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Universal Healthcare proposals in NYC and California (1 Viewer)


Both the new governor of Calif. and mayor of NYC have plans to push universal HC for all including illegal immigrants.  What's the chances that either promise is met especially when you consider the staggering price tags? 

Tim - give us some insight into whether or not the people of Calif support.

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Isn't California down to about 7% uninsured, about 3 million people with about 60% undocumented adults?  If those numbers are roughly correct then I'd guess the price tag is about 15 billion (lazily using $5000 per person which is a bit more than private per capita in 2014 and a bit less than medicaid per capita so ball park nice round number that is admittedly outdated).  Since California spends about 200 billion a year that would add 7 or so percent to that spending.  Which I believe is the first real problem in California in that they have some constitutional amendment that requires some percentage of funding to go K-12 education.   

Now this is for universal health care where these 3 million people are rolled onto California's version of the exchanges and/or Medicaid.  I think the supporters in California are OK with this as part of a transition plan but ultimately the goal would be single payer.   That would be a heavier lift as there would be these primary challenges-

  • Convert from paying for insurance with premiums mostly as part of employment to paying for insurance with taxes.  This is about 15 million or so people.  So instead of 5K make this 6.6K for an even 100 billion that would now be collected as taxes rather than premiums.  (And how that X% for K-12 education.)
  • Work out waivers with the federal government for Medicare, Medicaid, "ObamaCare", and probably few other programs to allow those federal funds to be used by California's single payer.  This may be especially problematic with a hostile  administration.
  • Assuming that California also eliminates the out of pocket costs for its 35 million residents that would be another 50 billion or so to absorb that isn't just shuffling which line the payroll deduction is coming from.
I don't live in California nor do I really follow their politics.  I just have a thumbnail idea of what is wanted and rough numbers.  Most importantly though I think the best way to solve challenges like this is to list out the problems to be solved.  Those seem to be mostly political challenges in explaining where the money is going and how Californians would benefit.  Oh, and all of the numbers above ignore the savings that would be achieved and simply assume that costs were static.  Billing one payer instead of hundreds alone (not counting millions of individual) alone would drive massive cost out of the equation.  Then again this would put a bunch of back office people out of work.

 It will be fun to see if those from California disagree with this or list other challenges.

ETA:  Don't know about NYC

ETA2:  For that first part I should point out that the cost aren't just the state paying the full premium on 3 million people.  If they did that there would be 3 more million who would stop paying to get in line for the state to pay the full thing.  Instead there would be some level of sweetening the incentives such that most of those opting out would sign up along with making some eligible.  There are also some that are just going to opt out regardless.  And while not for the "illegals" some percentage of this is going to fall under federal programs paying a share.  But I figure whatever percentage isn't part of this would flow to some of those already in the various programs.  So as I stated I lazily just went 3 million people times $5000 per as "close enough" for now.   

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Hard to tell what the final cost will be as many uncounted illegals may sign up driving the final cost figure much higher.  Take it out of federal hands and lets states manage their own health care system.


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