California looks to copy Canada's health-care system

[Judi Lynn]

California looks to copy Canada's health-care system
Kelly Patterson, CanWest News Service; Ottawa Citizen
Published: Thursday, August 31, 2006

OTTAWA - California legislators are poised to vote for a "Canadian-style" health-care system this week, in a bill that would outlaw private care throughout the state.

Senate Bill 840, which is widely expected to pass final reading, would provide free medical, dental, vision and prescription drug coverage to all California residents through a state-run agency.

Canada has been front and centre in the vitriolic debate sparked by the bill, which must be approved by Gov. Arnold Schwarzenegger to become law.

"We've learned from the Canadian system and integrated it into a plan specifically for California," said Sara Rogers, a spokeswoman for Senator Sheila Kuehl, who put forward the bill.
(snip/...)

http://www.canada.com/topics/news/world/story.html?id=0...

[Richard D]

1. Well . . .

. . . while I think this might be a good idea, I could see California being bankrupt by floods of people who for years didn't have insurance and were holding back on going to a doctor seeking medical care the day the bill was put into effect.

[Spazito]

2. Kudos to California! This Canadian loves our system, it is fair,

affordable and cost effective.

[JohnnyBoots]

3. Will Doctors make significantly less money in CA then? Why would

Dr.'s want to practice there? Coming out of school don't they have like a quarter million in debt to pay off?

[stopbush]

4. Drs would save considerable office overhead by not having to process

all the paperwork from all the different insurance companies. 50% of every dollar spent right now
for an American Rx goes to overhead.

BTW - that's the first I've heard that this bill would "outlaw" private insurance. I'm suspicious of that claim,
but it might be true.

[cyclezealot]

31. I understand you can buy a private policy if you choose.

That is your right, if you like fighing with their gatekeepers. But, employers/employees will be taxed for the California Plan. WOuld you buy a second policy from the insurance crooks, if you already had a reliable policy for less.
For now, we live in France. Visited our doctor. No receptionist, just sign in a wait for the doctor to come out into the lobby. No one to even greet you. No insurance forms to be made out. The doctor has but to submit one post card size form to the ministry of health.
No stacks of forms for billing staements. Just medical records storage. and would you believe, the doctor , when between patients answers their own phones. And, the clincer. We had more time with the doctor than we are used to in California, with the 8 minute doctor visit, preceded by a nurse doing the patients vitals. Here, the doctor did the vitals.
About one month ago, I came down with heat exhaustion after biking too long. Started trembling about 9:30 PM. Doctor came to our home. Examined me. Gave me a valium shot to get over the shaking. Cost was 20 euros, because a house call was involved.

[jamesinca]

6. It will not lower what a Dr. makes

it makes it easier for them to negotiate a price for a procedure. It will be easier to do this with the plan than it will be under the current system. Payment should come quicker to the Dr's. The cost of providing insurance to employees will basically not exist, it comes out of the paycheck.

www.healthcareforall.org
www.healthcareforall.org/factsheet.pdf
www.healthcareforall.org/lewin.pdf
www.healthcareforall.org/basics.html
www.healthcareforall.org/summary840.pdf

edit: to add links

[dipsydoodle]

5. Would that encourage people to move to CA ?

I ask because we have a situation in the UK whereby in Scotland the elderly receive free care without means testing whereas in England they are means tested. This has encourage some old folk to move to Scotland.

[DavidDvorkin]

7. If it does encourage people and businesses to move to California

That would in turn encourage other states to follow California's example.

Not the people moving, but the businesses doing so. Businesses have been leaving California for years, or at least opening up offices elsewhere (such as here in Colorado) because of the high costs of property, rent, and wages in California. Eliminating the cost of healthcare plans could make up in part for those other costs.

So I should correct myself. Such legislation might not be enough to make businesses move to California, but it might keep jobs there that would otherwise leave.

[NV Whino]

8. I think that it would

simply encourage other states to adopt the same or similar plans. California has almost always lead the nation in progressive plans. Our emissions standards, for instance, have encouraged other states to implement higher standards of their own.

[Book Lover]

13. I think our high cost of living will balance that out

It will be a nuanced financial decision for households to consider, both specifically for our elders as well as the population as a whole.

[dipsydoodle]

9. When they say "free"

what do they mean. Ours in the UK isn't literally free - it's paid by a stealth tax by both employees and employers. That aggregates to about 20% of gross earnings / individual. It would be better described a pre-paid health care. So - how would CA fund it ?

[muriel_volestrangler]

11. "Stealth tax"? That's a very emotive way of describing it

and not very accurate, since there's no tie between National Insurance contributions and NHS spending. NHS treatment doesn't depend on whether you've paid NI or not. The NHS is paid for from general government revenue.

[dipsydoodle]

18. I forgot they wouldn't grasp stealth tax

but you know exactly what I mean - hidden income tax by another name.

[Ravenseye]

43. People with insurance already pay it

they probably pay more, 300-400 a month coming directly out of their paycheck before they see a dime. Instead of going to insurance companies it'll go to the state medical thingy.

People with Health Care area already paying it. For most nothing will change.

[Book Lover]

15. According to the article

"The plan would be funded by an eight-per-cent payroll tax and a three-per-cent individual income tax."

Going by my quick calculations and using myself as an example, that means the total amount paid for my health insurance (for myself and two others) would be reduced to about the amount I myself pay per month (my employer and I split the monthly cost of health care).

[Nikki Stone 1]

21. Some of us pay that much for our health insurance anyway

So it wouldn't make much difference. Of course, if you make 6 figures or more, that might be an issue.

[daleo]

10. Oh no, now we will be bombarded with stories about Canada's waiting lists

Seriously, though, good luck to California. Our system (the Canadian system, I mean) works just fine. Like anything, there are always things to quibble about, and refinements to make, though.

Here is a summary of an interesting article:

Study: Health and health care use in Canada and the United States
2003
Americans in the lowest income groups are much more likely than their Canadian counterparts to be in fair or poor health, according to a study comparing health status and access to health care services between the two nations.

The study was based on the Joint Canada/United States Survey of Health, a unique population health survey conducted jointly by Statistics Canada and the US National Center for Health Statistics of the US Centers for Disease Control and Prevention between November 2002 and June 2003.

The study, published recently in the journal Health Affairs, found that almost one-third (31%) of Americans with the lowest incomes reported fair or poor health, compared with 23% among their Canadian counterparts.

At the other end of the income spectrum, there were no differences in health status between Canadians and Americans in the highest income group.

In terms of access to health care services, the situation for Canadians was more like that of insured Americans. Canadians and insured affluent Americans were similar regarding their access to physicians, including access to a regular medical doctor. However, Canadians experienced fewer unmet health care needs overall.

http://www.statcan.ca/Daily/English/060803/d060803a.htm

[demo dutch]

12. The Governator will probably veto that one.

[Casablanca]

16. Unless Ahnie learned something from his years in Austria.

Fat chance, but hope springs eternal.

[jayfish]

14. I Think It Will Be Disastrous For California To Go It Alone...

on this. That might be the plan from the start too. When the program is an abysmal failure, the ReThugs can forever point to it as the best reason why universal health-care won't work for the US. They will get to destroy the most liberal state in the union to boot.

Jay

[Casablanca]

17. Good timing

Forces Ahnold to take a stand on this in an election year, and CA voters will remember it if he waffles.

[zann725]

19. ...and to think I was thinking of leaving CA. THIS could make me stay...

...IF it passes, and TRULY provides coverage promised to all.

[bleedingheart]

20. This is a great draw for business...

think of the vast amounts of money large companies spend on managing health care for their employees.

Then think of the many small companies that lose good people because they can't afford to offer health care ...

I have actually told politicians that this kind of program would be a benefit and not a detriment to a state.

[SoCalDem]

25. It would free everyone.. employers AND employees

There are MILLIONS of people tied to jobs they loathe, but dare not leave because of the insurance issue.

Employers could concentrate on producing their products/selling them instead of being "insurance agent", always looking for ways to save a penny here and there.

Wages would/could actually go up..

These days, employees are often "given" raises that "almost" cover the additional health care costs they are responsible for...not a raise at all..

If employees were "covered" by the state, they would suddenly be free to become what Bush loves so much...entrepreneurs..

there are a lot of people who would love to open their own businesses, but they are also family people, and need company-paid insuarnce for their families.

If Ahhhnold does this, he will be re-elected..

lets see how badly he want;s to remain governor.

[bleedingheart]

28. I agree with you on all points. I think it is a great idea.

and as California goes...so goes the Nation....

[SoCalDem]

29. The only problem I see is that there would HAVE to be a way

to identify "real" Californians, as opposed to people who show up pretending to have "moved" here..

I guess this would be the test case for the "real ID" plan..

An all-in-one all-purpose ID card would be my guess..

Show up with an official birth certificate, and a couple of other forms of id that prove you live here, and get issued a California ID...good for health care, social services, and voter ID, since it lists citizenship (from the birth certificate or naturalization papers)

This could actually work, and would point the way for other states to follow..

of course the whole thing will the violently challenged by the insurance lobbies and would end up tied up in court for decades

[jamesinca]

35. Here are links to the whole plan

www.healthcareforall.org
www.healthcareforall.org/factsheet.pdf
www.healthcareforall.org/lewin.pdf
www.healthcareforall.org/basics.html
www.healthcareforall.org/summary840.pdf


The lewin.pdf is the one that really lays it out in detail. It is only 116 pages long. The rest of the links go to very nice one page summaries and talking points.

[Ayesha]

22. This would be great

However, personally I'd prefer a system more like the UK's, and I think it would have a better chance of passing. My understanding is that in the UK, both private and public insurance exist. For people who can and will pay for private care, they have more coverage of certain things, such as dental, and don't have waiting lists if they go private. This provides an incentive for people to have both kinds of coverage, and the people who use private funds save the government money. It also reduces the number of people on the waiting lists, making them shorter.

I guess I see both the pluses and minuses of a plan like this. I worry about the lack of choices and giving the government control over what care you receive. I have a lifelong disability and use a wheelchair. I currently have private insurance which covers the high-end wheelchair I need. But my friend who has MediCal can't get a replacement chair like the kind she has, because due to MediCal cuts they won't cover it anymore. I've also heard of the UK health plan not covering certain cancer drugs because they're too costly. I work with people who have cancer and see those same drugs saving lives here in CA. I fear that without private insurance as an option people would be condemned to die because keeping them alive is expensive.

On the other hand there is my partner, who has a serious chronic illness and can't work. Her Cal-COBRA is over $600 a month; if I wasn't paying it she'd be without insurance. So universal health care would be of huge benefit for her. I just think that private supplemental coverage should be an option if you need more than the basics.

[Le Taz Hot]

23. Outlaw private insurance????

Oh, I'm NOT liking this! I happen to be one of the fortunate few with outstanding health insurance and I don't want to switch to a state-run plan. I think it's outstanding that those who currently don't have insurance will be covered -- I was one of those about a year ago, but why do I have to abandon my excellent insurance???? Unless I'm missing something here, I'm not liking this at all.

[cyclezealot]

33. Unless you are loaded with cash.

You insurance is not guaranteed. Sooner or later you will be without. Particularily, when you get older and they DONT want you. This plan will guarantee you will always be covered. Another reason. You get some major illness. You will have a hard time getting any kind of insurance from anyone. You will then be a health risk for an insurer.
Besides, your costly insurance costs way in excess of it's value due to inherient cost overruns. Your policy costs your employer far more than necessary, it makes the costs of your companies business far more than it need.
That makes ALL of our products unnecessarily costly and uncompetitive harming us all.

[jamesinca]

36. You can keep your insurance plan

You may opt out of the state run plan. All it is going to do is get the entire state covered. It will also make the insurance companies work real hard to keep up. It is all explained in the lewin.pdf report.

www.healthcareforall.org
www.healthcareforall.org/factsheet.pdf
www.healthcareforall.org/lewin.pdf
www.healthcareforall.org/basics.html
www.healthcareforall.org/summary840.pdf

[warrens]

24. Those fools!

Don't they know it takes eleventyseven years to see a doctor in Canada, and they operate with old rusty can-openers and the only medicine they have is out-of-date Children's Bayer aspirin and the average life expectancy is only 7 because they're all SOCIALISTS????

(Please tell me I don't need a sarcasm thingie here...I know the senses of humor around here have gotten a bit strained, but...)

[underpants]

26. Watch the jobs come pooring into Ca if this happens

There is nothing employers like more than having employees pay for their own health insurance...actually having employees HAPPY to pay for it.

[pitohui]

27. how long would you need to live in california to be considered a resident?

what if you lived in a tent? would you still be a resident? i'm not joking around, if something happens to my husband, i can't get health insurance here, yet i can't afford housing there

better to live in a tent and be alive than be housed and dead, is what i'm thinking

how do you stop people from other states from using the program? or is it not really "universal" because it still sounds like it is tied to employment -- they mention a payroll tax?

it would be better if there was such a program offered in all of the 50 states to keep california from being swamped or from having to build a fence complete with gun towers to keep the rest of us out!


still you gotta start somewhere and it sounds like a good start if it is actually implemented

[Book Lover]

30. If the resident college tuition requirement is anything to go by...

you are required to have lived in California for one year prior to your first scheduled day of class, and take steps to establish California as your permanent place of residence in order to be eligible for in-state tuition rates. From www.sfsu.edu :

If I am a nonresident, how do I qualify for California resident status?
To be eligible for resident status for tuition purposes, you must, for at least one year prior to the residence determination date, maintain physical presence in California and establish your intent to make California your permanent home. Evidence of intent to remain in California indefinitely can vary based on individual circumstance, but should include items listed below as well as the absence of residential ties to your former state. Keep in mind that physical presence in California for the specific intention of academic study does not constitute intent to make California your permanent home.

If you are not a citizen of the United States, you must also maintain, for one year prior to the residence determination date, an immigration status that allows you to establish California residency.

The following will be considered when your resident status is reviewed:

California driver's license
California voter registration
California automobile registration
California state income tax obligations on total income
Ownership of residential property or continuous occupancy or leasing of an apartment where your personal belongings are kept
Active, continuous savings and/or checking accounts in a California bank since the prior year
Immigration status with legal capacity to establish California residency
Maintaining a permanent military address and home of record in California
Military leave and earnings statements showing California as legal residence
Financial independence from parents for the current year and for three years prior to the current year. (Please note that information regarding financial independence is not required from applicants for admission, but is required from current students seeking residence reclassification.)

[jamesinca]

34. Residence is established in 3 months

That is what they are proposing. Unless you relocate because of divorce or death of a spouse, then it is immediate. People that are in California to work are also covered.

www.healthcareforall.org/lewin.pdf

edit: to add link

[SleeplessinSoCal]

32. We want to be and stay healthy!!!

[Vidar]

37. Bravo Califormia.

[YankeyMCC]

38. Wow...

First CO2 cap and now this?

[cyclezealot]

39. The Dem candidate Phil Angelides is on board with this?

I hope so. I seems a team player. I find Angelides very impressive. Can't imagine him going against Legislative Democrats. Blue Cross/Blue Shield is not lining Angelides pockets, they way the do Arnie's?

[CollegeDUer]

42. The Insurance boys are after every Governor

I doubt they are going to allow Cali to do this without a fight.

[cyclezealot]

46. We Californians' put this issue on the ballot in 94, I think.

The insurance companies put up $50 million in slick tv ads to get this destroyed. Single payer still carried San Francisco county.

[Lydia Leftcoast]

40. Canadians may correct me if I'm wrong, but

I believe that Canada's healthcare system started when one province (Saskatchewan?) went it alone. The others soon followed.

[daleo]

44. That's pretty much true

The socialist government of Saskatchewan under Tommy Douglas brought public medicare into Saskatchewan, which was initially resisted by much of the medical community. Once he proved it could be done, the political pressure in other provinces became impossible for those governments to ignore. The federal government eventually helped to provide an overall framework for medicare. This happened in the fifties and sixties. Tommy Douglas was recently named as "the greatest Canadian" in a popular poll, so people haven't forgotten the significance of medicare, and the struggle it required.

[cyclezealot]

45. My family originated from Canada.

But, Tommy Douglas is considered the architect of the Canadian Single payer system. Polls show him one of the most revered Canadians of recent times. Think it was Saskatchewan , single payer originated from/ not Manitoba? But, yes, it took root in one province alone and spread to the nation at large.

[w4rma]

41. Buisnesses will flock to California if this passes. (nt)