahead and covering for most of the least expensive patients--and using whatever proceeds that the insurance companies are getting to pay for that?"--and I think that we all know why 'that question' isn't being asked.....and I do see this as a collusion between government and corporation....

But, that's only part of the story.   From a personal physician level, the third party payment structure as it exists in the United States has offered a way of having the physician be able to increase his income without having to contend directly with charging the patient.  I've tried to explain this to my lawyer daughter.   When the physician had to directly face the patient to charge them for the service--you know, look them in the eye and say, 'Pay this!'--it was a little difficult on the physician's behalf to do that without regard to, somewhere in the back of the physician's mind, determining a 'fair payment amount' because, if the physician didn't do that, the patient's reaction would quickly fill in for it.  In offices, some physicians (who still may be getting direct payment from patients) may be getting around that by having their office worker say 'Pay this!'--that way, the physician can still appear like money is no object and, if the patient complains, even say something like, 'It's not me, it's my office manager'--that's why every physician doing that, maintaining such a nice and compassionate demeanor needs a bitch as an office manager....8^).....

But, now, to continue with the third party payment structure, there has been introduced into the relationship between doctor and patient a remote money source.   Now, when it comes to paying the physician, instead of the physician having to be at odds with the patient in coming up with an appropriate charge, the physician and the patient can actually be on the same side against the remote third party--and a smart physician does this all the time (and the patients love him or her for it).   Now, instead of the physician having to hold his hand out to the patient and say, 'Pay this!'--the physician can hold the patient's hand and claim that 'It's me and you against the government (or the insurance company--or whoever the third party payer is)'--and, then, order and perform with impunity and even basic disregard for best medical practices.  Sure, lawsuit threats have, in some ways, 'justified' this process but physicians started charging more because insurance companies started paying more.  And, insurance companies actually want that--that way most Americans cannot afford many of the medical treatments on their own so that they will have to pay insurance (my father has offered the reasoning that if he needed an expensive medical procedure, why doesn't he just pay it out month-by-month instead of paying the insurance premium in the same manner--but, I suspect that most people don't think that way).   And, when it comes to government being the third party, when you get to learning their 'process', a lot can be covered in 'the paper work'.   I have seen patients that cannot walk get knee replacements 'just because the family wanted it' (and someone--or something--else was paying for it).   Same thing goes with eye surgeries on patient's that cannot see--once you learn them, there is always a way to get around the 'third party policies' of government and insurance companies (and most patients are just eager for you to do that with, as I said, some of the smartest physicians in that regard being able to get the patient on their side about this--instead of 'Pay this!', it's now 'Me and you against the government--or the insurance company--both requiring some "customer satisfaction" to deal with'). 

But, now, it's even gotten worse--and the most recent intervention in medicine is what I would call 'the corporatization of medical practice'.  While corporations have been involved in the financing and structuralizing of medical care for at least the past two to three decades, it's only recently that such structural policy implementations have come in to preempt the care and direct physician behavior towards the patient.    Now, you might initially think that that takes care of this issue of the physician perhaps extending services beyond best clinical practice to 'take charge of the costs of medicine'--but, I think that assessment is absolutely wrong.   'Blanket policy implementations' by corporations, under the guise of 'standardizing care', has actually made the application of medical care even less efficient.  Now, instead of having the physician use his judgment to distinguish when a chest pain is more likely to be a heart attack vs. anything else (actually most chest pains aren't heart attacks), treatment has to be instigated to each chest pain as if it were a heart attack in a brief order.  In that line, instead of having the physician which chest pains can go home from the ER vs. be hospitalized (or, in rural ER's cases, transferred) for likely heart conditions, in the interest of 'getting the patient out of the ER as quickly as possible', more chest pain patients are admitted (and, then, in a rural setting, if they turn out to be acute heart conditions, still transferred).   Of course, all of this is being done for 'the customer's benefit' (that's exactly what they call them), not 'the patient's'.   And I really doubt this is being done to 'cut medical costs'.   In fact, I suspect just the opposite.   I suspect that this is the medical industry's form of 'bubble creating' just like the financial market did--and in a very similar fashion.   While the financial market had 'policies' put in place to have each loan officer ignore basic good loan practices to 'hand out these loans to everyone or your job is at stake' and propping up the stats on their 'productivity' to look good for the stockholders and the markets themselves to 'bundle these into different assets sold between us', the medical industry is doing the same--imposing upon the direct care givers to 'admit more, do more, manage more, and do it quicker' (as 'policy dictates') to 'prop up the business' and make their 'productivity stats' look better for similar reasons as the financial markets did for real estate.   And, just like what I am sure most loan officers on the ground thought when they contemplated the point that 'these people can't afford these loans we are being coerced to make them or risk our own job' (do to 'policy', of course, usually 'government policy'), many of the health care workers have already commented on 'how is all of this new activity really getting paid for'?    And, just like what happened in the financial markets, the medical industry will glut the market as much as it possibly can and, then, when someone finally realizes that there is no financial foundation for their activities in the long run as dictated by their policies 'propping up the business profitability'  in the short run, they will just hold up their hands and say 'Hey, government policy made us do this.   We need bailing out.'--just like the financial markets with real estate.   In the meantime, get out as much profits as possible in the manuever....and I am sure some will make millions--maybe even billions--off of it--just like the financial markets with real estate. 

This all takes a collusion of government policies and regulations in line with corporate interests--and, don't try to kid yourself, that's what we've been under for the last two to three decades and if what is happening to the application of medical care right now is any representation of the rest of the market, this isn't getting better, it's getting worse.   And, even the activities of the local hospital is showing it.   A new corporate administrator has recently come into one of the hospitals that I work in and has hired some new high level office workers locally--some with, as everyone knows, no experience in the positions that they have been given.   However, everyone of them does have a 'special ability'--they are all close relatives of members of the local (and elected) hospital board (you know, the one that obtains the local taxes that supports the hospital and, then, gives that to the corporations for 'operating costs'--this hasn't gone unnoticed by the people but, then, this may be a short term 'profit manuever' for the corporation, also, that cares not about its appearance--by the time something can be done about it, one, they have 'taken the money and run' and, two, at that stage, depending upon when they predict this will all crash, they can hold up their hands and say 'What the fuck happened?   We were just following government policy.   We need to be bailed out.'.....and, the beat goes on.....).  

Few doctors I know went into medicine to make money.  They are satisfied with a decent return on their investment and skill, but they want to do medicine without worrying about all that crap.  Other societies have found good ways to pay for universal healthcare without making it a direct fee for service between patient and doctor, and I think we could too.  There is no question that nothing about the current healthcare reforms get the profiteers out of the picture.  They are constrained from their worst practices, but the politics of healthcare keep their corporate entitlements in place.  We can do a lot better, but I agree with Wendell Potter that Obamacare is better than what it replaces.

DRC, that's the doctors you know.  I've known ones who were lousy and their main interest was playing golf, flying their airplane or sailing their boat.  I suspect in those case "daddy" was a physician and they wanted the same lifestyle even if they lacked the talent their dad had.

Obamacare won't do any better if it plays into this new 'corporatization of medical practice' that is more designed to eek out of the application of health care as much of the profits as it can before, like the financial industry with the loan crisis, it, too, becomes insolvent...in fact, I suspect that those who instigated this 'corporatization of medical practice' are banking on 'Obamacare'...

What Thom did say was that two of the senators that did not vote yes took money form insurance companies.

There was the caller this morning who didn't like the term "Obamacare".  Thom agreed but what we should really call it is "Republican Comprised Health Care".  So when anybody calls it "Obamacare" correct them with that.

I've read some of the bills passed by the assembly and some read like they were written by 3rd graders.  Recently included in my bill from the waste disposal company was a notice that syringe needles and lancets should be placed in a "certified" disposal box which you have to take to the local waste disposal center to turn in.  Apparently a concern about waste sorters being stuck with contaminated needles prompted a bill to be passed in 2008 requiring you to dispose of these items in such boxes.  I never heard of it until the notice in the bill.  So I went online and read it and is was so stupidly written by someone who barely understood the issue.  And furthermore it had to be pushed through for the benefit of some companies hoping to profit on little boxes that cost less than 25 cents to make and because they are "certified" charge $4 for them!  Talk about corruption in California!

I am sure that some here have heard of my own offer on how this could be set up in a way that I think would be equitable and fair IF we are to still have insurance companies involved in the payment structure--and I initially heard about this (believe it or not) from the comedian Penn Jillette on the Glen Beck show (I know, Glen Beck).   Instead of making people buy insurance, it would probably be better in curtailing costs by having the government cover everyone in a 'catastrophe ceiling'--in other words, have everyone's potential medical catastrophes--those things in medicine like major traumas, heart attacks, and cancer--that could bankrupt most people if they had to cover it for themselves.  Have government take over once it reached a certain amount--like something on the order of a medium house payment ($200,000 or something like that).  

That way, what insurance companies would, then, have to do is compete on an even level in a way that everyone could understand (and understand the policy coverage)--coverage to the 'catastrophe limit'.   Or, if the person so desired, not even have insurance coverage and be responsible for that form of payment, themselves (but that would still be maxed out at something on the order of a medium house payment).   But, as far as insurance companies go, since every policy would basically be the same, then the consumer could truly be able to compare prices with respect to that coverage--and insurance companies would, then, have to compete on a more even playing field.  In the long run, I think that would be a much better way to supply health care if government and insurance companies are going to have to be both involved in the coverage--plus, it still gives each consumer the option of NOT buying insurance.   Interesting that one of the more rational proposals has to come from a comedian....but, because it's so rational (and to the favor of the average taxpaying consumer), I doubt it would ever fly....

And, as far as government costs go, 'catastrophe coverage' wouldn't be as expensive as many might think.   Remember, government already covers most of the costs for most of the most expensive patients--and, even in Texas, there are already government subsidized programs in place covering for most major trauma cases, most major burns, most pregnancies, most elderly, most childhood illnesses, etc.--in other words, most of the costliest services.  What more would it take just to cover for everyone's catastrophes and, then, have insurance compete with policy coverages for the rest that everyone could understand (instead of what they do now, 'picking and choosing' policy coverages in the paperwork that many who obtain insurance may not realize that 'certain things' won't get covered--or take large co-payments to get covered....).   

This is from CaliforniaOneCare.org:

I would imagine that proposal would put the huge burden on the State. So how does a state like California pay for that? Would it be the tax payers or the Insurance companies contributing to a fund. I vote the latter.

I don't know what it would cost.   However, I'm not sure the burden would be 'huge'--as I said, the state of Texas (as well as federal programs like Medicare) already covers for the costs of many forms of catastrophes to many people--just not all.   Perhaps the coverage could come from a combination of tax subsidies and insurance policy 'charges'.  The point being the coverage could be for all people--and the consumer could not only be on a more even playing field in deciding insurance policies (since they would basically all be the same, a real form of market competition could be involved)--or, the consumer could still choose no coverage at all. 

These are good ideas. We just need to see some numbers to see if they can work (at least on paper).

Why can't we just have what other countries have?  Why compromise?  Are we afraid the health insurance CEOs will cry?

Well, I'm not sure that we are afraid of that the health insurance CEO's would cry so much as we should be concerned over this not being a viable possibility probably because the health insurance industry weighs in too much on the 'legislative decisions' put forth by our government--with 'the deciders' probably as concerned about their subsidies provided by the industry as much as anything for 'the American people'--or for the benefit of the average taxpaying consumer (notice that I lump those together as the 'taxpaying consumer'--it is basically the same person paying for both financial means of funding health care--as a taxpayer for government and as a consumer for insurance companies--the same person is being required to pay twice for the same services--and people wonder why health care costs twice as much per capita than any other country in the world?). 

My remarks above where predicated with the word 'IF' America had to continue to have this collusion between the health care industry and government as the means of financing medical practice, this might be one way to have the costs curtailed--and it keeps the idea that 'government isn't running all of it' and it actually better supports the concept of a 'competitive market' with the industry, itself, since all health insurance companies would be competing for exactly the same thing--coverage to the 'castrophe limit'--each consumer could better 'compare and contrast' each policy to the other...perhaps even to be competitive in such an environment, the CEO's might have to take a cut in pay, no?   That might make them cry.....8^)......maybe even make some of them that are doctors actually go back to seeing patients....

The bottom line is in the US business is considered sacred and the public is considered expendable.  A sorry state of affairs indeed.