Op-Ed: Why We Need CalCare

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By Jon Abad

Calcare or AB 1400 is about to clear the California assembly on its way to becoming a law. It provides universal healthcare for all in California. It was introduced last year and it cleared health committee and it cleared appropriations committee last week, but must be approved by the full assembly before the end of January to stay alive. It will expand Medicare-like universal healthcare for all in California. It will cover 100% of medical expenses including dental, vision, prescription and long-term care just like in much of the rest of the world provides for all it's citizens now.

Let's face it.... The only reason anyone would be against this bill is if they worked for or paid by insurance or pharmaceuticals industry that will undoubtedly suffer the worst.....Clearly under this plan, over 90% of all California will end up spending less on healthcare than any added taxes to fund it. 

Universal care isn't perfect, people in other countries may complain about waiting a long time for non-life-threatening procedures or treatments.  But way too many Americans only wished they had this option for waiting to afford life-saving treatments as half a million Americans go bankrupt from hospital bills every year….and countless more reluctantly have to choose to forgo life-saving treatment just so they can leave their life savings to loved ones....... It's no wonder our life expectancy rate in the US are near the bottom in the list among industrialized nations with all of them having universal healthcare for all.

Over and over other countries have proven that universal care system is the best way to run healthcare. It works for the sickest and oldest here in the US with Medicare, doesn't it? So why not expand it to all? It works in all of Europe and the rest of the world so why not here? 

Medicare is still being funded by the same 1.45% payroll taxes that it was funded with when it started sixty years ago.... Can you point to any health insurers that can survive when two years without a rate increase?  Private insurance spends up to 20% of premiums to administer healthcare while in single payer programs like Medicare, it only costs less than 2% to administer it as there's no cost going to lobbying, marketing, profit and huge executive compensations.  

Between employer and employees portion of healthcare insurance in the US, over $20k annually is spent on typical HMO insurance in this country for each family.   At about $60k in median household income, this means half the US spends about a third of their income just on healthcare premiums!  If you include health insurance cost to taxes we pay, don't we pay more than taxes in any other countries with universal healthcare for all? 

Did you know that the US spends over 18% of our GDP on healthcare while all other developed countries spend less than 13% of their GDP towards healthcare... That's up to a trillion dollars annually we can save if this country adopted single-payer system that the rest of the world have already proven to work over the last past 80 years!  Anyways, hope you would supported it, if not, at least state your concerns publicly so that it be incorporated into the final product.  Here's the proposed funding sources below:

Annual excise tax on businesses with $2 million income of 2.3%

Payroll tax for employers with 50 or more resident employees of 1.25%

For workers earning more than $49,000 a 1% payroll tax

Personal income tax for those earning $149,509 or over


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Chip of SB Jan 25, 2022 07:53 PM
Op-Ed: Why We Need CalCare

I think the root cause of this problem is the cost of healthcare. Whether individuals and businesses, the state, or the feds sign the checks, the burden still falls on taxpayers at the end of the day and the exponentially increasing costs are unsustainable. Before we focus on who is paying for healthcare, let’s start with asking why healthcare is so expensive. Why do our prescription drugs cost orders of magnitude more than the same drugs cost in other countries? Why does it cost more to get a CT scan in the us than it costs to get a round trip plane ticket to Europe or Japan in addition to the cost of getting the same scan there and repeating that process a few times over? Why can’t a hospital quote you to cost of the services you need ahead of time? And perhaps most importantly, why do care providers charge different people different prices for the same thing? That is an illegal anticompetitive business practice punishable by substantial fines and imprisonment yet mysteriously not enforced for the healthcare industry. If everyone could pay the same preferred rates as the insurance companies, would there even be a need for insurance? If we could import prescription drugs from overseas for a fraction of what we pay now, would we even need prescription drug coverage? In order to truly solve this problem we need to restore free market pricing and fair business practices to healthcare. Whether the state pays for it or not, disaster is inevitable unless we address the cost of healthcare.

a-1643169641 Jan 25, 2022 08:00 PM
Op-Ed: Why We Need CalCare

This addresses the high cost of healthcare by removing the drivers of those high costs - the insurance companies and middlemen. It works well all over the world, even in countries with better healthcare than we have.

UCSB98 Jan 26, 2022 05:04 AM
Op-Ed: Why We Need CalCare

CHIP OF SB

Fair market pricing is that main culprit of the cost of healthcare being three times more than in any other parts of the world outside the US. First, let's agree that everywhere else in the world, universal care is available to all citizens. In the US, our universal care is limited to the VA, Medicare and Medicaid.... Which is only available to only half the population. For the rest of us, it's priced at market rate with help of private insurance.

Think about it.... Healthcare provides life saving products and services where people are felt compelled to buy at any price.... Isn't that a corporations wet dream? Do you really want something like that priced at market?

can you point to another country with a working healthcare system with less government control than in the US? No you can't.... So, doesn't this make the US the healthcare system with the least government control in the world and the more freely priced? If all the other healthcare system have more government control and less free than the system in the US.... Then why push for less government control that isn't working anywhere else?

Chip of SB Jan 26, 2022 10:08 AM
Op-Ed: Why We Need CalCare

UCSB, our healthcare has a tremendous amount of government control. Unfortunately, when the government regulates an industry there is a revolving door between the industry and the government. For example, the same people alternate between serving on Pfizer’s board of directors and the FDA. How does making favorable regulations and decisions while working with the government influence compensation when transitioning back to industry? It seems to help a lot! As a result, regulations do little to protect consumers and instead shield the insurance, pharmaceutical, and healthcare industries from liability and facilitate exponential growth in costs. Why is it illegal to import prescription drugs from overseas? Because the government/industry regulatory complex made it that way in order to charge more for prescription drugs. When Medicare was created in the 60s, healthcare spending accounted for about 3% of our GDP. Today that has ballooned to 20%. Given the state of our healthcare system, transitioning to single payer might actually be an improvement, especially if doing so could eliminate/bankrupt the health insurance industry middlemen. However, it is not accurate to characterize our existing system as a “free market.” Our healthcare system is the poster child example of crony capitalism, regulatory capture, anti-competitive business practices, and corruption. A true free market healthcare system would provide the best care in the world at the best possible price. If we implemented such a system, healthcare would be affordable for everyone, health insurance would be a low cost way to cover an unforeseen catastrophic event, and medical spending would drop back to 3-4% of our GDP where it belongs.

Curmudgeon Jan 25, 2022 10:12 PM
Op-Ed: Why We Need CalCare

To OP Abad: Like many posters I am initially skeptical but willing and anxious to have unambiguous facts and information by which to judge the plan on merit. We'll see if we get it.

At any rate I note one glaring inaccuracy in your commentary where you state, "...Medicare is still being funded by the same 1.45% payroll taxes that it was funded with when it started sixty years ago..."

In fact, beginning in 1966 the payroll tax started at .35% and increased over many years to the present rate of 1.45% (an increase of just over 400%.) Source: Social Security web site. https://www.ssa.gov/oact/progdata/taxRates.html

So, while you write an interesting endorsement of Calcare, I must wonder if other statistics you quote are accurate.

Thus, I must withhold judgment on the program until further notice.

Curmudgeon Jan 25, 2022 10:37 PM
Op-Ed: Why We Need CalCare

P.S. - And, of course, there is currently no upper limit to the income level subject to the 1.45% payroll tax.

UCSB98 Jan 26, 2022 04:55 AM
Op-Ed: Why We Need CalCare

CURMUDGEON
Medicare tax applies to all earned income in 1960... Why do you think they made that change? Health insurance costs on the other hand increases three times faster at 400% every 20 years... White cutting services and raising copays and out of pocket costs.

Think about it..,..Medicare is a lot cheaper than private insurance, it's taken more widely accepted ..,.because with health insurance, you have to make sure to go with certain in network providers or you'd pay outrageous costs.... Why else would people prefer keeping their insurance over Medicare? Especially with Calcare covering 100% of the cost and encompassing even dental, vision, prescription and long term... Seriously, under what reason would anyone prefer keeping their health insurance?

Curmudgeon Jan 26, 2022 08:28 AM
Op-Ed: Why We Need CalCare

UCSB 98 - Medicare was signed into law in 1965 and payroll taxes began for 1966 at up to $6600 of income.

a-1643246733 Jan 26, 2022 05:25 PM
Op-Ed: Why We Need CalCare

I can provide several reasons why someone would want other insurance over the proposed "universal medicare." Most important is quality of doctors. Those who haven't worked in healthcare may have naive ideas about how this plan would work, but the reality is that the better doctors will not contract with this new plan. Therefore, to get good medical care you will have to pay out of pocket. Not a good deal. My European and Canadian friends and relatives have to pay out of pocket to get better care. In my experience, poor health care is worse than no health care. This sounds good on paper, but devil is in the details.

a-1643247438 Jan 26, 2022 05:37 PM
Op-Ed: Why We Need CalCare

Hmmm. So, you'd rather stay with bad care that's expensive?

Ahchooo Jan 26, 2022 06:18 PM
Op-Ed: Why We Need CalCare

5:25 PM, I’d like to see a robust study of the issue you bring up. I really don’t know the truth on that. But I was told to never get an HMO because I’d have no choice of which doctors I see. But I have an HMO with Sansum and there are plenty of stellar doctors there. If most of the population is covered by CalCare, won’t most of the doctors take those patients? There are lots of great doctors, and they can’t all hold out for private-pay rich people.

UCSB98 Jan 26, 2022 06:23 PM
Op-Ed: Why We Need CalCare

A-1643246733

So then why is the US ranked 30th in the world behind all those countries with universal healthcare for all?

David0593 Jan 26, 2022 06:13 AM
Op-Ed: Why We Need CalCare

3 years to widen 5 miles of the 101.
$350,000 per hotel room to house the homeless in Goleta. (Super 8 hotel)
$77 billion dollar bullet train to nowhere
$5 gallon gas
$300 gas bill to heat house
Our government is ineffective. Anyone who thinks otherwise is ignorant.
We deserve better. Until the government gets their act together I would not support any ideas out of Sacramento.

a-1643221720 Jan 26, 2022 10:28 AM
Op-Ed: Why We Need CalCare

David, what the shoot are you trying to say? The 101 project is being built by private contractors in a way to mitigate the impact on 101 users. The $5 gas is the result of private corporate policy and world wide exploitation of the energy market by cartels. $300 to heat your house is probably a fair price in winter but the cost would be much greater if public utilities were not regulated by the PUC. (And if the PUC actually did the job right we would be better off.) If private businesses provided these necessities we would see something more akin to the price of cable TV by the way. Unbridled, unregulated, unreviewed free market capitalism is a disaster wherever it gets control. I (a voter) am the government and I want my government to act in my interests to protect my environment, my income, my savings, my future. I certainly would not trust that to the robber barons.

a-1643210495 Jan 26, 2022 07:21 AM
Op-Ed: Why We Need CalCare

https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1400

jsavell Jan 26, 2022 10:30 AM
Op-Ed: Why We Need CalCare

Those over 65 will have to give up their Medicare to fund this, and then have to wait in line behind illegals to get care. Those who have good commercial insurance will have to give that up too. California government cannot do anything right and I don't trust them to create a healthcare system.

Funding will require a waiver from the Federal government to send Medicare and MediCal revenues to the state, which is unlikely to happen.

sacjon Jan 26, 2022 11:47 AM
Op-Ed: Why We Need CalCare

JSAVELL - " have to wait in line behind illegals to get care" - how do you figure? Does this legislation give preference to undocumented immigrants to be seen before citizens? Lots of doom and gloom and short on facts it seems.

UCSB98 Jan 29, 2022 07:50 AM
Op-Ed: Why We Need CalCare

This expands Medicare into paying 100% instead of just 80%.... Plus it adds dental, vision, prescription, and long term care..

banana Jan 26, 2022 12:12 PM
Op-Ed: Why We Need CalCare

Studies of health plans such as Calcare have been done in numerous states and by the Federal Budget Office. All show immense savings and improved quality possible. They stabilize costs over time and, when well designed the way Calcare is, can cover all needed care for 100% of the population without co-pays or deductibles, while spending less from day one. Why? Mainly because one risk pool reduces administrative costs for all business, care providers, the government, and others because only one comprehensive health plan is needed and and a predictable, negotiated fee schedule is there for all. An analysis of how single payer works is at: https://www.ucsf.edu/news/2020/01/416416/single-payer-systems-likely-save-money-us-analysis-finds . Wait times are caused by too many patients seeking too few providers. More folks in health care are needed. All of us would save millions of dollars on health costs just for government workers if we all were in a single risk pool. That would be social justice too. Win-win-win for all except health insurance sales folks. The Bill provides funding for retraining the displaced into other jobs, likely more useful to society and rewarding for the worker. The Covid-19 pandemic should have taught everyone that if anyone who can not or will not access recommended health care, then that person can give you or your children a deadly disease and destabilize the health care delivery system for all regardless of private or public health insurance. Health care, as Medicare has demonstrated, is better financed through taxes. Licensed and accredited health providers remain in the private sector. Under Calcare, you may choose anyone you want who is participating. In Medicare, at least 90% of providers participate. Payment is guaranteed without a fuss. Also, you, as a patient and any doctor who wants too, may opt out and self pay and self charge. But you may not opt out of the tax system that is designed to be fair to all. That is freedom and justice for all.

oops Jan 26, 2022 01:22 PM
Op-Ed: Why We Need CalCare

If u like the service at the DMV or post office, you’ll love this!!

UCSB98 Jan 29, 2022 07:49 AM
Op-Ed: Why We Need CalCare

DMV isn't healthcare.... More like if you can't wait to get on Medicare then you'd like this as it expands into paying 100% instead of just 80%.... Plus it adds dental, vision, prescription, and long term care..

a-1643247752 Jan 26, 2022 05:42 PM
Op-Ed: Why We Need CalCare

It would be wonderful to join the civilized world, but too many in our populace don't understand civilization.

Channelfog Jan 29, 2022 09:34 AM
Op-Ed: Why We Need CalCare

As a builder, I carried my own $3million PPO w/ $5k deductible and no co-pay and did so for 35yrs. The cost for the two of us, healthy beings, was $20k per year! (in 2015) That expense precluded much in the way of vacations as we had to kick out $5k every 3 months or be cancelled and be forced to reapply for a lesser, more expensive plan.
Uruguay has government paid health care, the quality is good, and for another $2k/yr we get private hospitalization for both of us. Here the hospitals will treat you for anything and everything, and worry about payment later just as it once was in the US. Single payer provides the best care to cost ratio for the population and NO profit for the abusive, greedy insurance industry :-)

edney Jan 29, 2022 12:44 PM
Op-Ed: Why We Need CalCare

If you scroll down to page 21, you will see that Doctors are more likely to not take Medi-Cal patients.
https://www.chcf.org/wp-content/uploads/2021/03/PhysiciansAlmanac2021.pdf

Low reimbursements, and bureaucracy problems. Bad combination

State workers and their bosses are no more altruistic than for profit corporation workers. They know how to feather their nests too.
Look at the LA DWP people who plead guilty recently

edney Jan 29, 2022 12:55 PM
Op-Ed: Why We Need CalCare

The state becomes the middle man and probably winds up hiring most of the people currently working in the insurance hives. The CEO's will sign up as very highly paid consultants.
The "middlemen" people will threaten to go on strike every 7 years... they won't actually ever have to strike because no one is going to say no to their demands.

They'll all retire after 30 years with full state pensions and benefits at the age of 55. At that time, life expectancy should be over 100 unless they completely *bleep* up the system

banana Jan 30, 2022 01:51 PM
Op-Ed: Why We Need CalCare

If we are all in one risk pool with an improved health plan similar to but better than traditional Medicare, all licensed and accredited health care providers will be paid at a rate that is at least the Medicare rate, not the traditionally way-too-low Medi-Caid (MediCal in CA) rate. Please read the studies and think before making up stuff out of whole cloth. Your own experiences such as that of CHANNELFOG are very valuable to telling the story.

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