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Originally Posted by hiredgun
I think it's a fairly creative (yet minimalistic, as far as universal healthcare schemes go) solution to a complicated problem. I do worry about whether it places too much of the burden on those it is meant to help, ie the poorest of us. I think the principle is great, if the following assumptions are true:
a) the level of assistance provided by the state to the lowest-income families significantly increases the quality of their access to healthcare
b) the program succeeds in bringing insurance costs down as a whole
The second is kind of a fundamental issue, while the first could be achieved just by jiggering with the numbers a bit, so long as it's fiscally feasible.
What are your thoughts on the plan?
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I agree with your items A and B above as true measures of a successful plan. I truely see the issue in terms of what is the most cost effective and most effiecient means to get the highest medical care to the most people.
Everyone has access to healthcare in California but the current system is broken and is costing the State billions of dollars per year, employers are spending billions, individuals are spending billions and the federal government is spending billions. There are also hidden costs of people avoiding medical care because of the costs or lack of insurance. The first thought I have is how can you best reduce the costs and improve access to healthcare and improve quality.
Forcing everyone to have health insurance helps spread the costs over more people, but by itself does not reduce the costs.
If everyone has health insurance perhaps the demand for emergency room services with drop. Assuming emergency room visits are the most costly form of healthcare, we should see a reduction in costs. And assuming people use healthcare plans for preventative treatment we should also see a cost reduction because of that as well.
However, if there is not an increase in the supply of healthcare services with the expected increase in healthcare demand with everyone having coverage, you will see increased costs or access will decrease, or the quality of care will decrease.
The problem with the California plan is that it does not address the supply of health care part of the equation. If the people wanting to regularly see a treating doctor increases by a factor of lets say 5, the system can't handle it.
The AMA has worked very hard over the years to control the supply of doctors. California ( or the Federal Gov), has to address this issue. Perhaps nurses and others be allowed to do more. Perhaps we do more to increase the number of doctors. Increasing taxes on doctors and hospitals is not going to ecourage more to set up shop. If I were a doctor and could make $250K per year in California or make $250K in Arizona all other things being equal the 2% tax might make me setup shop in Arizona. the same logic applies to hopitals and employers.
My hat is off to The Govenator for trying, hopefully they have an answer to the concern I point out.