Mr. Universe's muscular agenda

January 8, 2007 11:09 PM

California's Governor Seeks Universal Care: Under a plan by Gov. Arnold Schwarzenegger, California would become the largest state to attempt to provide near universal health coverage.
posted by kliuless (53 comments total)

Wow. I never thought Arnold Schwarzenegger would do something that I approve of. What's the catch? In order to get this healthcare is he going to cede control of California over to aliens?

Also: Under Mr. Schwarzenegger’s plan, which requires the approval of the Legislature, California would become the fourth and by far the largest state to attempt near universal health coverage for its citizens. The other three states are Maine, Massachusetts and Vermont.

Damnit. I've lived in both Vermont and Massachusetts and here I am now in Rhode Island where all we've got going for us is gay divorce. Poop.
posted by grapefruitmoon at 11:17 PM on January 8, 2007

Welcome to the 20th century.
posted by furtive at 11:33 PM on January 8, 2007 [1 favorite]

This sanity will not spread.
posted by IronLizard at 11:42 PM on January 8, 2007

As California's tax burden wasn't already high enough. It's driving business away now.
posted by Steven C. Den Beste at 11:44 PM on January 8, 2007

He recently vetoed a single-payer. I think this resembles the Massachusetts plan in theory, which favored the insurance industry, who lobbied for its key provisions.
posted by Brian B. at 11:49 PM on January 8, 2007

That would be "vetoed a single-payer plan."
posted by Brian B. at 11:50 PM on January 8, 2007

I love it -- lauded Republican governors getting all socialist on us.

SCDB writes It's driving business away now.

Ah, yet another unsubstantiated claim. Although I find them preferable to the ones you substantiate with utter bs.

I think state governments are waking up and realizing that a person getting an annual check-up is cheaper (and more importantly, healthier) than someone who can't afford basic up-keep, and winds up in an ER with a disease or condition that's no longer treatable. And that businesses that don't provide reasonable health packages are essentially passing the buck along to said state government and tax-payers eventually.

The Massachussetts plan has some issues, but it's a step in the right direction IMO. It's a good trend to witness, but it might be too late to save the system. Luckily, plane tickets to Mexico and India are still relatively cheap.
posted by bardic at 12:13 AM on January 9, 2007

Yippee! Plow chops for everyone!
posted by Brittanie at 12:49 AM on January 9, 2007

As California's tax burden wasn't already high enough. It's driving business away now.

Well, if he gets it right the businesses being driven away by higher taxes will be replaced by businesses attracted to not having to spend awesome amounts of money giving their employees health insurance.
posted by A Thousand Baited Hooks at 1:07 AM on January 9, 2007

Detective John Kimble: I have a headache.
Lowell: It might be a tumor.
Detective John Kimble: It's not a tumor!
posted by rfbjames at 1:45 AM on January 9, 2007 [1 favorite]

yes, the argument is that it saves money.
posted by A189Nut at 1:49 AM on January 9, 2007

SCDB

Why would taking a huge business expense and transfering it to the government drive business away?
posted by sfts2 at 3:16 AM on January 9, 2007

Government will need to tax business to make up the shortfall for the low income, which far outnumber those who can afford it IMHO. Though the impact will be lessened drastically if you consider those currently on medicaide/chips.
posted by IronLizard at 3:20 AM on January 9, 2007

hi, little canada!
posted by dflemingdotorg at 4:00 AM on January 9, 2007

Government will need to tax business to make up the shortfall for the low income, which far outnumber those who can afford it IMHO. Just curious if anyone's run the numbers. How many of the under/un insured are young people who use the system less in agregate than older people? Is it possible that by forcing 20 year olds into the insurance system we'll actually lower per capita costs. I'm sure there must be research on this, but I can't find anything in the vast noise machine that is our political debate on health care in this country.
posted by humanfont at 4:15 AM on January 9, 2007

If they can force me to pay for others' healthcare, can they please force said others to take better care of themselves?
posted by ZenMasterThis at 4:26 AM on January 9, 2007

If they can force me to pay for others' healthcare, can they please force said others to take better care of themselves?

This argument works better in Arkansas, or Mississippi. In California, not only have they abolished all forms of smoking, they also euthanize the ugly.
posted by Civil_Disobedient at 4:39 AM on January 9, 2007 [2 favorites]

As California's tax burden wasn't already high enough. It's driving business away now.

Not when business find out they don't have to provide health insurance, which probably costs more then taxes.

Being that this is America, though, it's probably going to be required that companies both pay insurance for their employees, and that general taxes will pay for everyone else's. Also, if they don't cover illegals, it won't actually be "universal"
posted by delmoi at 4:43 AM on January 9, 2007

If they can force me to pay for others' emergency rooms, can they please force said others to not have random accidents?
posted by snoktruix at 4:44 AM on January 9, 2007

Remember, kids: Paying administrators to process and pay claims is wrong, but paying 200+ different sets of administrators to process and pay claims is right.
posted by eriko at 5:18 AM on January 9, 2007

all citizens? what about illegals? any info on this?
posted by Postroad at 5:25 AM on January 9, 2007

I think the term 'citizens' excludes illegals by definition.
posted by IronLizard at 5:29 AM on January 9, 2007

1) Remove 20% profits for "health care insurers." Check

2) Remove 30% claim processing expenses with single source. Check.

3) Better [free] preventive care reduces costs. Check.

4) Fewer emergency room visits reduces costs. Check.

Save money, encourage businesses to relocate to the world's sixth largest economic area. Yup. Ask Ford, GM or Chrysler what they think of universal health care. That's why they like Canada better than the US.

Next thing Mr. Clueless will tell you is that raising the minimum wage puts poor people out of work. Same lies told to protect private profits every time and some swallow it every time.
posted by nofundy at 5:37 AM on January 9, 2007

Excuse me for interrupting, but didn't you just contradict yourself, nofundy?
posted by IronLizard at 5:41 AM on January 9, 2007

Let's be clear on this. This is not socialism, but a plan where the financial burden falls upon individuals.

The plan will require all individuals to purchase health care, if they (a) are self-employed and (b) don't fall into the "employers with 10 or more workers." This is, for the working poor, hardly a case where the state "provides" universal health insurance. This would involve the uninsured working poor, who are already paying state and federal taxes, to pay for health care or face penalties -- much like the universal health care bill that went through in Massachusetts last year.

There also doesn't seem to be any concern here for the unemployed.

Only in America can forcing extra costs upon the working poor be considered "socialism." This idea is no different in its timbre than a welfare-to-work program.
posted by ed at 6:28 AM on January 9, 2007

Possibly. Can you elaborate?
posted by nofundy at 6:29 AM on January 9, 2007

Save money, encourage businesses to relocate to the world's sixth largest economic area. Yup. Ask Ford, GM or Chrysler what they think of universal health care. That's why they like Canada better than the US.

Then:

Same lies told to protect private profits every time and some swallow it every time.

I don't see why they would be lying to protect their profits if universal health care would save them money. I may not be privy to some information you've left out, however.
posted by IronLizard at 6:34 AM on January 9, 2007

I think there is a growing change on the business side of the equation to pushing for government to do something about health care. Companies like Ford, who have had decent health care benefits for their workers are finding the bills to be too expensive, but also too hard to just dump.

I wouldn't be shocked to see large businesses lobbying for universal health care on the national level within the next few years.
posted by drezdn at 6:44 AM on January 9, 2007

I see what you are saying now.

Let me try to explain.

Many systems are much more efficient (less expensive) if done by goverment agencies.

The inefficiencies of private health care insurers is one of those.
Health care insurers have massive profit margins and wish to protect those profits against a more efficient system.

As a result others suffer the added expense, for example, the auto industries.

Eliminating the inefficiencies of health care create incentives for others to relocate.
I use the auto industries because they have recently highlighted health care expenses as their most burdensome overhead in the US and mention that Canada is a more attractive location as a result.

The same inefficiencies exist in other areas that could be/have been better addressed by government but some hate to have to admit that fact (SDB for one).
posted by nofundy at 6:48 AM on January 9, 2007

Well, so far in this thread we've had lots of idle speculation, grand theories tossed around and plenty of arguing. Does anyone have some links that point to actual data about topics such as:

1) The cost of this plan;
2) Will it require a tax increase? If so, how much?
3) How are the state plans performing in Mass/VT/Maine?
4) How much are the plans costing in those states?
5) What do the people in those states think of the plan so far?

Thanks in advance.
posted by tgrundke at 6:59 AM on January 9, 2007

"4) Fewer emergency room visits reduces costs. Check"

I have to wonder if this will really happen - we already have a big enough problem of people using the ER as their primary physician because they think it's going to be faster to be seen there instead of calling their actual primary physician. ER wait times are long enough as it is.

It could happen, and we could have fewer ER visitors. But the opposite could happen as well. "Oh, you have the sniffles. It's Saturday morning and you won't be able to call the doctor until Monday. Just go into the ER.. after all, it's now free for us!"
posted by drstein at 7:28 AM on January 9, 2007

Anecdotal: Data from a medical monitoring program show people who live near the (a former nuclear processing site) are living longer and following healthier lifestyles than the general population. Why? Because their free, regular health checks are catching things like cancer and risk factors for heart disease.
posted by tizzie at 8:26 AM on January 9, 2007 [1 favorite]

drstein writes "'Oh, you have the sniffles. It's Saturday morning and you won't be able to call the doctor until Monday. Just go into the ER.. after all, it's now free for us!'"

My experience in Canada is that's not really a problem, clinics are so much faster than the ER. You come to the ER with minor problems and the triage nurse has you waiting around until no one more serious is waiting.
posted by Mitheral at 8:54 AM on January 9, 2007 [1 favorite]

Here's a first-look breakdown.

It's important to remember that other countries spend half on healthcare for more coverage and better results than the US by emphasizing prevention, capping costs, batch-buying of drugs (illegal in the US thanks to lobbying) and uniform paperwork that reduces administration and replaces most liability. I see California's plan as a complex maze of pro-insurance policies. The US has traditionally divided and conquered its electorate over healthcare, giving it the elderly, veterans and low-income, but never to working taxpayers.
posted by Brian B. at 8:56 AM on January 9, 2007

Mitheral is right. No one goes to the ER with a cold unless they have nothing better to do with their day. You will wait a long time for any service. Its always funny reading comments from Americans who are so afraid of universal health care. Oh noes the communisms! I suspect this won't go anywhere. Who knows.
posted by chunking express at 9:00 AM on January 9, 2007

damn, it just struck me I was was having this same stupid argument in a college dorm bull session exactly 20 years ago.

Progress!
posted by Heywood Mogroot at 9:00 AM on January 9, 2007

If they can force me to pay for others' healthcare

Who's forcing you to live in Cali ? If it is so terrible, try Iraq.
posted by elpapacito at 9:28 AM on January 9, 2007

If they can force me to pay for others' healthcare

That's what insurance does.
posted by Brian B. at 9:34 AM on January 9, 2007

It's important to keep in mind that in the Medical "food chain," ER care is by far the most expensive and least cost effective. IANAD, but I don't think car analogies are far off -- if you pay that 30 bucks every six months to change your oil, you have a much better chance of avoiding a total engine failure in five years.

As for expecting people to stay in better shape? That doesn't really bother me. Just as long as we don't start screening people for cancer or other terminal diseases and then telling them they have to pay higher premiums due to their genome. Although I worry that this goes hand in hand with further genetic research.

And my "socialism" comment was intended ironically. I guess I should bite my tongue and admit that it tooks guts for Romney to do what he did, and for the Governator to do what he's doing. If Democrats want to take some credit for these initiatives they better act soon.
posted by bardic at 10:11 AM on January 9, 2007

The United States government currently pays more for health care than any other country.
This does NOT include private health care.

Health care insurers, big pharmaceuticals, and health services corporations make obscene profits while 47 million go without ANY health insurance. Time for some governmental tough love for those greedy bastards.
posted by nofundy at 10:40 AM on January 9, 2007

Krugman: A Healthy New Year

First, Do Less Harm
posted by homunculus at 11:49 AM on January 9, 2007

Maybe Arnie smacked his head good against a Douglas Fir during his last skiing accident.

Good in the "good" sense of the word....
posted by rougy at 12:14 PM on January 9, 2007

Hey,

On Ahnold, it is "message received."

He's become the best Democrat the Republican party ever had!
posted by nofundy at 1:00 PM on January 9, 2007

STOP calling this damn thing universal! It isn't universal unless you're a kid!

80% of businesses are exempt from this turd. The Chicago Tribune correctly describes it as MANDATORY health insurance. This plan would require people to be insured, and damn well help them if they make little enough money. It even says insurance companies can't exclude someone for pre-existing conditions, but nowhere does it say insurance companies have to offer affordable rates.
posted by ilsa at 2:06 PM on January 9, 2007

He's become the best Democrat the Republican party ever had!
posted by nofundy

I had my doubts about him during the middle of his first term but voted for him (again) when the election rolled around and caught a lot of grief from my friends over that vote. I'll feel vindicated if he can pull this off as it is desparately needed here. I have too many friends that are uninsured due to pre-existing conditions and/or being unable to afford $700/month or more to insure a healthy couple in their 50s.

This is definitely a concept whose time has come and I will be pissed if the lobbyists from business, unions and the medical industry are able to kill it.
posted by buggzzee23 at 2:14 PM on January 9, 2007

Who says, buggzzee23, that your friends won't be paying $700/month because the State of California requires them to?
posted by ed at 6:46 PM on January 9, 2007

also see: "There is a solution, proven effective for hundreds of millions of people: single-payer health insurance."

and fwiw...
Veterans Drug Plan Seen by Democrats as Way to Reduce Costs
posted by kliuless at 8:14 PM on January 9, 2007

AustraliaFilter: I love my country... free healthcare for all!
Also, as a doctor, I would definitely pony up the proposed 2% if it meant better health care for the community. The opposition from the medical sector in CA probably reflects some interesting twists and turns in the proposed legislation that are not evident on a surface glance that might concern the said doctors, but if they're just balking at the money then they are in the job for the wrong reasons (IMHO). Interesting that the push here is to subsidise the existing insurance / user pays system rather than go the other way and develop a/the free state/federal funded public health care system.
Also: "The United States government currently pays more for health care than any other country"... is this per capita, or total expenditure?
posted by dubious at 9:52 PM on January 9, 2007

dflemingdotorg: in Canada, is it goverment funded free health care derived from taxes like Australia?
posted by dubious at 9:57 PM on January 9, 2007

The numbers are a touch dated but the Washington Monthly had an excellent writeup about funding levels between Canada and the US and how all the single payer bugaboo in the US is foolish for anyone who doesn't own an insurance company.

Canada insured 100 percent of its citizens for $2,250 per person in 1998 while the United States expended $4,270 per person insuring only 84 percent of our [USA] citizens.

Also healthcare isn't free in Canada, all but the very low income pay premiums but they are fairly low and the same for everyone. Health premiums are a not uncommon benifit, my employer pays for my whole family.

Everyone who interested in differences between Canada and the US should read it.
posted by Mitheral at 10:27 PM on January 9, 2007

Thanks Mitheral. Certainly makes you stop and think about the situation in the US, doesn't it. Good luck with it all you guys!
posted by dubious at 2:06 AM on January 10, 2007

If they can force me to pay for others' healthcare, can they please force said others to take better care of themselves?

Part one: They can and are forcing others to pay for *yours*, so why not? Or does your magic 8-ball assure you that you will never get cancer or some other major disease requiring expensive treatment? Maybe you have a trust fund and can pay your way, but not many people can...

Part two: With regular checkups at the doctor and basic preventative care, they *will* be taking better care of themselves and requiring less health care expenditures overall.

But I realize your question may have been purely rhetorical.
posted by beth at 2:51 AM on January 10, 2007

"clinics are so much faster than the ER"

Clinics are a great idea. I actually wish more of the "Doc in a Box" type clinics were open 24 hours.

Wasn't Wal-Mart talking about putting urgent care clinics in some of their stores? my feelings about Wal-Mart aside, I can't say that it's a terrible idea.

If you have the sniffles or a small cut on your hand, you probably don't need an ER. An urgent care clinic would be an excellent choice. Many of them are also cheaper, too.
posted by drstein at 6:59 PM on January 11, 2007