California Senate passes Single Payer.

[SirNitram]

Link

SACRAMENTO, Calif. -- The California Senate approved creating a government-run health care system for the nation's most populous state on Thursday, ignoring a veto threat from Gov. Arnold Schwarzenegger.

Supporters said it is time for state legislatures to take up the debate as the Obama Administration's national health care proposal falters in Congress.

"If it's not to be done at the national level, let us take the lead," said state Sen. Christine Kehoe, D-San Diego.

The move in California comes after Massachusetts voters changed the calculus in Congress by electing a Republican to the Senate who opposes the pending plan.

Democrats are the majority in both houses of the California Legislature. The 40-member state Senate passed the single-payer plan on a 22-14 vote, sending it to the Assembly. One Democrat voted against the measure.

Schwarzenegger promised to veto the proposal, as he has two similar plans that previously reached his desk. Spokeswoman Rachel Arrezola cited the state's massive budget cuts and looming $20 billion deficit in arguing the state cannot afford to shift to a single-payer health care system.

"Any elected official who thinks it's a good idea to strap the state with tens of billions of dollars from a government-run health care system is clearly not in touch with what voters need and deserve," Arrezola said.

The proposal by Sen. Mark Leno, D-San Francisco, authorizes $1 million to establish a commission that would decide how to pay for the system. The funding plan would ultimately have to be approved by voters.

Leno argued the state-run plan would replace the $200 billion Californians already pay for their health care while eliminating insurance companies' share. He previously said the system could use existing state and federal money and a payroll tax, coupled with increased efficiencies from a government-run system.

"We are spending $200 billion currently," Leno said. "It is the same $200 billion used in a more efficient, cost-effective fashion."

Republicans derided the timing of the vote, saying Democrats are ignoring the lesson in Massachusetts at their political peril.

"This plan is to the left and radical of what couldn't get out of Washington," said Sen. George Runner, R-Lancaster.

Senate President Pro Tem Darrell Steinberg said Republicans refused to support even a $14.7 billion health care reform bill that Schwarzenegger, a Republican, negotiated with Democratic leaders two years ago.

"Not a single Republican vote - so what are you for?" asked Steinberg, a Democrat from Sacramento who usually strikes a conciliatory bipartisan tone. "The demagoguery needs to be answered and addressed."

Schwarzenegger's proposal actually was undone by Democrat Don Perata, Steinberg's predecessor in the Senate, when he ordered a financial review that found the plan would be billions of dollars out of balance within a few years.

But the movie star must strut for his manly man ways, so he'll veto it while begging for Federal money.

[Formless]

Oooh, that's interesting <---- my initial reaction to seeing this thread.

Seriously, though. If more states were to take the initiative like this we could bypass the current clusterfuck at the federal level WRT health care (not to mention many other things). I wonder why they don't do that?

[Erik von Nein]

There is something to be said about not having the funds to implement this. The state's already cutting huge portions of the budget, including plenty of state-funded aid programs. The county I live in has been feeling this impact pretty badly, since there's a large number of homeless people. Assistance programs have taken a beating lately.

That's not to say the program isn't a good idea, just that Ahnold may not be vetoing it just because he's a Republican. That may be the case, and it wouldn't come as that much of a surprise, but I suspect the reasoning of "can't afford it" is more likely.

[Koolaidkirby]

does the state senate have the votes to override a governors veto?

[Guardsman Bass]

I suspect the reasoning of "can't afford it" is more likely.

Although I support state-level efforts for universal health care as well as national-level ones, this is usually what gets most state-level reforms. Massachusetts is actually a bit of a rarity in that it has lasted this long.

[aerius]

There is something to be said about not having the funds to implement this. The state's already cutting huge portions of the budget, including plenty of state-funded aid programs.

They just gotta fire all their government employees and hire them back for reduced wages. I'm pretty sure there's a bunch of useless leeches down there getting paid $40 an hour to mow lawns or something ridiculous like that. I know for a fact that there's lifeguards making 6-figure wages since I saw an article on that recently.

[Pollux]

As a Californian with no healthcare, I will be following this very closely.

I live in a rather conservative area, so I expect there to be a general uproar tomorrow, when most other people get the news. They can cry all they like, I just hope this passes.

[The Duchess of Zeon]

The problem is that it's an unfunded mandate, and the only way to fund it will be to raise taxes at least enough so that all the money that was going into people paying for private health insurance will now go into taxes.

[Erik von Nein]

There is something to be said about not having the funds to implement this. The state's already cutting huge portions of the budget, including plenty of state-funded aid programs.

They just gotta fire all their government employees and hire them back for reduced wages. I'm pretty sure there's a bunch of useless leeches down there getting paid $40 an hour to mow lawns or something ridiculous like that. I know for a fact that there's lifeguards making 6-figure wages since I saw an article on that recently.

They are firing people. Quite a few public employees are getting the cut and their unions are flipping out.

[Arthur_Tuxedo]

The problem is that it's an unfunded mandate, and the only way to fund it will be to raise taxes at least enough so that all the money that was going into people paying for private health insurance will now go into taxes.

Yes, and even though the tax increase would most likely be less than the decrease in premiums, such a large increase in taxes would cause a massive uproar. People wouldn't understand that they were actually saving money overall.

The other big problem is that if California were the only state to do this, uninsured people with serious health issues from all over the country would move to CA and drive care costs through the roof.

[Alerik the Fortunate]

Besides, California is not that liberal overall. Most of the state is rural and redneckish, or dominated by socially conservative minorities where there's a paucity of socially reactionary whites. And we have a way of botching everything in this state, so I wouldn't be surprised if what results after all the resistance and budget cuts have gutted the single payer system will be held up as an object lesson on why single payer never works. Or it will just be ignored. I don't think most Californians other than progressives in the Bay Area and a few other clusters, or businessman with ties to Republican politicians really follow politics that closely; certainly not at the local level.

[Arthur_Tuxedo]

The only way I could see state-level single-payer work is if several states did it simultaneously with one payer for multiple states. This could actually work since the most liberal states that could conceivably pass single-payer are also the most populous. Between California, New York, and a few other blue states you could have 100 million insurees. Faced with the stark contrast between the relatively good cost and effectiveness in the single-payer states and the abysmal results in other states, the others would either have to join the system or face an exodus of taxpayers and businesses.

However, I have no illusions that the federal Congress would allow the states to do this or that state voters even in very liberal states would pass it after the health industry spends literally billions in every state that considers it to block it, which they can do much more easily after the recent Supreme Court ruling on corporate political advertising.

[The Duchess of Zeon]

The only way I could see state-level single-payer work is if several states did it simultaneously with one payer for multiple states. This could actually work since the most liberal states that could conceivably pass single-payer are also the most populous. Between California, New York, and a few other blue states you could have 100 million insurees. Faced with the stark contrast between the relatively good cost and effectiveness in the single-payer states and the abysmal results in other states, the others would either have to join the system or face an exodus of taxpayers and businesses.

However, I have no illusions that the federal Congress would allow the states to do this or that state voters even in very liberal states would pass it after the health industry spends literally billions in every state that considers it to block it, which they can do much more easily after the recent Supreme Court ruling on corporate political advertising.

States collaborating to minimize costs would also be unconstitutional without Congressional permission.

[The Yosemite Bear]

California we will vote to make X reality, and fund it with IOUs and hot air.

[Liberty]

The only way I could see state-level single-payer work is if several states did it simultaneously with one payer for multiple states. This could actually work since the most liberal states that could conceivably pass single-payer are also the most populous. Between California, New York, and a few other blue states you could have 100 million insurees. Faced with the stark contrast between the relatively good cost and effectiveness in the single-payer states and the abysmal results in other states, the others would either have to join the system or face an exodus of taxpayers and businesses.

However, I have no illusions that the federal Congress would allow the states to do this or that state voters even in very liberal states would pass it after the health industry spends literally billions in every state that considers it to block it, which they can do much more easily after the recent Supreme Court ruling on corporate political advertising.

States collaborating to minimize costs would also be unconstitutional without Congressional permission.

How would it be unconstitutional?

Also, this fits right in with Lafollette's "laboratory for democracy." http://en.wikipedia.org/wiki/Robert_M._La_Follette,_Sr.

[Andrew J.]

The only way I could see state-level single-payer work is if several states did it simultaneously with one payer for multiple states. This could actually work since the most liberal states that could conceivably pass single-payer are also the most populous. Between California, New York, and a few other blue states you could have 100 million insurees. Faced with the stark contrast between the relatively good cost and effectiveness in the single-payer states and the abysmal results in other states, the others would either have to join the system or face an exodus of taxpayers and businesses.

However, I have no illusions that the federal Congress would allow the states to do this or that state voters even in very liberal states would pass it after the health industry spends literally billions in every state that considers it to block it, which they can do much more easily after the recent Supreme Court ruling on corporate political advertising.

States collaborating to minimize costs would also be unconstitutional without Congressional permission.

How would it be unconstitutional?

"No State shall, without the Consent of Congress...enter into any Agreement or Compact with another State..."

Article I, §10, Paragraph 3.

[ArmorPierce]

I am reading something that states that section is meant to refer to entering into something such as an alliance or confederacy.

the Supreme Court say:

There are many matters upon which different States may agree that can in no respect concern the United States. If, for instance, Virginia should come into possession and ownership of a small parcel of land in New York which the latter State might desire to acquire as a site for a public building, it would hardly be deemed essential for the latter State to obtain the consent of Congress before it could make a valid agreement with Virginia for the purchase of the land. If Massachusetts, in forwarding its exhibits to the World's Fair at Chicago, should desire to transport them a part of the distance over the Erie Canal, it would hardly be deemed essential for that .State to obtain the consent of Congress before it could contract with New York for the transportation of the exhibits through the State in that way. If the bordering line of the two States should cross some malarious and disease-producing district, there could be no possible reason, on any conceivable public grounds, to obtain the consent of Congress for the bordering States to agree to unite in removing the cause of the disease. So, in the case of threatened invasion of cholera, plague, or other causes of sickness and death, it would be the height of absurdity to hold that the threatened States could not unite in providing means to prevent and repel the invasion of the pestilence without obtaining the consent of Congress, which might not be at the time in session.

[CarsonPalmer]

States collaborating to minimize costs would also be unconstitutional without Congressional permission.

It doesn't need to be a formal compact, though. I don't think there's any way to prevent, the Democratic Party in New York and the Democratic Party in New Jersey from getting together and saying "We'll put single-payer forward at the same time".

[CmdrWilkens]

The problem is that it's an unfunded mandate, and the only way to fund it will be to raise taxes at least enough so that all the money that was going into people paying for private health insurance will now go into taxes.

Yes, and even though the tax increase would most likely be less than the decrease in premiums, such a large increase in taxes would cause a massive uproar. People wouldn't understand that they were actually saving money overall.

The other big problem is that if California were the only state to do this, uninsured people with serious health issues from all over the country would move to CA and drive care costs through the roof.

Two things: Its all in HOW the taxes are changed. If you make it a payroll tax then much like current payroll taxes it becomes almost invisible. Companies usually don't disclose to their employees how much they spend on that amount but it comes as part of the cost of employment. From the corporate end turning variable employer contribution schemes in to a single state payroll tax deduction would actually simplify things and while it may impose more cost for employers who don't currently provide healthcare it would provide a net savings in efficiency terms to those who do. Again the taxing would still be there but it would be "behind the scenes" as it were and probably go unnoticed. If in the first six months or so after funding legislation passed folks didn't notice a change in their paychecks (and they likely wouldn't) things would be fine.

As to folks moving to California in order to get healthcare it isn't as simple or even all that particularly economically detrimental. The reason is that folks would have to physically move to California itself and establish residency (most likely). The act of doing so entails a large amount of money and time portions of which would help fill state coffers even aside from the basics of increased rental or real estate incomes throughout the state. Leaving aside that those without health insurance for reasons of economic hardship aren't likely to have the funds to move to California (unless they are already nearby) there is still some benefit to a larger population base in terms of domestic market for goods. In other words while you could, and might, get an influx of the previously uncovered that by no means guarantees a net negative economic impact.