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FilthyImp
Sep 30, 2002

Anime Deviant

Raskolnikov38 posted:

hell the lost tax revenue from prop 13 alone is probably a trillion or two
Coyld you could sneak in a stealth Kill 13 for Businesses section in the healthcare legislation?

That's probably the best shot for getting rid of that thing if so.

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Duckbox
Sep 7, 2007

Can't Prop 13 only be amended by ballot initiative though?

Raskolnikov38
Mar 3, 2007

We were somewhere around Manila when the drugs began to take hold
lol just got an email of this video by eric bauman in which he calls for universal health care..... at the federal level only

https://www.facebook.com/cadems/videos/10154695011503317/

Martin Random
Jul 18, 2003

by FactsAreUseless

Duckbag posted:

Can't Prop 13 only be amended by ballot initiative though?

We can kill it or modify it with a super majority, which we have. There's really no excuse for these loving people anymore.

Grand Prize Winner
Feb 19, 2007


Raskolnikov38 posted:

lol just got an email of this video by eric bauman in which he calls for universal health care..... at the federal level only

https://www.facebook.com/cadems/videos/10154695011503317/

burn down the california dem party imo

Lightning Lord
Feb 21, 2013

$200 a day, plus expenses

I saw a comment somewhere about how Trump might cut federal funding if Cali passes a single payer act. Any merit to that you think?

CopperHound
Feb 14, 2012

I think he says a lot of stuff.

The Glumslinger
Sep 24, 2008

Coach Nagy, you want me to throw to WHAT side of the field?


Hair Elf

Lightning Lord posted:

I saw a comment somewhere about how Trump might cut federal funding if Cali passes a single payer act. Any merit to that you think?

The AHCA is already gonna cut funding massively, regardless of extra Trump shenanigans, but they could theoretically decline to give CA an exception to use their (remaining) Medicaid funding as a block grant to help fund a single payer program

Instant Sunrise
Apr 12, 2007


The manger babies don't have feelings. You said it yourself.

Lightning Lord posted:

I saw a comment somewhere about how Trump might cut federal funding if Cali passes a single payer act. Any merit to that you think?

The very Supreme Court ruling that originally upheld the ACA also set a precedent regarding cutting off funding because a state did a thing you didn't like.

Which is that if it's going to be a significant part of the state's budget, that's a no-no.

Bueno Papi
May 10, 2009

Instant Sunrise posted:

The very Supreme Court ruling that originally upheld the ACA also set a precedent regarding cutting off funding because a state did a thing you didn't like.

Which is that if it's going to be a significant part of the state's budget, that's a no-no.

Different regulatory framework. It doesn't withhold funding but change the method of the funding. You still end up with the same dollars either route. It's really up to the Sec. of HHS to grant a waiver. Under Obama, a waiver could be granted if the same number of people would be covered. Under Price, HHS seems to be down with granting waivers as long as states use the block grants to gently caress the poor.

lobotomy molo
May 7, 2007

by Jeffrey of YOSPOS

Cup Runneth Over posted:

What a loving liar. The only reason he didn't kill the bill is that Californians would have his head on a goddamn silver platter. We're not going to get poo poo.

Motherfucker. So, aside from angrily calling my state representative & senator to yell at them, what else can be done to put some pressure on the bastards?

Raskolnikov38
Mar 3, 2007

We were somewhere around Manila when the drugs began to take hold

Fly Molo posted:

Motherfucker. So, aside from angrily calling my state representative & senator to yell at them, what else can be done to put some pressure on the bastards?

if you live in LA start a recall petition on rendon

ThisIsWhyTrumpWon
Jun 22, 2017

by Smythe
You people seemed to not have learnt anything from the Vermont Debacle.

Roland Jones
Aug 18, 2011

by Nyc_Tattoo
Yeah, harass your assembly members, and if you live in Rendon's district push for a recall or support a primary challenger or something I guess. Make Rendon miserable. Heck, make them all miserable. Make them afraid for their seats. Promise to make 2018 a reckoning for sitting CA Dems if they keep this bullshit up; their job is to help and serve us, and if they're not going to do those things in the face of Republicans trying to kill us (literally, in the case of the AHCA), then they can give up their seats for people who will.

Lemming
Apr 21, 2008
I called him today and let them know I'll be calling every day until he brings the bill back

Edit: I have a piece of poo poo R assembly member but I'll be calling as well, as pointless as it is

Dead Reckoning
Sep 13, 2011

apropos to nothing posted:

The state of California has about $1.3 trillion in state and local debt, so it seems as though making sure government programs are fully costed isn't as much of a priority as they might make it out to be. I'm not arguing for a balanced budget, nor am I saying that making sure the legislation was costed appropriately isn't important. Just trying to point out the fact that excuses like there's no money or we'd have to raise taxes or cut this are always the excuses used to halt and destroy working class political concessions.
OTOH, most proposed legislation doesn't cost 30% of the State's current budget.

apropos to nothing posted:

In my own town (not California) we have property developers who have received multi-million dollar property tax rebates while the city poor-mouths that we don't have the funds to provide adequate housing for our homeless population.
No one actually likes or wants the chronically homeless.

Duckbox
Sep 7, 2007

ThisIsWhyTrumpWon posted:

You people seemed to not have learnt anything from the Vermont Debacle.

Oh gid, not this poo poo again. California isn't Vermont.

Also, shut up.

lobotomy molo
May 7, 2007

by Jeffrey of YOSPOS

Roland Jones posted:

Yeah, harass your assembly members, and if you live in Rendon's district push for a recall or support a primary challenger or something I guess. Make Rendon miserable. Heck, make them all miserable. Make them afraid for their seats. Promise to make 2018 a reckoning for sitting CA Dems if they keep this bullshit up; their job is to help and serve us, and if they're not going to do those things in the face of Republicans trying to kill us (literally, in the case of the AHCA), then they can give up their seats for people who will.

Yeah, I plan on calling Rendon, my assembly member, and my senator, and telling all three of them I'll vote Republican just to spite their dumb asses unless this bill gets a vote. (lol I'm not that dumb/self-destructive, but it never hurts to threaten)

gently caress those dumb assholes. And they wonder why the Democrats are losing left and right.

Roland Jones
Aug 18, 2011

by Nyc_Tattoo

Duckbag posted:

Oh gid, not this poo poo again. California isn't Vermont.

Also, shut up.

Don't respond to them, they're an MIGF rereg or something.

Fly Molo posted:

Yeah, I plan on calling Rendon, my assembly member, and my senator, and telling all three of them I'll vote Republican just to spite their dumb asses unless this bill gets a vote. (lol I'm not that dumb/self-destructive, but it never hurts to threaten)

gently caress those dumb assholes. And they wonder why the Democrats are losing left and right.

Who's your senator? They already passed it, and most Dem senators voted for it, though not all. The other two are fair game though, though yeah, they're better than a Republican (probably; Glazer is debatable), so replacing them with another, better Democrat is preferable. Maybe promise to support any primary candidate they get over saying "I'll vote Republican". It's a more realistic bluff, and doesn't play into the stereotypes about single payer supports and other progressives.

lobotomy molo
May 7, 2007

by Jeffrey of YOSPOS

Roland Jones posted:

Who's your senator? They already passed it, and most Dem senators voted for it, though not all. The other two are fair game though, though yeah, they're better than a Republican (probably; Glazer is debatable), so replacing them with another, better Democrat is preferable. Maybe promise to support any primary candidate they get over saying "I'll vote Republican". It's a more realistic bluff, and doesn't play into the stereotypes about single payer supports and other progressives.

Fair point.

ThisIsWhyTrumpWon
Jun 22, 2017

by Smythe

Duckbag posted:

Oh gid, not this poo poo again. California isn't Vermont.

Also, shut up.

No it's not , it has even higher taxes and is even more expensive to live in than Vermont.

Mozi
Apr 4, 2004

Forms change so fast
Time is moving past
Memory is smoke
Gonna get wider when I die
Nap Ghost
Vermont has a small population of a lot of old people, so the math didn't work out. California is a massive state with a diverse population.

So shut up.

Cup Runneth Over
Aug 8, 2009

She said life's
Too short to worry
Life's too long to wait
It's too short
Not to love everybody
Life's too long to hate


"Trying this 'health insurance' thing again?! Didn't you learn anything from Vermont? It's just the healthy paying for the sick!" - Paul Ryan, probably

stone cold
Feb 15, 2014

ThisIsWhyTrumpWon posted:

No it's not , it has even higher taxes and is even more expensive to live in than Vermont.

:rolleyes:

yes that really is the takeaway you clever child

Lemming
Apr 21, 2008
Lmao Rendon's been getting a lot of calls, he setup a switchboard so they can take messages about sb562 specifically instead of taking calls

Roland Jones
Aug 18, 2011

by Nyc_Tattoo

Lemming posted:

Lmao Rendon's been getting a lot of calls, he setup a switchboard so they can take messages about sb562 specifically instead of taking calls

Oh wow they really did; I just called myself to confirm it, and yep, third option the automated response gives you is specifically for comments about SB-562. I guess he really, really wants to ignore this.

So, if you're planning on calling him about it, don't let him; pick one of the other options, and maybe call them out on this while you're at it.

Dead Reckoning
Sep 13, 2011

Duckbag posted:

Oh gid, not this poo poo again. California isn't Vermont.

Also, shut up.
In what way is California different that will allow it to effectively control costs?

Mozi posted:

Vermont has a small population of a lot of old people, so the math didn't work out. California is a massive state with a diverse population.

So shut up.
That doesn't change the calculus any, because again, California has no way of controlling costs while at the same time keeping all the promises that people who have sponsored this bill have made.

Duckbox
Sep 7, 2007

Dead Reckoning posted:

In what way is California different that will allow it to effectively control costs?

We've been over this. Bargaining power and economy of scale, not to mention an actual track record of managing huge public services. If you can't even understand the absurdity of comparing one of the world's biggest economies to a rural state with 1/70th its population, there's not really much point in having this discussion.

VitalSigns
Sep 3, 2011
Probation
Can't post for 29 hours!

Dead Reckoning posted:

No one actually likes or wants the chronically homeless.

Fortunately we can make people not homeless anymore simply by giving them homes.

Dead Reckoning
Sep 13, 2011

Duckbag posted:

We've been over this. Bargaining power and economy of scale, not to mention an actual track record of managing huge public services. If you can't even understand the absurdity of comparing one of the world's biggest economies to a rural state with 1/70th its population, there's not really much point in having this discussion.

You're handwaiving, because neither you nor anyone else can explain how these economies of scale can be achieved while providing the same level of care that Californians with private insurance have now. Remember Prop 61 last year? Remember how every sober analysis concluded that California couldn't actually compel pharmaceutical companies to pay lower rates? What exactly has changed since then?

stone cold
Feb 15, 2014

Dead Reckoning posted:

You're handwaiving, because neither you nor anyone else can explain how these economies of scale can be achieved while providing the same level of care that Californians with private insurance have now. Remember Prop 61 last year? Remember how every sober analysis concluded that California couldn't actually compel pharmaceutical companies to pay lower rates? What exactly has changed since then?

care to cite those analyses while we're on the topic of hand-waving?

also, if you think ca and vt are the same thing you might not comprehend the concept of economies of scale

Raskolnikov38
Mar 3, 2007

We were somewhere around Manila when the drugs began to take hold
its hilarious that a state with 4x the population than the VA sees is apparently going to have less negotiating power than them

Lemming
Apr 21, 2008
Dead Reckoning is the physical incarnation of the belief the status quo is perfect and must be defended from progress at every turn

Walka Blocka Shame
Apr 30, 2006

This is fine
Doctor Rope
California has a larger population than Canada. If they can do it, so can we. Yes, we have some very real limitations due to being a state rather than a sovereign country, but we certainly don't lack bargaining power.

FilthyImp
Sep 30, 2002

Anime Deviant

Walka Blocka Shame posted:

California has a larger population than Canada. If they can do it, so can we. Yes, we have some very real limitations due to being a state rather than a sovereign country, but we certainly don't lack bargaining power.

If that shithole Texas can dictate textbook contents Cali should be able to strongarm health costs.:colbert:

Walka Blocka Shame
Apr 30, 2006

This is fine
Doctor Rope

FilthyImp posted:

If that shithole Texas can dictate textbook contents Cali should be able to strongarm health costs.:colbert:

Agreed, though I suspect that pharma and the healthcare industry as a whole would do their best to make us a cautionary tale. They'd probably be willing to accept dramatic losses in the short term to ensure that single payer went belly up and the capital class would support them in that endeavor. One thing that I've gained an appreciation for lately is how insanely dirty the establishment fights in order to maintain the status quo.

Bastard Tetris
Apr 27, 2005

L-Shaped


Nap Ghost

Walka Blocka Shame posted:

Agreed, though I suspect that pharma and the healthcare industry as a whole would do their best to make us a cautionary tale. They'd probably be willing to accept dramatic losses in the short term to ensure that single payer went belly up and the capital class would support them in that endeavor. One thing that I've gained an appreciation for lately is how insanely dirty the establishment fights in order to maintain the status quo.

My work had a grand opening of a new site and had all the bigwigs visit, and our CEO probably spent more time talking to anyone who would listen about the evils of single-payer than anything we actually did for the company.

Dead Reckoning
Sep 13, 2011

stone cold posted:

care to cite those analyses while we're on the topic of hand-waving?

Sure. Here's the short but rather flamboyant Pete Rates analysis, and the more sober report from the Office of the Legislative Analyst.

Takeaway from the Legislative Analyst:

quote:

Drug Manufacturers Might Decline to Offer Lowest VA Prices to the State for Some Drugs.
The measure places no requirement on drug manufacturers to offer prescription drugs to the state at the lowest VA prices. Rather, the measure restricts actions that the state can take (namely, prohibiting the state from paying more than the lowest VA prices for prescription drugs). Therefore, if manufacturers decide it is in their interest not to extend the VA’s favorable pricing to California state agencies (for example, to avoid consequences such as those described above), drug manufacturers could decline to offer the state some drugs purchased by the VA. In such cases, these drugs would be unavailable to most state payers. Instead, the state would be limited to paying for drugs that either the VA does not purchase or drugs that manufacturers will offer at the lowest VA prices. (However, to comply with federal law, Medi-Cal might have to disregard the measure’s price limits and pay for prescription drugs regardless of whether manufacturers offer their drugs at or below VA prices.) This manufacturer response could reduce potential state savings under the measure since it might limit the drugs the state can pay for to those that, while meeting the measure’s price requirements, are actually more expensive than those currently paid for by the state.


stone cold posted:

also, if you think ca and vt are the same thing you might not comprehend the concept of economies of scale

Raskolnikov38 posted:

its hilarious that a state with 4x the population than the VA sees is apparently going to have less negotiating power than them
Economies of scale does not mean "bigger numbers = better than", which seems to be the extent of your thinking. For example, if I'm building airplanes or cars, economies of scale might mean the costs of R&D, tooling, and other start-up costs are spread across a larger number of units, resulting in a lower per-unit cost for the manufacturer. This obviously isn't applicable to annual healthcare costs, but if you're going to claim savings from economies of scale, you need to explain how those savings will be realized.

The VA isn't a great example, since it serves a homogeneous population of older, mostly male veterans, who have passed a military physical that weeds out a whole slew of pre-existing conditions. This allows them to only cover certain medications. (They have a process for deviating from their formulary, but the point is that it is the exception, rather than the rule.)

California can't practically follow the VA's model, both because the state population is far more heterogeneous, and because the promise of single payer for all is that there won't be a screening that weeds out people with preexisting conditions. Even assuming that it was practical for the state to establish a formulary, it would mean that the promise to maintain the same level of care for people who currently have health insurance would be a lie: some percentage of Californians would no longer have access to the drugs that their doctors had recommended for them, instead having to take whatever the state deemed to be an adequate substitute, or nothing.

Oh, and even with single payer, the State government still won't be negotiating on behalf of all Californians, since Medicare and the VA, etc. will still exist.

Lemming posted:

Dead Reckoning is the physical incarnation of the belief the status quo is perfect and must be defended from progress at every turn
No, I just think any proposed change needs to be demonstrated to be an improvement on its own merits, rather than "but the status quo is bad because I don't get what I want!" This is partially because 75% of the asspain I have experienced in my working life has been due to people deciding to make changes without thinking it through.

Walka Blocka Shame posted:

California has a larger population than Canada. If they can do it, so can we. Yes, we have some very real limitations due to being a state rather than a sovereign country, but we certainly don't lack bargaining power.
Yeah, we do. See my response to Stone Cold above. Once you enact single payer, you create an entitlement that obliges California to provide people certain drugs. Pharmaceutical companies are not obligated to sell California those drugs, so California has to blink first. California can beg for them to sell at a lower price, but has no means of actually compelling them the way Canada does.

Instant Sunrise
Apr 12, 2007


The manger babies don't have feelings. You said it yourself.
If you're Merck, are you really going to let a customer with 38 million patients walk away from the table to switch to a different medication that Phizer offers just because you're too intractable about prices?

Yeah the amount per patient is in all likelihood going to be lower, but you're still dealing with losing 40 million customers at once.

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Vincent Van Goatse
Nov 8, 2006

Enjoy every sandwich.

Smellrose

Instant Sunrise posted:

If you're Merck, are you really going to let a customer with 38 million patients walk away from the table to switch to a different medication that Phizer offers just because you're too intractable about prices?


If I think I can bleed them for more cash, then yes I do.

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