<p>“universal” health care in CA, massive school spending, global warming pollution standards – talk about ambitious… and un-Republican sounding. What do you think, Californians (and others)?</p>
<p>The governator knows in that state following the party line, will cost him the position. There is nothing wrong with using concepts from both sides to form your own opinions. I think he may have learned from his efforts to change the public workers pension and other reforms that it is easier to drive down the middle than run on the shoulder.</p>
<p>Little will pass AND be implemented – he’s running for the Senate in '10.</p>
<p>I’m a Californian and I like it that he does not want to participate in Bipartisian politics. He’s a trailblazer IMO and I wish that more politicians did not walk lock/step with their party.</p>
<p>“it is easier to drive down the middle than run on the shoulder.”</p>
<p>I liked it.</p>
<p>Schwarzenegger is definitely BTB – better than Bus…tamante.</p>
<p>From the sidelines, he seems visionary… but if in fact he’s running for the Senate in '08, bluebayou is probably spot-on. </p>
<p>My company has just announced massive health insurance changes - not for the better. How I’d welcome a realistic debate about health care in this country - and who better than lead that debate than CA - one of the world’s biggest economies…</p>
<p>National Health Care will be front-burner for Hilary in '08. I’d make book on it.</p>
<p>There is no way that a conservative Repub can win in California. Unless he is willing to compromise, he is gonna lose that governorship.</p>
<p>fastMEd,</p>
<p>I dunno man. I heard that, oh what was his name…Ronald…ummm…Reagan? I think that’s it. Ronald Reagan. I heard that guy was pretty conservative.</p>
<p>I understand that there are two key features of the plan as proposed that will drive insurance companies from the state. The result could be universal but unavailable health insurance.</p>
<p>Guaranteed issue means that insurance companies must sell insurance when asked to and cover whatever conditions the individual has. Currently in most places insurers can choose whether to insure an individual and to write coverage with exclusions or waiting periods for pre-existing conditions. </p>
<p>Community rating means that insurers must charge everyone the same regardless of their health status or anticipated cost to the insurer.</p>
<p>What’s the big deal, you ask. Washington State, where I practiced 10+ years ago made much the same change. Insurance wasn’t mandatory but the insurers were placed under the restrictions described above. Here is an example of how it worked: I had a patient who had been healthy for all of the first 50+ years of his life and who had never bought health insurance making him one of the much discussed “uninsured”. I diagnosed him with cancer. He then bought insurance that cost him a few hundred dollars a month (remember the insurers had to sell it to him and had to price it the same as policies sold to the general population). Over the next couple of months he got treatments costing between $30,000 and $40,000 and then, once his cancer was in remission, he stopped paying for the insurance. When I asked what he was doing he said that he no longer needed it since he didn’t have any expenses and he would buy insurance again when/if he needed more treatment in the future.</p>
<p>The insurers in WA soon figured out that collecting a few hundred dollars in premiums while paying tens of thousands in benefits was not a good model for a profitable business and began pulling out of the state. Making insurance mandatory may mitigate the abuse described above, but if price controls are imposed on premiums, as implied, then we can expect insurers to not want to do business in California. Those employers that have a largely young, low cost work force will find their health costs rising to the community rating and will begin to think about leaving the state if they can for a less expensive location. Which will provide for more strident calls for a state or even national health insurance. Maybe that is the real agenda.</p>
<p>And as an MD in California and can’t tell you how much I look forward to my extra 2% taxes. I’m just so excited!!! And the paperwork that will undoubtedly follow. I went to medical school because I just love doing paperwork. It was really cool that Mr. S has specifically singed out “doctors” for his new tax, errr, fee, and not non-md practioners who also bill and get paid by insurance companies. What a guy! I just don’t know how I’m going to fit in all those new patients who will have health insurance and wil now want my services - - my practice is already full as there already seems to be a doc shortage around here. Oh well, I’m sure Mr. Kennedy, errr, Swartzenager, will figure out how to get more docs here. Probably via a new law making it illeagle for MD’s to leave the state if they ever set foot here.</p>
<p>Do you know how the proposed law defines “practitioner”? M.D., D.O., D.C., N.D., F.N.P., accupuncturist, physical therapist, massage therapist? Sweet for the others if only MDs have to pay the tax. Oh, I am sorry, Mr. S. is against new taxes. It’s a fee. </p>
<p>The politics behind that decision will be interesting. In WA years ago another change in insurance that was required was the mandatory coverage of chiropractic care by insurance policies. Before that, if you didn’t believe in the theory underlying chiropractic, you could buy insurance that didn’t cover it and save some money. It turned out the insurance commissioner behind the law was a client of chiropractic, undergoing a lifetime of adjustments. So coverage was mandated.</p>
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<p>Wait…do I sense sarcasm here? ;)</p>
<p>Schwarzenkennedy
<a href=“http://■■■■■■■.com/23n983[/url]”>http://■■■■■■■.com/23n983</a>
“Last November, Gov. Schwarzenegger won landslide re-election in part by winning 91% of Republicans with an ironclad pledge not to raise taxes.”</p>
<p>But he didn’t say anything about raising “fees”. Congress could learn from the man. No new taxes, just new fees.</p>
<p>edit- I thought the above link was free, but it may lead to the fee only online WSJ site. Sorry.</p>
<p>More
"Ted Kennedy, the nation’s most persistent backer of nationalized health care, must be smiling at the irony. Almost four decades after he first proposed the idea, Gov. Arnold Schwarzenegger, a Kennedy relative by marriage, is touting his own version of universal coverage, and, if adopted, the idea could go nationwide quickly. It’s no wonder critics are already dubbing the ostensibly Republican chief executive “Schwarzenkennedy.”</p>
<p>This isn’t the first time Mr. Kennedy has found a Republican to carry water for him. In 1971, after Medicare spending had increased by more than 70% in five years (although the number of people enrolled grew by only 6%), Richard Nixon declared a “health-care cost crisis” and worked with Mr. Kennedy to propose mandatory employer-provided health insurance. The idea foundered, but a modified version now has been revived by Mr. Schwarzenegger, who wants to require that every person buy health insurance, or be covered by an employer or the government. Massachusetts has a more modest law in place, and an adviser to Mitt Romney helped Schwarzenegger aides on their plan.</p>
<p>Liberals are overjoyed at the about-face by a governor who in 2005 vetoed a Democratic bill that would have merely expanded the state’s coverage of children, saying the $300 million price tag was too high. Assembly Speaker Fabian Nunez praises the governor’s new proposal: “This is a plan Assembly Democrats could have written.”"</p>
<p>“Liberals are overjoyed at the about-face by a governor who in 2005 vetoed a Democratic bill that would have merely expanded the state’s coverage of children”</p>
<p>You can count me among the overjoyed number. Based on the little I know about it, I don’t think the plan is perfect by a long shot, but I’m thrilled that 10% of the country is now taking the problem seriously.</p>
<p>I guess the cautionary data about Medicare made no impression?</p>
<p>“In 1971, after Medicare spending had increased by more than 70% in five years (although the number of people enrolled grew by only 6%)…”</p>
<p>More from the article:
"But now the estimated cost of the Schwarzenegger plan to cover California’s uninsured, including two million illegal aliens, is $12 billion. State subsidies for people to buy insurance will extend to those earning up to $50,000 a year, more than California’s median income. “He’s creating a welfare state where more than half the people are in the wagon being pulled than outside the wagon pulling,” says one health-care analyst.</p>
<p>As bad as the policy implications are, the governor’s plan may be fatally flawed, politically. He insists it doesn’t raise taxes, despite billions in new charges on doctors, hospitals and employers. He prefers to call the new revenue “in-lieu fees” and “coverage dividends.” “He excoriated Phil Angelides, rightly, for proposing the same tax increases he has put on the table,” says GOP state Sen. Tom McClintock. “He is now pushing the second largest tax increase in California history. I won’t be able to trust anything he says.”"</p>
<p>Sounds like a real winner to me.</p>
<p>None of these numbers are instructive unless you compare them to the cost we’re currently paying to provide emergency and catastrophic care to the uninsured, to care for the children of people who die too early because they had no preventive care, disability payments made to people crippled by preventable illness, etc. etc.</p>
<p>Personally, I wouldn’t involve insurance companies in this at all. Why should the state pay for a private company’s profits? It’s not like they’re any good at keeping costs down.</p>
<p>You’re barking up the wrong tree if you expect me to panic at the prospect of a tax increase. What I care about is how the money is spent, not how much they’re taking. I’d much rather that they take 40% of my income, and spend it efficiently on things that are worth buying, than take 10% of my income and waste it on crap (like, say, a war of choice).</p>
<p>Having read more about this proposal, it’s disheartening to see the extra burden on doctors instead of, say, insurance companies… I’ve seen incredibly talented people leave the medical field, defeated by the paperwork, lawsuit concerns, diminshed earnings vs. increased work load. This proposal doesn’t seem to address any of these issues.</p>
<p>“I’d much rather that they take 40% of my income, and spend it efficiently on things that are worth buying”</p>
<p>You believe the government spends efficiently? And that the government knows better what is worth buying than individuals? I think you have defined Liberal very well.</p>