Comments on: California’s health care reform: "Just like in the Soviet Union" http://www.kevinmd.com/blog/2007/01/californias-health-care-reform-just.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2007/01/californias-health-care-reform-just.html/comment-page-1#comment-73762 Anonymous Sun, 08 Apr 2007 23:12:00 +0000 http://clients.emmense.com/kevinmd/2007/01/californias-health-care-reform-just-like-in-the-soviet-union.html#comment-73762 Assuming MD's aren't stupid the California proposal to tax doctors to fund the uninsured will be passed onto all patients. It is really a sales tax on health care -- and is somewhat regressive.<br/><br/>I am concerned with other aspects of the California Plan. Does it provide for mandated guaranteed issue (meaning all those who buy the insurance are mandated to buy from a high risk pool)? <br/><br/>According to the New York Times Guide to Getting Affordable Coverage by Fred Brock (pages 99-105)<br/><br/>"[Individual Medical] Premiums in the five guranteed-issue states [ NY, VT, NJ, MA, ME] are uniform and high. ...if you are health and live and work in a guaranteed-issue state like News York and New Jersey .. you could move to a nearby state with less expensive premiums and commute to your job"<br/><br/>Mr. Brock compares some monthly premiums<br/><br/>Male or Female age 22.<br/>Springfield NJ PPO $374.67<br/>San Jose, CA $36<br/><br/>Married Couple 48 years old<br/>Springfield NJ PPO $749.34<br/>San Jose $171 Assuming MD’s aren’t stupid the California proposal to tax doctors to fund the uninsured will be passed onto all patients. It is really a sales tax on health care — and is somewhat regressive.

I am concerned with other aspects of the California Plan. Does it provide for mandated guaranteed issue (meaning all those who buy the insurance are mandated to buy from a high risk pool)?

According to the New York Times Guide to Getting Affordable Coverage by Fred Brock (pages 99-105)

“[Individual Medical] Premiums in the five guranteed-issue states [ NY, VT, NJ, MA, ME] are uniform and high. …if you are health and live and work in a guaranteed-issue state like News York and New Jersey .. you could move to a nearby state with less expensive premiums and commute to your job”

Mr. Brock compares some monthly premiums

Male or Female age 22.
Springfield NJ PPO $374.67
San Jose, CA $36

Married Couple 48 years old
Springfield NJ PPO $749.34
San Jose $171

]]> By: Anonymous http://www.kevinmd.com/blog/2007/01/californias-health-care-reform-just.html/comment-page-1#comment-71530 Anonymous Fri, 09 Feb 2007 09:45:00 +0000 http://clients.emmense.com/kevinmd/2007/01/californias-health-care-reform-just-like-in-the-soviet-union.html#comment-71530 To the "ER Doc" from another:<br/><br/>It's fine that you might get more money from your patients with insurance, but I get paid a straight hourly rate regardless of the patient's status. SO, all I would see from this is the extra TAX (unless the hospital decides to let some of the "extra" money they would receive from these "insured" patients trickle down to us in the trenches). <br/><br/>Also, 4,000 off the top of 200K only results in a savings of 1,320 in taxes (at 33 % tax rate)...hardly balances out does it? All I see is that I'm out another 2,680 to the government every year. And what makes you think they would stop at 2 % and not have it go UP more each year?? To the “ER Doc” from another:

It’s fine that you might get more money from your patients with insurance, but I get paid a straight hourly rate regardless of the patient’s status. SO, all I would see from this is the extra TAX (unless the hospital decides to let some of the “extra” money they would receive from these “insured” patients trickle down to us in the trenches).

Also, 4,000 off the top of 200K only results in a savings of 1,320 in taxes (at 33 % tax rate)…hardly balances out does it? All I see is that I’m out another 2,680 to the government every year. And what makes you think they would stop at 2 % and not have it go UP more each year??

]]> By: Anonymous http://www.kevinmd.com/blog/2007/01/californias-health-care-reform-just.html/comment-page-1#comment-70388 Anonymous Sat, 13 Jan 2007 18:55:00 +0000 http://clients.emmense.com/kevinmd/2007/01/californias-health-care-reform-just-like-in-the-soviet-union.html#comment-70388 MY BAD, YOU ARE RIGHT IT IS 4K MY BAD, YOU ARE RIGHT IT IS 4K

]]> By: Anonymous http://www.kevinmd.com/blog/2007/01/californias-health-care-reform-just.html/comment-page-1#comment-70387 Anonymous Sat, 13 Jan 2007 18:54:00 +0000 http://clients.emmense.com/kevinmd/2007/01/californias-health-care-reform-just-like-in-the-soviet-union.html#comment-70387 BTW 2% of 200k is $8,000 BTW 2% of 200k is $8,000

]]> By: Anonymous http://www.kevinmd.com/blog/2007/01/californias-health-care-reform-just.html/comment-page-1#comment-70381 Anonymous Sat, 13 Jan 2007 17:09:00 +0000 http://clients.emmense.com/kevinmd/2007/01/californias-health-care-reform-just-like-in-the-soviet-union.html#comment-70381 If I was in California and this thing went through, I probably still wouldn't accept MediCal. There's no way their reimbursement will be even close to other providers. With more physicians likely accepting this plan your bargaining power just went up the other private insurers. If I was in California and this thing went through, I probably still wouldn’t accept MediCal. There’s no way their reimbursement will be even close to other providers. With more physicians likely accepting this plan your bargaining power just went up the other private insurers.

]]> By: Leaving CA http://www.kevinmd.com/blog/2007/01/californias-health-care-reform-just.html/comment-page-1#comment-70380 Leaving CA Sat, 13 Jan 2007 16:56:00 +0000 http://clients.emmense.com/kevinmd/2007/01/californias-health-care-reform-just-like-in-the-soviet-union.html#comment-70380 Don't know the intricate details either, but extra money doesn't magically appear and it just puts the governments hand in the flow of healthcare money. I would rather see a "self pay" than a Medi-cal patient, because with the medi-cal patient I have to accept the joke of a payment it brings and the patient feels entitled because they have "insurance".<br/><br/>Paying more taxes in no way helps. Since CA is a high tax state the AMT tax nullifies extra state and property taxes anyway.<br/><br/>This proposal just drives healthcare farther and farther away from the wonderful thing of the free market and subjects the physician to more government control. With this new "state fund insurance" what is to keep them from determining that managing a respiratory arrest is worth a payment of 35$, a craniotomy worth 50$, appendectomy worth 25$ etc...????? And then eliminate any balanced billing that the Governor has already tried to do? Don’t know the intricate details either, but extra money doesn’t magically appear and it just puts the governments hand in the flow of healthcare money. I would rather see a “self pay” than a Medi-cal patient, because with the medi-cal patient I have to accept the joke of a payment it brings and the patient feels entitled because they have “insurance”.

Paying more taxes in no way helps. Since CA is a high tax state the AMT tax nullifies extra state and property taxes anyway.

This proposal just drives healthcare farther and farther away from the wonderful thing of the free market and subjects the physician to more government control. With this new “state fund insurance” what is to keep them from determining that managing a respiratory arrest is worth a payment of 35$, a craniotomy worth 50$, appendectomy worth 25$ etc…????? And then eliminate any balanced billing that the Governor has already tried to do?

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