NationStates Jolt Archive


Schwarzenegger's plan to tax physicians to help the uninsured..

Vydro
11-01-2007, 06:31
I supported the Governator when he ran for office, and I lament the fact that many people are uninsured... but I find this plan ridiculous. First of all, it requires that everyone be insured whether they want it or not. This isnt car insurance where we are required to buy it to protect others, this is something that people should be able to chose for themselves.

To institute a tax to help the uninsured on no one other than the physicians that work hard to help them, is one of the most ridiculous things that I have heard of. There is a shortage of doctors as is, does he think that this will inspire more of them to move to California? Or does he not believe that hospitals will simply pass on their "fees" to the consumers, increasing charges to patients and to insurance companies, who will raise premiums?

Not only that, but one must see that the 4 percent penalty on employers is nothing. Many employers that chose to insure their employees already spend more than that, usually 6+% of their revenue. If this bill passes such employers would actually save money by getting rid of their insurance plans and either the employees would have to buy their own or quite possibly they would get it from the government. Who would get the money from physicians.

http://www.nytimes.com/2007/01/10/us/10health.html
SAN FRANCISCO, Jan. 9 — When Gov. Arnold Schwarzenegger took the oath of office last Friday, he called on legislators in Sacramento to set aside party loyalty in favor of “the Party of California.”

And sure enough, just 96 hours later, Democrats and Mr. Schwarzenegger’s fellow Republicans are already in agreement: his first big idea of his second term — a sweeping plan unveiled Monday to assure health care to all Californians — is promising and ambitious, but faces a long, hard fight before enactment.

Chief among the challenges, politicians and policy analysts said Tuesday, is the enormous number of political players — from big labor and big insurance to small-county government — that would be affected by any universal health care bill.

“I cannot think of another topic that requires so many people to be heard to build consensus,” said one Democratic lawmaker, Don Perata, Senate president pro tem. “You’d have to rent out Madison Square Garden to get them all in there.”

Mr. Schwarzenegger’s plan would extend care to the 6.5 million Californians who currently have no insurance, including an estimated one million illegal immigrants. That is just one of the elements to which Republicans are objecting.

“Health coverage for illegal aliens is a nonstarter for us,” said Robert Huff, chairman of the Assembly’s Republican caucus. “It creates a magnet for them coming here rather than staying there.”

Like some Democrats, Mr. Huff was also skeptical about the plan’s estimated cost, which the governor’s office put at $12 billion a year. “I think it’s just throwing a dart at the wall,” he said. “It’s anybody’s guess what it would cost.”

Then there is the financing, which among other things would require doctors and hospitals to pay 2 percent and 4 percent of their revenue, respectively, into a fund to cover the poor and uninsured. Mr. Schwarzenegger calls those payments a “fee,” but other Republicans said that was just another word for “tax.”

The California Medical Association, which represents more than 34,000 doctors in the state, gave the proposed overhaul mixed reviews. Though the association praised the idea of universal coverage, the fee on doctors could be a deal breaker.

“We feel it’s a regressive tax,” said Dr. Anmol Singh Mahal, the group’s president.

The distinction between fee and tax is more than semantic: under California law, fees can be adopted by a simple majority vote of each house of the Legislature, while new taxes require a two-thirds majority. Democrats control both houses but do not have enough votes to muster two-thirds without Republican help.

Anticipating a raucous health-care debate in the Legislature this year, Mr. Schwarzenegger noted in his State of the State address on Tuesday night that proposals other than his had been advanced, and said that “they are all on the table.”

Kim Belshé, the state’s health and human services secretary, said the governor had expected people to disagree with elements of his plan.

“Health care reform is hard,” Ms. Belshé said. “If these were issues that were easy to address and solve, they would have been addressed and resolved long ago.”

Building consensus will be especially important for Mr. Schwarzenegger because of the referendum-addicted nature of California, where laws passed by the Legislature are sometimes overturned by ballot initiatives. In 2004, voters voided one ambitious health care law, the Health Insurance Act, which would have required medium- and large-size employers to offer care to their workers or pay a fee to the state.

Mr. Schwarzenegger’s plan would employ similar “play or pay” mechanisms: employers with more than 10 workers would have to offer insurance or pay 4 percent of wages that are subject to Social Security tax into a fund subsidizing the purchase of health care for the uninsured.

Ms. Belshé said the state also expected to pay for the program in part through billions of federal dollars that California would get by increasing its Medi-Cal reimbursements to doctors and hospitals. The increase would automatically bring federal matching funds.

Such increased payments would be critical to health care providers, said C. Duane Dauner, the president of the California Hospital Association, because they would offset the new “fees” — or are they taxes? — the governor has proposed for doctors and hospitals.

Mr. Dauner said he thought the plan was “very innovative” but stood little chance of passing as is.

“I don’t care what the plan is or who introduces it, whether it be the governor of California or the president of the United States,” he said. “It goes through a process.”
Vydro
11-01-2007, 21:38
Bah! no replies yet. Im sure its totally inappropriate, but I think that this is an important issue at least... so... BUMP.
Teh_pantless_hero
11-01-2007, 21:47
Hospitals already have to pick up the slack for people without insurance and for those that can't pay absurd fees.
Vetalia
11-01-2007, 22:00
This is one of the worst ideas I have ever heard in my entire life. This is the equivalent of cutting someone's pay and demanding they work twice as much...it makes no sense and just drives doctors away, worsening the situation.

I mean, if you really want to raise money for the health system, put a tax on "unhealthy" products like tobacco, refined sugar, liquor, fast food and whatever else could fall under that category. Even better, combine it with a tax on hotel rooms to make money off of tourists. You could make money like there's no tomorrow given how many people visit California (and they're not going to change their destination because of a 10% hotel tax).
Farnhamia
11-01-2007, 22:04
This is one of the worst ideas I have ever heard in my entire life. This is the equivalent of cutting someone's pay and demanding they work twice as much...it makes no sense and just drives doctors away, worsening the situation.

I mean, if you really want to raise money for the health system, put a tax on "unhealthy" products like tobacco, refined sugar, liquor, fast food and whatever else could fall under that category. Even better, combine it with a tax on hotel rooms to make money off of tourists. You could make money like there's no tomorrow given how many people visit California (and they're not going to change their destination because of a 10% hotel tax).

Tax? Tax? What are you, a Democrat? :p What's wrong with the ethic that populated the continent, if you can't work hard enough to earn enough money to buy proper insurance, you fall by the side of the trail and die? That worked once, why not now? :rolleyes:

Given that the number of uninsured people is a problem, what would you propose instead of this plan?
The Alma Mater
11-01-2007, 22:10
Given that the number of uninsured people is a problem, what would you propose instead of this plan?

Follow the Dutch example ? Being insured for healthcare is required by law there. Average fee is about 100 euros a month.
Vetalia
11-01-2007, 22:13
Tax? Tax? What are you, a Democrat? :p What's wrong with the ethic that populated the continent, if you can't work hard enough to earn enough money to buy proper insurance, you fall by the side of the trail and die? That worked once, why not now? :rolleyes:

I love the free market as much as anybody, but a little reading about the urban slums of the 19th century is enough to convince me that it's a bad idea to allow basic medical care to go unprovided.

Given that the number of uninsured people is a problem, what would you propose instead of this plan?

Well, you're going to have to tax something, so I'd say tax the products I mentioned instead of the providers. After all, if we cut down on the amount of unhealthy stuff sold, we'll indirectly improve the health of the citizens and reduce the strain on the health system to begin with.

If it were affordable, you could also look in to universal insurance for all citizens of the state.