Bill to Study State-Based Single-Payer Passes Senate



Thank God for Washington State!
Do we have all the answers - no
But at least the state- in many areas- is asking the right questions
And to the extent we can answer the questions, Washington state can make it easier for other states to follow along.


Washington loves its studies.


@2 And virtue signalling. When the inevitable $100 billion+ annual price tag becomes shared, this will quietly fade away like every other state that has looked into it. But at least it's something right?


@3- A number of states have single payer health care. It is just that that single payer is a for-profit health insurance company. No one seems to be upset about that. Seems like this outrage is mostly about disrupting the profit margin.


What if I want to keep my current private plan and not be forced into a state-enforced system with its inevitable rationing?


@4 Simple math. Annual health insurance runs about $20K per year. There's 7 million in WA (which would rise tremendously with sick people flocking here if we were the only state to offer free* health insurance). Costs would go down? Maybe, a bit, so lets say $15K per year. That's a cost of $105 billion per year. California tried the same thing and came up with $400 billion per year. They are no longer "studying" the matter. The only way this could work is at the national level (with tight immigration controls) and even at that you'll be looking at rationing and "death panels" and ever increasing supplemental costs for the individual. Will it be better that what we have? No idea. There is no good option.


@5 your health care is already being rationed and anyway it’s more likely they would establish a public option open to anyone regardless of age or income within the existing health care marketplace and not literally take over the industry


@6, You're also making a bunch of dubious assumptions about the nature of the universal model they would adopt (which is understandable given that people use the terms single-payer and universal interchangeably) and the idea that sick people would 'flock' to your state for the promise of what people disingenuously call 'free' health care as a way to ridicule it, when the people who are sick enough to be a burden on the system are unlikely to move anywhere because they are too sick and/or about to die. Whether there is a good option is debatable but whether there are better ones than the for-profit model we have accepted is not. We need to consider other ideas because the system we have right now is failing us.


Everybody thinks they are entitled to the best healthcare available but no one thinks they should have to pay for it, let alone pay for their neighbor's.
It's a conundrum.


American healthcare used to work.
What happened to cause it to start failing us?


@10 Take a look at any film from the '60s and watch for what regular folks in the street scenes looked like. Then compare that with what you see on the street now, especially in the midwest, southeast and southwest. Also, end of life care. One of my grandparents lived to 101. At 98 the doctor suggested a pacemaker. He was surprised when she declined. Treatment options have increased exponentially since then as well. Insurance administration costs, regulatory costs...


@8 Not going to argue and I agree that we need to start exploring alternatives. What I do know is if we survive the end of the Boomers, there is going to be a financial reckoning and we're probably not going to like it too much.


I'm for universal healthcare but not if we are still on this obesity celebration kick we can't seem to move away from


@10 Obesity.

70% of US healthcare costs come from 3 chronic diseases: heart disease, diabetes and hypertension.

All because folks eat shitty food, by choice.

Now they want a bailout.


@14 Of for fuck sake do some research you stupid god damned troll. The high price of Healthcare in the US has almost nothing to do with obesity or any specific disease being treated disproportionately in the US.

Look up the Harvard T.H. Chan School of Public Health and the London School of Economics and Political Science study on the matter (among dozens of other studies that found the same thing).

If obesity was the cause it would not explain why prescription drug prices here are 4-20 times more expensive than the average in other countries with regulated pharmaceutical prices. We USED to regulate pharmaceutical prices in the US. And low and behold when we stopped they quickly quadrupled.

Healthcare utilization rates in the US are almost identical to the rest of the world. Our fatties don't go to the doctor anymore than anywhere else.

But US Administrative costs are almost five times higher than the next expensive European healthcare system and that has nothing to do with what patients are being treated over. It has to do with Health insurance corporation executive salaries and the returns stockholders expect. And our doctors get paid almost twice what the next most expensive healthcare system pays.

It's because, unlike the rest of the civilized world, we have a for-profit system. Period.

Fromt the Abstract:

"Findings In 2016, the US spent 17.8% of its gross domestic product on health care, and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The proportion of the population with health insurance was 90% in the US, lower than the other countries (range, 99%-100%), and the US had the highest proportion of private health insurance (55.3%). For some determinants of health such as smoking, the US ranked second lowest of the countries (11.4% of the US population ≥15 years smokes daily; mean of all 11 countries, 16.6%), but the US had the highest percentage of adults who were overweight or obese at 70.1% (range for other countries, 23.8%-63.4%; mean of all 11 countries, 55.6%). Life expectancy in the US was the lowest of the 11 countries at 78.8 years (range for other countries, 80.7-83.9 years; mean of all 11 countries, 81.7 years), and infant mortality was the highest (5.8 deaths per 1000 live births in the US; 3.6 per 1000 for all 11 countries). The US did not differ substantially from the other countries in physician workforce (2.6 physicians per 1000; 43% primary care physicians), or nursing workforce (11.1 nurses per 1000). The US had comparable numbers of hospital beds (2.8 per 1000) but higher utilization of magnetic resonance imaging (118 per 1000) and computed tomography (245 per 1000) vs other countries. The US had similar rates of utilization (US discharges per 100 000 were 192 for acute myocardial infarction, 365 for pneumonia, 230 for chronic obstructive pulmonary disease; procedures per 100 000 were 204 for hip replacement, 226 for knee replacement, and 79 for coronary artery bypass graft surgery). Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries. For pharmaceutical costs, spending per capita was $1443 in the US vs a range of $466 to $939 in other countries. Salaries of physicians and nurses were higher in the US; for example, generalist physicians salaries were $218 173 in the US compared with a range of $86 607 to $154 126 in the other countries

Conclusions and Relevance The United States spent approximately twice as much as other high-income countries on medical care, yet utilization rates in the United States were largely similar to those in other nations. Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries. As patients, physicians, policy makers, and legislators actively debate the future of the US health system, data such as these are needed to inform policy decisions.."


The fastest way to kill a bill is to appoint a blue ribbon panel to study the issue.

Years from now, the panel will conclude that the topic requires further study. The legislature will use this to delay hearing any bills on the topic indefinitely.