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To call the Democrats’ new universal healthcare legislation “bold” is an understatement. It would be a life changing for virtually all Californians.

It would also require by far the largest state tax increase in history.

Some powerful opponents will call him “socialist”. But aren’t social security and health insurance socialist? And they’re some of the most popular government programs in America.

Some proponents hail it as a California version of the federal “Medicare for all”. But really it is medicare for no one. Californians on Medicare would be transferred to the new state-run “CalCare”.

No more health insurance in the country’s most populous state. Nor Medi-Cal, the California version of Medicaid insurance for the poor. And private health insurance would essentially be bankrupt. Everyone would be transferred to CalCare.

As announced by CalCare supporters, most Californians would be better off with the state’s new plan: “No bonuses, co-payments or deductibles… or other out-of-pocket expenses. “

But more benefits: “Including all primary and preventive care, inpatient and outpatient services, prescription drugs, dental care, vision, audiology [hearing aids], reproductive health services, maternal and newborn care, long-term services and… mental health and addiction treatment, laboratory and diagnostic services, outpatient services and more.

“Patients will have the freedom to choose doctors, hospitals and other providers… regardless of whether a provider is ‘networked’. “

It looks like a late night TV commercial for miracle pills.

The assumption is that Sacramento can handle such a massive business. There are many reasons to be skeptical.

“I look forward to hearing Democrats explain how they plan to successfully capture more than 10% of the state’s economy when over the past decade they have proven unable to do so. simple things like building a railroad, providing clean water, keeping lights on and filling potholes, ”said Republican Assembly Leader Marie Waldron of Valley Center in County. San Diego.

Even a big Democratic supporter, Assembly Health Committee Chairman Jim Wood of Healdsburg in Sonoma County, has similar concerns.

“When you look at California, especially with COVID, you clearly see things that aren’t working very well,” Wood told me.

“I have always supported healthcare for everyone,” added the dentist. “But I have serious and legitimate concerns about how an entity like this would be governed. I’m just worried about whether we have the capacity to handle this.

Wood cited as a blatant example of mismanagement the state’s Department of Employment Development, which paid out billions of dollars in fraudulent unemployment benefits at the start of the pandemic, including to people in jail.

But state government is a mixed bag, Wood continued. He praised Covered California, which operates an expanded version of the federal affordable care law, as “a model for the country.”

He also called federal medicare a “well-run system”.

“Doctors and hospitals don’t like Medicare because the rates are lower,” Wood said. “But Medicare beneficiaries like it. “

And California would leave him.

Wood is prepared to get rid of the current private insurance.

“In the healthcare industrial complex, the focus is so much on profit that the best interests of the patient are often lost,” he said.

One thing is indisputable: Paying for this business would require an unprecedented tax hike – $ 163 billion a year, according to opponents.

It was after Washington was convinced to turn over all the money the federal government currently spends in California on Medicare, Medicaid and other health programs to CalCare.

There would be a wide array of new taxes on business and employees, including personal income taxes – in a state that already has the highest levies in the country.

Not only that, but future tax hikes to fund CalCare could be approved by a simple majority legislative vote. Any tax increase now requires a two-thirds vote.

“This measure would increase the cost of living in California and lead to job losses,” said Robert Gutierrez, president of the California Taxpayers Assn. “Californians have already been taken to the cleaner by costly measures that the world promised but did not deliver.”

As with the high speed train.

The CalCare Bill, AB 1400, and the Tax Raise Constitutional Amendment ACA 11, were both introduced by Assembly Member Ash Kalra (D-San Jose) and came from powerful politics California Nurses Assn.

They argue that even with higher taxes, Californians would pay less overall and get more benefits because there would be no need to pay for insurance company profits.

“We have the most expensive medical system in the world and have the worst results of any industrialized country,” Kalra said. “Ultimately, the richest state in the richest nation on Earth should join with other nations in providing health care for all.”

It will take a lot of conviction – not just within the legislature, but among voters, who must approve the tax increases.

Don’t be surprised if tax laws are quietly on the back burner for a while. Even Democrats aren’t eager to vote for a tax hike in an election year when they run in new districts that have just been reconfigured.

Find out which taxes will be voted on next year. If passed, they would be entered on the 2024 presidential ballot when there is a high turnout that traditionally benefits Democratic causes.

But the “one-payer” health bill faces a rushed deadline in the assembly. Under the legislative rules, it must be sent to the Senate by January 31. It probably will be. Then there will be a battle for the final passage in August.

Governor Gavin Newsom would likely sign it. But the measure could not enter into force until the taxes were approved.

CalCare faces a tough fight. The odds against her are stiff.

But it’s a worthwhile debate, unlike most bills in Sacramento.




Los Angeles Times

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