Health care

Free health care will attract more illegal immigrants to California

July 13, 2019 By Jim Breslo 12 Comments

California is expanding its program to provide taxpayer-funded health care for illegal immigrants, though it’s not going as far as many Democratic presidential candidates want the nation to go.

At the second presidential primary debate, all 10 Democrats on stage said they favored government – meaning all of us who pay taxes – picking up the tab for health care for illegal immigrants with low incomes.

Democratic Gov. Gavin Newsom signed a bill into law Tuesday that provides free health care to all low-income young people ages 25 and younger in California, regardless of their immigration status. Previously the state funded health care for people 18 and younger with low incomes, including illegal immigrants.

State officials estimate that raising the age of health care coverage from 18 to 25 will benefit about 90,000 people, although the estimate is far from certain.

It’s surprising that California didn’t go further and allow older low-income illegal immigrants to also get coverage under its Medicaid program, which it calls Medi-Cal, right away. …

Click here to read the full article from Fox News

Filed Under: Top Stories Tagged With: Health care, Immigration

Medicare For All Would Wipe Out Jobs, Pensions and 401(k)s

July 5, 2019 By Sally C. Pipes 50 Comments

Donald Trump famously made “You’re fired!” a household catchphrase. It may re-enter the American vernacular if the likes of Senators Bernie Sanders, Elizabeth Warren, or Kamala Harris take the White House.

That’s because Sanders, Warren, and Harris — along with Kirsten Gillibrand and Cory Booker, who are also competing for the Democratic presidential nomination — all support a brand of health reform that would wipe out millions of jobs. And that’s Medicare for All.

Sanders introduced a new iteration of his Medicare for All bill earlier this year; Warren, Harris, Gillibrand, and Booker have signed on as co-sponsors. The bill would abolish private health insurance and enroll all Americans in a single, government-run health plan.

A single government-run plan can in theory drive a harder bargain with doctors, hospitals, and other healthcare providers. Medicare for All envisions paying providers at Medicare’s rates, which are generally lower than those paid by private insurance.

But Medicare doesn’t pay hospitals enough to cover the cost of existing beneficiaries’ care. For every dollar hospitals spend on Medicare beneficiaries, they receive just 87 cents from the government.

Healthcare providers currently make up the difference by charging private insurers more. Medicare for All would abolish them, of course. To balance their books, providers would have little choice but to reduce their costs.

That means layoffs — or closing up shop altogether. According to a new report from JAMA, a medical journal, hospitals would eliminate up to 1.5 million clinical and administrative employees under Medicare for All. Dozens of hospitals, especially those in rural areas, would shut down. That would remove the biggest employer from scores of communities across the United States.

The effects would ripple through local economies. All the firms that counted on those hospitals as clients — construction firms, purveyors of cleaning products, food-service operators — would take a hit.

Then there are the hundreds of thousands of people employed by private health insurers whom Medicare for All makes no bones about throwing out of work. Health insurers employ more than half a million people directly, according to the Insurance Information Institute. The industry also supports hundreds of thousands of brokers and third-party administrators.

These jobs pay well — an average salary of $70,000. Medicare for All would destroy almost all of them.

At least Medicare for All’s supporters acknowledge as much. Congresswoman Pramila Jayapal, who has sponsored Medicare for All legislation in the House, recently said, “There’s about a million people we think will be displaced if Medicare for All happens.”

Even those with no apparent connection to the private health insurance industry would be collateral damage.

Many pension plans, mutual funds, and retirement accounts hold health insurance company stocks. CalPERS, the giant California public pension system, owns 2.8 million shares of UnitedHealth Group and more than 1 million shares of Anthem. The current value of those two holdings exceeds $900 million. The New York State Common Retirement Fund — the third-largest pension plan in the nation — owns more than 1 million shares of Cigna, worth more than $150 million.

If Medicare for All puts those companies out of business, then the retirement savings of millions of people could lose billions of dollars in value in short order.

“You’re fired” used to be confined to reality TV. If Medicare for All comes about, that line may become a grim reality for millions of Americans.

This article was originally published by Townhall.com

Filed Under: Top Stories Tagged With: Health care, jobs, Medicare

Healthcare tax for citizens, free healthcare for noncitizens

June 18, 2019 By Jon Coupal 6 Comments

If there was any question whatsoever as to whether California has gone completely off the rails, proposals in the new state budget should remove all doubt. Perhaps the most egregious of these involve changes in state law as they relate to health care.

As of this writing, those proposals have yet to be adopted by both houses of the legislature – which is constitutionally required to pass the budget bill by June 15th every year – but statements by legislative leaders have caused a great deal of angst among the taxpayer public.

First among the inexplicable ideas is the proposal to force citizen and legal immigrant taxpayers to pay a new healthcare tax in order to subsidize healthcare for California residents who are living in the country illegally. Yes, you read that right. The tax that Gov. Gavin Newsom wants to impose is a penalty on all those who don’t comply with the “individual mandate.” If this sounds familiar, it should. The individual mandate was a key component of Obamacare at the federal level until the penalty was repealed by the Republican-led Congress in 2017.

If it passes, California would be one of only four states imposing a tax on those who won’t or can’t obtain the kind of health insurance coverage the government requires. The state-imposed mandate would parallel the federal mandate which, in 2016, amounted to $695 per adult or 2.5 percent of yearly household income, whichever was higher. The tax is projected by Newsom to generate about $1 billion over three years.

To read the entire column, please click here.

Filed Under: Top Stories Tagged With: Health care, HJTA, Jon Coupal

Gov. Newsom Backtracks on Single-Payer Health Care Promises

May 17, 2019 By Chris Reed 9 Comments

Twenty months ago, then-Lt. Gov. Gavin Newsom sealed the endorsement of the powerful California Nurses Association in the governor’s race with an impassioned promise to bring single-payer health care to the Golden State.

“There’s no reason to wait around on universal health care and single-payer in California. It’s time to move [Senate Bill] 562. It’s time to get it out of committee,” Newsom told a nurses union conference in September 2017. “If we can’t get it done next year, you have my firm and absolute commitment as your next governor that I will lead the effort to get it done. We will have universal health care in the state of California.”

But now, as Newsom undertakes a “California for All” tour of the state’s largest cities, that ambitious rhetoric has long since given way to more modest proposals – and to attempts to dampen expectations. Instead of the governor reviving Senate Bill 562 – a 2017 measure passed by the Senate that would have committed the state to creating a single-payer system – he now says that’s not feasible without the assistance of the federal government.

Newsom has asked the Trump administration to give California a waiver from federal laws allowing the state to set up its own unique health care system – and for a sum equivalent to the amount the federal government now spends on health care for state residents. Senate Bill 562 died in the Assembly over expectations it would cost about $400 billion a year – double the state’s budget.

Governor risks backlash from fellow Democrats

The May Revise of the 2019-20 state budget that Newsom unveiled last week includes several proposals to expand availability of health care partly subsidized by the state government, in particular raising the income threshold of eligibility up to $73,000 a year. Individuals who make $48,000 a year or more are not eligible for federal subsidies under the Affordable Care Act. But he stopped short of extending Medicaid coverage to unauthorized individuals in California, citing its $3.4 billion cost. And he made no concrete proposals on advancing single-payer beyond previously announced plans to use the newly created state Council on Health Care Delivery Systems to examine how the state could transition to such a system.

The potential for a backlash from Newsom’s own party is clear. Politico reported in March than Newsom believed strongly that leadership on single-payer should be led by “the horseshoe,” an insider’s term for the governor’s unusually shaped office. But having a commission look at the state’s possible courses of action isn’t the dramatic move that fans of Democratic presidential candidates like Sen. Bernie Sanders and Sen. Elizabeth Warren want. A Quinnipiac University poll released in February showed 61 percent of state Democrats back a government-run single-payer system in California.

The California Nurses Association has expressed disappointment with the lack of progress. In February, CNA lobbyist Stephanie Roberson told the Sacramento Bee that it was “baffling” that no state lawmaker had introduced a measure like Senate Bill 562 and said her union strongly believed that incremental improvements in health care access were not enough.

“We can’t, as leaders, just protect what we have because we fundamentally believe that health care is [a] human right,” Roberson said.

This article was originally published by CalWatchdog.com

Filed Under: Top Stories Tagged With: Gavin Newsom, Health care

Price Controls by Another Name

May 5, 2019 By Wayne Winegarden Leave a Comment

The costs of medicines continue to dominate the headlines, attracting the attention of Congress and the Trump Administration. Reforms are necessary, but many of the reforms under consideration will make the situation worse. Indexing U.S. prices to the prices in other countries that use price controls, or using third-party arbitration to set the price of prescription drugs, exemplify these wrong-headed policies.

The Trump Administration’s proposal would set Medicare Part B prices (prices for drugs administered in a clinical setting) to the average prices charged in more than a dozen countries. Senator Rick Scott’s proposal (the Transparent Drug Act) would set U.S. prices equal to the lowest price in five countries. Regardless of the particulars, these price indices are government-created price controls; only the U.S. government is outsourcing these controls to foreign governments.

Third-party arbitration proposals are no better. Under arbitration, both the government and drug manufacturers would submit prices to a third-party arbitrator, who would then select the price based on these submissions. So, here again, the U.S. government is outsourcing the authority to set price controls; except instead of outsourcing this power to a foreign government, the government is empowering random arbitrators to set prices for the U.S. health care system.

These policies will have adverse consequences for patients and will lead to higher costs elsewhere in the health care system. However, the complexity of the pharmaceutical market often clouds the obvious costs these ill-considered policies will create. If policymakers were proposing to impose these regulations on workers instead of medicines, then perhaps the consequences would be easier to grasp.

Toward this end, imagine the following story.

One day your boss comes into your office complaining that he needs to cut the company’s unsustainably high costs. He understands that the company spends a lot of money maintaining the factory and purchasing new equipment, but he has decided that the company will reduce its expenditures by lowering its labor costs. He also has an ingenious way of doing this.

In the next town over, the government mandates a maximum wage. This maximum wage establishes an income ceiling or a salary threshold that no worker’s salary can exceed. This maximum threshold is below how much your company currently pays its employees.

While the purpose of this maximum wage is to make business costs more affordable, the actual effect is to discourage people from working in the town. In fact, the town is plagued with labor shortages.

Seeing these adverse impacts, no one in your town wants to pass such a bad law. But, your boss has a great way around it. Instead of imposing a maximum wage law, he offers you a choice between one of two options.

Under option one, your boss will set your wage equal to the wages of the people working your job in the neighboring town who are subject to the maximum wage law (e.g. the proposed drug price index proposal). Option two, you and your boss both submit a proposed new wage for you to an arbitrator, which could even include people working in your field from the neighboring town (e.g. the arbitration proposal).

After the initial shock, your first reaction would likely be, who cares between option one and two? The ultimate impact will be a reduction in your take-home pay. But, with respect to the actual proposals for pharmaceuticals, the more important question is: how would you react?

While you will continue working for this company in the short-term, since you have no other choice, over time you would clearly look for other opportunities. Everyone else at the company would feel the same. Soon, just like the neighboring town, the company would find it difficult to find qualified workers and might even face higher overall production costs as management searches for ways to alleviate its labor shortages.

While this scenario is ridiculous when applied to workers, it is exactly what policymakers are considering for the pharmaceutical industry. And, just like with workers, the consequences from these policies are clear: pharmaceutical price controls create access issues that worsen over time.

Precisely because there are no price controls in the U.S., Americans have access to nearly 90 percent of all of the new medicines that were introduced between 2011 and 2017. People living in Germany, the country with the next highest access rate, can only access around 70 percent; Australians only have access to one-third.

Policies that impose arbitrary price indices or mandate price arbitration are simply “price controls” by another name. If implemented, these policies will diminish medical vitality, discourage health care innovation, and jeopardize the creation of future cures. In short, they will make the health care system worse, not better.

This article was originally published by Forbes.com

Filed Under: Top Stories Tagged With: Health care

Medicare expansion would make socialized health insurance inevitable

March 10, 2019 By Sally C. Pipes 4 Comments

Several lawmakers want to pull more people into Medicare. This would hurt anyone with private insurance, and it would inevitably lead to single-payer, government funded healthcare, which would deprive people of any choice over their healthcare.

Sen. Debbie Stabenow, D-Mich., recently introduced S.470, a bill that would let any citizen or permanent resident between the ages of 50 and 64 buy into Medicare. It received broad support from her Democratic colleagues. Numerous 2020 presidential hopefuls, including Sens. Cory Booker, D-N.J., Kamala Harris, D-Calif., and Kirsten Gillibrand, D-N.Y., have co-sponsored the bill.

Lawmakers in the House of Representatives want to go even further. In December, Reps. Rosa DeLauro, D-Conn., and Jan Schakowsky, D-Ill., introduced a plan called Medicare for America. It would allow anyone in America, regardless of age, to buy into an expanded Medicare system that covers prescription drugs along with dental, vision, and hearing benefits. Those currently covered by Medicare, Medicaid, and CHIP would be shunted onto the new plan, as would anyone who buys policies on the individual market.

These proposals would cause prices for private plans to spike.

Medicare underpays for the services its beneficiaries receive. In 2017, hospitals only received 87 cents per dollar spent treating Medicare patients. That means Medicare underpaid hospitals by $53.9 billion.

As more patients shift to Medicare, providers will have to charge private insurers more to make up the difference. That will result in higher premiums for the privately insured.

In other words, Uncle Sam would charge people twice for Medicare, once through the IRS and again at the doctor’s office.

Gradually, people on private plans would get sick of high prices and start moving to Medicare. As people abandoned private plans, insurers would start going out of business. Before long, it would be easy to turn Medicare into an obligatory, single-payer program. That would leave patients with no insurance options.

Patients wouldn’t like that. More than seven in 10 folks with employer-sponsored health insurance are satisfied with their plans. Nearly 60 percent of people say they oppose Medicare for All if it comes at the expense of private insurance, according to a recent Kaiser Family Foundation poll.

Expanding Medicare is a bad deal. Lawmakers should abandon the idea.

This article was originally published by the Pacific Research Institute.

Filed Under: Top Stories Tagged With: Health care, Kamala Harris, Medicare

Expect More Surcharges as Businesses Cope with High California Costs

March 8, 2019 By Susan Shelley 9 Comments

“Stopped by a Pizza Hut to bring some food in last night and was met with this beauty,” an L.A. Daily News reader emailed under the subject line, “Soon to be all over California?”

Two photos were attached. One showed a bright red sign displayed prominently on the restaurant counter. Printed in bold type was this message: “Service Fee Disclosure – This location includes a service fee on all transactions. The service fee partially offsets the increased cost of operations in the State of California.”

The second photo showed a receipt with a 3.5 percent “service fee” below the subtotal and above the sales tax, and in extra-large letters, “SVC fee partially offsets the rising costs in CA.”

But it’s not “soon to be” all over California. It’s already all over California.

Ground zero seems to be San Francisco in early 2008, when a local law known as the Health Care Security Ordinance went into effect. The law requires any business in San Francisco that has 20 or more employees to set aside funds for workers’ health care.

Many restaurants decided to add an extra charge to customers’ checks instead of raising menu prices. Initially, some restaurants labeled the fee, “Healthy S.F. Surcharge.” Then in 2011 the Board of Supervisors amended the ordinance to require that any restaurant owner adding a “health” or “healthy” surcharge had to spend 100 percent of the money collected on health care. The city attorney investigated dozens of restaurants, leading to a costly settlement in 2013. The surcharges didn’t go away, but the name changed. Today they’re generally called “SF Mandates.”

This year, San Francisco’s Health Care Security Ordinance will cost employers $1.95 for each hour that each worker is paid, unless the employer has 100 or more employees, in which case the rate is $2.93.

The restaurant business is labor-intensive, and the cost of labor in California has been going up.

In 2015, the state mandated that employers give their workers three days a year of paid leave. In the Northern California town of Redding, Che Stedman, the co-owner and executive chef of Moonstone Bistro, began adding a 3 percent charge to customers’ checks to help cover the cost. “That is 24 hours of full paid leave,” he said, “so now every single employee that we have, we have to make sure that we have that money banked.”

Then in March 2016, on the Saturday before Easter, Gov. Jerry Brown cut a backroom deal with labor union leaders and state lawmakers to ratchet up the minimum wage in California to $15 an hour by 2023 for smaller employers, and by 2022 for larger ones. The Assembly Appropriations Committee passed the measure in 90 minutes and within 24 hours it was on the governor’s desk for his signature.

The California Restaurant Association was steaming like a Chinese dumpling but they couldn’t do a thing about it.

Or could they?

“Due to a myriad of legislative and court decisions, some restaurants in California have elected to add a surcharge to their receipts to defray increased costs incurred over the last several years,” begins an article on the association’s website titled, “Understanding and Guidance on Surcharges.” The tone is matter-of-fact. “The increased costs of operating a restaurant can be attributed to minimum wage increases, health care, paid sick leave, restrictive scheduling, cost of food and supplies and increased pay equity between traditionally tipped employees and heart of the house employees.”

The article offers advice on how to calculate taxes correctly and how to avoid getting sued by a city attorney, such as the one in San Diego who filed a slew of cases in 2017 charging some surcharging restaurants with false advertising and consumer fraud.

Last November, a San Diego Superior Court judge ruled in one of these cases that “the surcharge is not unlawful as a matter of law.” Similar rulings followed in similar cases.

Still, the California Restaurant Association recommends that restaurant owners minimize the risk of lawsuits by clearly disclosing the existence of a surcharge on a prominent sign or posting, large and conspicuous enough so that the sign is “likely to be read and understood by an ordinary individual under customary conditions of use and purchase.”

To avoid the problem that San Francisco restaurant owners had with the “health” surcharge, the association recommends keeping the reason for the surcharge as broad as possible, suggesting as one example, “to defray the increased cost of operations.”

“In the State of California,” added the owner of the Pizza Hut in Los Angeles, a city in which businesses also have to deal with a gross receipts tax and a trash monopoly franchise system that has sharply raised the cost of sanitation service.

Stephen Zolezzi, CEO of the Food and Beverage Association of San Diego, said in 2018 that surcharges allow the restaurant industry to send a message.

“Yes, it’s a political statement,” he said. “We’re trying to show people the consequences of legislation that adds to the cost of doing business.”

So the next time you see a “rising costs in CA” service fee on your restaurant receipt, don’t complain to the management. Go online to findyourrep.legislature.ca.gov and get the names and phone numbers of your state Assembly and Senate representatives. Chew them out for passing laws that are running up your bills.

Susan Shelley is a columnist and member of the editorial board of the Southern California News Group, and the author of the book, “How Trump Won.”

Originally published in the Los Angeles Daily News

Filed Under: Top Stories Tagged With: business, Health care, Susan Shelley

Can California Afford to Provide Universal Health Care Coverage?

February 1, 2019 By David Kersten 14 Comments

Perhaps no issue looms larger on both the state and national political stage than the question of universal health care coverage.

U.S. Presidential hopeful Kamala Harris (D) sent a shockwave through the national health care debate on Monday Jan. 28^th by nonchalantly stating that she would eliminate private insurers as a necessary part of implementing “Medicare-for-all,” according to a CNN report.

Due to a firestorm of attention, most of it negative, the next day the Harris campaign walked back the previous day’s remarks in large part by stating that the candidate would also be open to more moderate health reform plans, which would preserve the private industry, according to the CNN report.

Newly elected California Governor Gavin Newsom (D) campaigned on the issue of single-payer health care and on his very first day in office unveiled a comprehensive package of reform proposals aimed at expanding state health care coverage subsidies and lowering its costs, which includes extending Medi-Cal to undocumented immigrants, according to a report by the LA Times.

In an interview, Gov. Newsom told the LA Times “These are not just symbolic gestures…We’re hoping to ignite a new conversation. It’s a moral imperative, not just economic,” states the LA Time report.

But as many experts, including Gov. Newsom, have pointed out, big systemic reform to the system, such as a move to a single-payer health system, would require the unlikely support of the Trump Administration.

Newsom has done a good job of tempering expectations for single-payer health care and his proposed coverage expansions and prescription cost controls demonstrate to the his supporters and the public that he is serious about expanding coverage as well containing costs.

But the 800-pound guerilla in the universal health care conversation is where will all the money come from to provide guaranteed government financed coverage to every Californian and everyone who likely to come to California once universal health care is guaranteed by the state?

“Where do you get the extra money? This is the whole question…I don’t even get it…how do you do that?,” said former California Governor Jerry Brown (D) following a universal healthcare discussion in Washington, D.C. in a 2017 interview with the LA Times.

At the time, Gov. Brown pointed out that the overall cost of medical care in California is equal to 18% of the state’s gross domestic product, which would be about $450 billion.

“You take a problem and say I’m going to solve it by something that’s an even bigger problem, which makes no sense,” then Governor Brown said at the time, according to the LA Times report.

Gov. Newsom developed some questionable rhetoric during the 2018 campaign, where he said that the State of California cannot afford not to move to a single-payer system because health care has become such a big expense in the state.

It appears that one of the major points of disagreement between former Gov. Brown and now Governor Gavin Newsom is the question of whether the State of California can afford to move to a universal health care system, specifically a single-payer system?

More recently, other high-profile liberal Democrats have come out against single-payer health care with former Mayor of New York City and billionaire Michael Bloomberg stating that Medicare-for-all “would bankrupt us for a very long time,” according to a CNN report.

“I think we could never afford that,” Bloomberg said, addressing pin factory employees in New Hampshire. “We are talking about trillions of dollars.”

“I think you could have Medicare-for-all people who are uncovered, but that’s a smaller group,” Bloomberg said.

“But to replace the entire private system where companies provide health care for their employees would bankrupt us for a very long time,” said Bloomberg according to the CNN report, which noted that Bloomberg made the comments in response to Sen. Kamala Harris calling for an end to the private health care market.

So what does all this mean for the current universal health care debate in California?

It means that California Democrats might want to heed the advice of two of the county’s most prominent liberal Democrats—former Gov. Jerry Brown and Michael Bloomberg—and proceed with great caution regarding the feasibility of California going it alone on universal health care.

There is no question that the state could choose to enact a single-payer or Obamacare-type universal health care system, but the million dollar question, or trillion dollar question rather in this case, is would such a system work and be fiscally sustainable over the long-term?

As a long-time analyst of fiscal issues in California, I believe that former Gov. Jerry Brown and Michael Bloomberg are correct to point out the major challenges and risks of moving to a universal health care system—both at the state level and the federal level.

David Kersten is an independent political consultant who lives in the Bay Area. Kersten is also an adjunct professor of public budgeting at the University of San Francisco.

This article was originally published by Fox and Hounds Daily

Filed Under: Top Stories Tagged With: Gavin Newsom, Health care, Jerry Brown, Kamala Harris