Friday, December 14, 2007

Healthcare "Reform" on Debt-bed

Apparently ictim #1 from the California implosion of State services; universal healthcare.

Don't get all spooled up about good/bad socialism, whatever. Ain't gonna happen just like CA-HSR ain't gonna happen. Here's a nice overview from the SFChron:

Tick, tick, tick - you hear that? It's the clock running out on health-care reform, and it's set to expire in Sacramento on Dec. 21.
If legislators don't produce a bill that the governor will sign by that date, California's hopes for health care reform this year - probably for the next several years - will implode.
"If we don't do it by then, it won't get done," said Assembly Speaker Fabian Núñez, D-Los Angeles, in a meeting with the Chronicle's editorial board this week. "This budget crisis is going to tie our hands behind our backs for the next six to eight years. And if the subprime problems go the way they're going we could be in the hole for the next decade."
...
Here are the key elements:
-- All Californians would be required to have health insurance.
-- All Californians would be able to obtain coverage, regardless of pre-existing conditions. HMOs would be required to spend at least 85 percent of premiums on patient care. The state would offer incentives for preventive care and healthy behavior such as smoking cessation.
-- Low and middle-income families would be eligible for state subsidies and tax credits.
-- Employers would be required to either provide health insurance or pay into a pool, which would be adjusted on a sliding scale based on the size of the workforce. The top rate would be about 6 percent of payroll. The smallest businesses would pay 1 percent.
-- New taxes on tobacco and hospitals also would help pay for the program.
-- The deal would be contingent on voter approval of the new taxes in November 2008.

Got that last part? contingent on voter approval of the new taxes in November 2008. Okay, sure. Not.

Near as I can tell there will be a special session of the Legislature right after the Feb Presidential primary with its various bond measures and Indian gaming agreements. The Governor and Legislature will be in meetings all through January trying to hammer together a deal but it won't work. Then they won't be able to wait any longer. This totally screws their Jun 3rd plans for some fancy bond sleight of hand. You'll know when they are taking this serious when they raise the prospects of laying of CHP and renegotiating the prison guard contracts. Before that happens wait for the screams from the counties when they discover their backfill arrangement with the State to supplement lost property tax streams is either cut way back or possibly cancelled outright.

In the meantime there's an interesting groundswell of Latino on Latino tension surrounding immigration. More on that later.

28 comments:

Ogg the Caveman said...

*looks around*

Murst!

Ogg the Caveman said...

If we don't do it by then, it won't get done," said Assembly Speaker Fabian Núñez, D-Los Angeles, in a meeting with the Chronicle's editorial board this week. "This budget crisis is going to tie our hands behind our backs for the next six to eight years. And if the subprime problems go the way they're going we could be in the hole for the next decade."

Does Speaker Núñez somehow think that budget problems down the road won't matter if only the spending bills get passed today? *shakes head*

Rob Dawg said...

Ogg, he's a Democrat. It's how they think. And why not think that way? It's been an electoral success for nigh on 70 years. Besides, Democrat shine when there is a crisis and something needs to be done. A crisis of their making isn't the point. Right now the Governor needs to issue a hiring freeze and 5% across the board departmental cut that is mandatory pending appeal. That's just to keep options open. If he doesn't CA could loose investment grade borrower status and then lots of options disappear.

Pleather Murse said...

Slightly OT (though the proposed measure would certainly raise drivers' blood pressure leading to health issues) --

Carpoolers' free ride may be over

A proposal to convert the carpool lanes on three Los Angeles County freeways into toll roads could be a boon to frustrated solo commuters willing to pay for a quicker drive to work.

But the big losers could be motorists who now use the carpool lanes for free. Carpoolers would also have to pay a toll, possibly reduced. Also, the proposal provides no toll exemptions for hybrid vehicles that can now use carpool lanes regardless of the number of passengers.

The concept doesn't sit well with some carpoolers and others, who argue that the lanes should remain free for ride-sharers, which they say reduces pollution and traffic.

"I think it's a horrible direction to go and I think it's immoral to sell the diamond lanes," said a Mid-City resident. "I also think it's outrageous that the feds take the position that they'll give us millions of dollars for lanes that exclude people who can't afford to pay for congestion pricing. If they want to help, let's get some mass transit in here -- and if they want mass transit, then let's have taxes for that."


from today's L.A. Times (main page)

aaron said...

OT but someone is finally getting closer to calling this current downturn in housing. None other then Fannie Mae's CEO.

'Fannie Mae's CEO told shareholders Friday he does not expect a housing market recovery until late 2009, "at the earliest," and that the mortgage-finance company is strong enough to ride out the downturn.'

http://news.yahoo.com/s/ap/20071214/ap_on_bi_ge/fannie_mae_shareholders

Rob Dawg said...

Pleather,
Congestion charges are just one of the plans to get more blood out of "us turnips." The sad part is the drain from mass transit costs is what causes congestion in Los Angeles. Without the drain of transit subsidies LA would have enough money to provide adequate infrastructure. Unfortunately there still appears one vestige of California's Golden Era in that municipalities seem incapable of saying no to development patterns that often overwhelm transportation capacity.

Aaron,
When a CEO of a GSE has to reassure that they have the resources to survive hold onto your wallet.

Lost Cause said...

Converting carpool lanes to toll is the worst possible scenario, so of course that is the solution that will be implemented.

1) Will not reduce congestion in the other lanes all that much, since the carpool lanes themselves have become congested.

2) Makes people pay for something that tax dollars have already paid for. Basically a punitive step that has no general benifit.

chickenlittle said...

Completely OT but how much longer will gasoline wholesalers let us enjoy "teaser prices"
I reckon with crude holding at $90,
gasoline should easily be north of $3.5 nationwide.

This
is why

Peripheral Visionary said...

The budget shortfall killing socialized healthcare is to be celebrated, one of the silver linings of the very dark clouds. I'm not knee-jerk reaction automatically against socialized healthcare, it's just one of those things which is potentially very disruptive, and always very expensive. When the budget is in dire straits is not the time to start experimenting around with one of the biggest drivers of the economy.

Rob Dawg said...

PV,
A local hospital on Tuesday announced that it will no longer accept Medi-Cal patients. Their reasoning was they weren't being paid. This is when your jaw should be on the floor. It wasn't just some gradual approac to an event horizon where they weren't being paid enough to continue but that in instances they weren't being paid. This is the State that people want to take over all health care?

Ogg the Caveman said...

@ Rob Dawg:

Ogg, he's a Democrat. It's how they think. And why not think that way? It's been an electoral success for nigh on 70 years.

When our Republican president submits a budget that won't require my grandchildren to pay for his adventures, then you can say something like that without me laughing at you.

Replace "Democrat" with "politician" and you might be on to something.

Rob Dawg said...

Ogg, you have a point. I am guilty of that which I so often excoriate. Núñez is a Liberal. Demo/Rep doesn't matter. This is how Liberals think regardless of affiliation. Bush is a Liberal too.

I eagerly await any enumerable objections to that last. I can think of only one serious objection that being stem cells.

sm_landlord said...

Hi Rob,

A real hospital not accepting Medi-Cal is big news. All it takes is one or two of these to push the patients onto the other facilities, and everyone will have to quit accepting Medi-Cal patients to avoid getting hammered into BK.

Guess I had better sell the last of my Cali Bonds if this is true. Which hospital took this action?

Rob Dawg said...

. [Disclosure a small department is a client.]

Story
here. Excerpt:
SIMI VALLEY, Calif.—Simi Valley Hospital has terminated its contract to accept Medi-Cal patients because state reimbursement is too low.
Noting losses of $2.5 million last year, the 153-bed hospital says it will now treat such patients only on an emergency or outpatient basis.

Story here:
The contract was terminated Dec. 8 after months of failed negotiations with the California Medical Assistance Commission, which negotiates Medi-Cal contracts on behalf of the state.

The hospital cited low reimbursement rates as the reason for the decision.


Story here:
As required by law, Simi Valley Hospital will continue to treat all emergency room patients regardless of their ability to pay, he said. But once stabilized, Medi-Cal patients will be transferred to another facility, he said.

Backstory :
"We're going to see more and more hospitals move in this direction. There's no question in my mind."

I have other clients who are just livid over unilateral and sometimes retroactive payment schedules being imposed. This will not end well.

sm_landlord said...

"This will not end well" is an understatement. Now it looks like healthcare reform in Cali is dead for the next N years, Medi-Cal costs will be driven up (as more hospitals drop out of the system) at just the time when the state is going broke (again). In one of the articles you linked, this means that Simi can still accept Medi-Cal patients but at something much closer to the market rate, assuming that the other hospitals can't take the overflow, and I'm pretty sure they either can't or won't or both.

Hold on to your wallets! Is it possible to do a mass recall of the bunglers in Sacto?

Also, check This out:
Up to 33,000 state prisoners may have received insufficient credit for good behavior.
"A preliminary analysis of the problem in August by the Department of Corrections and Rehabilitation concluded that the longer sentences boost the state's already swollen prison population by 600 inmates a day, at a cost of nearly $26 million annually."

With the state so well-managed, not doubt everything will be fine. :-(

rogersmith8080 said...

Núñez is a Liberal. Demo/Rep doesn't matter. This is how Liberals think regardless of affiliation. Bush is a Liberal too.


Correction, Bush spends like a Liberal but taxes like a Conservative. The worst of both worlds.

Bankruptcy is the best outcome for the state; we need someone to take the credit cards from our Governor and State Congress. They racked up 80 years of debt. If we do not our great grandchildren will be paying interest on this year’s extra debt.

If the Governor was more a man and stood by what he said when he was elected "California does not have a problem with income, it has a spending problem. We need to cut back the spending."

I wish my problems were that easy, our state is so Retarded they call cuts in Increases, spending cuts. It’s like getting a raise and calling it a pay cut because you expected to get a larger raise.

Ogg the Caveman said...

Hold on to your wallets! Is it possible to do a mass recall of the bunglers in Sacto?

If you'll excuse an out of stater for telling you what's what, that won't do a bit of good. The reason why it's so hard to balance the budget in California, and to a lesser extent the rest of the country, is that people want government to do things for them. They want health care, they want roads, they want mass transit, they want programs that will generate jobs, and they want to see things halfway around the world get blown up. Politicians get elected by promising to make the government do things for their constituents, not by saying that the government can't afford to. Fiscal conservation only wins elections when things are really bad.

I don't see how recalling the entire state government is going to help more than recalling the governor did. Remember that the Govinator came into office on a platform of fixing the budget.

Rob Dawg said...

They want health care, they want roads, they want mass transit, they want programs that will generate jobs, and they want to see things halfway around the world get blown up.

I disagree. They want flexible transportation capacity, they want safety nets, they want a sustainable economy and they want assurances of personal safety. Sometimes, especially in the past, that meant roads, transit, jobs and blowing the sh¡t outta dem damn feringers. Nowadays it means lockboxes, user fees, diversion programs, subsides and reinvestment. Don't get me started.

Pleather Murse said...

When every minor boo-boo costs four figures to treat and a ream of paperwork and nobody can say exactly who's paying for it, no wonder we're in trouble. The current system will not last long no matter what sort of three-card monte trick they use to move the money around.

My current health plan consists of "don't get sick." Everyone I know is in the same boat. Even my retired family/friends, with care mostly paid for, complain of gaps in necessary treatment and the usual gummint negligence and condescension.

Hell, makes you wonder how we survived a hundred thousand years before all this medical technology and whose pockets are getting filled by it. (Sure life expectancy was on average very low, but how much of that is attributable to lo-tech health care rather than simply rough living conditions?)

They've found skeletons of our paleolithic ancestors with broken bones, pieces of arrowheads, and so forth which forensics say did not kill the individual but which he/she just lived with for many years. Wrap it up, munch on some coca leaves and keep on walking.

In areas with lots of immigrants we're seeing a burgeoning growth of local healers, botanicas, and other sources of folk remedies. Not a bad trend at all even if much of the effect is psychosomatic.

Devich said...

EM of No Limits Ladies/CS fame, is in the studio audience of the Suze Orman special.

Edgar said...

It sounds like a great plan. California needs higher taxes and more gubbermint. Enjoy it comrades!

Lou Minatti said...

I am OK with California offering universal medical insurance. Ditto for other states that wish to do this. If the people want it and the system works, great, business and people will flock there and leave states that don't offer it. I just don't think it should be nationalized on the federal level.

None of these plans address the issue of medical care for illegals though. I suspect that even those who want socialized medicine would be against free hospital care for those who don't pay into the system, particularly when it costs many billions and service to taxpayers is reduced because of expenditures.

Akubi said...

I'm feeling pretty OK and clear with my asshole too (via Edgar's Toilet)

Akubi said...

BTW,
Prophet Yahweh
needs your sweet money help in the 500K range to communicate with aliens and such.
I want enough money to rent my "UFO SUMMONINGS ORIENTATION HOUSE," with a big back yard, fix it up, bring in the digital cable modem lines, and all things related to this, so I can start summoning UFOs "live" to the world from the back yard.
...
IN MY NEXT POSTING, I WILL SHOW YOU HOW I PLAN TO PAY ALL THIS BACK TO MY INVESTOR IN A YEAR! IT WILL BE EASY TO DO. IN THE NEXT POSTING, YOU WILL BE CONVINCED OF IT. THIS I PROMISE

Tyrone said...

Kinda long, and I couldn't sit through the whole thing, but somebody might find something worthwhile...

Featured speaker: Paul Leonard
66 minutes; forum discussion in Sacramento designed to inform policymakers, legislative staffers, and advocates about asset-building research, data, and policies.
California Event: The Mortgage Crisis in CA

Edgar said...

Akubi,

Don't you mean via edgar's toilet?

w said...

I'm confused. Was there something in the original post about tense Latina on Latina action?

serinitis said...

There are two types of conservatives. Social Conservatives and Fiscal Conservatives. The social conservatives want to screw with your lives as much as any liberal Democrat. The difference is they believe the rapture is coming real soon so they won't have to repay any debt they take out. Bush is a social conservative and unfortunately the social conservatives control the Republican party as much as the liberals control the Democrats.