Health Care for All--Santa Cruz Chapter
Your Questions Answered |
Q. Is there any hope of passing SB840 since that entails taking on the insurance industry, the drug companies and the governor?
A. This governor will probably veto it again but as Senator Kuehl points out this governor won’t always be there. Our only defense against insurance and drug company money is to educate the public so that they are sufficiently well-informed and can see through the misleading ads that’ll be launched against single payer.
Q . How is this plan different from those tried in other states?
A. SB 840 can contain costs by taking insurance company profits out of the mix. SB 840 will save the state billions of dollars each year.
Q. Will indecently high billing for services be monitored?
A. Yes, a Payments Board will negotiate fair reimbursement rates for providers. At present rates are inflated to allow providers to claim a business loss on the amount not covered by insurance plans and also to bill those without insurance at a much higher rate.
Q. How will undocumented persons be handled?
A All residents of California will be covered; all workers will have (roughly) 4% of wages deducted at source. At present emergency rooms frequently meet the needs of undocumented people and these high costs are passed on to our insurance premiums.
Even the governor’s proposal recognizes that the undocumented must be covered. It’s a public health issue
Q. How will single payer avoid the problem of Medicare’s inadequate reimbursement rates which result in a doctor shortage serving the elderly?
A. Medicare has refused to recognize the cost of doing business in cities like Santa Cruz and insists on designating us a ‘rural’ area. This is because Medicare is a zero sum game where if Santa Cruz is designated ‘urban’, the increases will have to be taken away from another community. Funding for SB 840 is not subject to this constraint?
Q. Will SB 840 help displaced staff in doctors’offices?
A .Yes, the bill provides for retraining of these workers. Also billing will probably be contracted out to insurance companies (as Medicare contracts with Blue Cross) so many workers in insurance companies will be retained (just shareholders will not profit from the company selling health insurance)
Q. Does single payer cover alternative medicine …acupuncture, chiropractic etc.?
A. Yes, where these treatments are medically indicated and have been shown to be effective.
Q. Will disabled Medicare beneficiaries be able to access this care?
A. Yes. No payments will be charged on the first $7000 of income. After that a tax of 4%
is levied on all wage or non-wage income.
Q. Will all providers be compensated at a set level and how will providers, especially mental health providers, be identified.
A. All those currently licensed to provide services will be able to participate. The rules for licensing will not change. Rates of reimbursement will be negotiated between the Payments Board and a representative panel of medical providers.
Q. What will prevent the Payments Board from forcing doctors to accept whatever reimbursement is offered.
A. Californian doctors etc will be in a strong position to negotiate since their services are needed. If offered inadequate rates they would leave the state in droves at a time when we will need more of them.
Q. What’s to stop this system suffering the same starvation as occurred to the British system under Margaret Thatcher?
A. Structurally this system is unlike the British one. Money goes into a Health Fund and cannot be used for any other purpose and is not part of the general fund. The negative experience of the British (and the Canadians) with this kind of political manipulation was useful in writing protections into the bill
Q. What will insure adequate funding of the bill?
A. The bill has a statutory spending limit, allowing growth no faster than the average growth of the state GDP. At present we know that if the money California currently spends on health care was actually going into health care, we would have great care for all our people. We spend twice as much as France which is acknowledged to have the best health care system in the world. The funding provisions of the bill are detailed; for a copy of the bill go to www.leginfo.ca.gov
Q. Does the bill take into account the extra needs of those with permanent disabilities?
A. Yes, in fact the whole basis of the bill is that some of us are unlucky enough to have considerable medical needs. The financial costs are to be shared by all, providing the best of care to the people who need it. All durable medical equipment is fully covered.
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Q. Who pays
malpractice insurance under single payer?
A. Doctors will still pay for their malpractice insurance which is a form
of liability
insurance.
Q. What work will
the insurance workers do?
A. There would be both job loss and job creation. The bill provides
for retraining
programs and transition assistance for those who do
lose their
jobs. There would be new jobs in health care education
and in the new
system’s quality and health planning programs.
If all 36
million Californians had health insurance, the would be
more jobs like
those that already exist in the health industry such
drivers,
nurses, interpreters, home health aides, and therapists.
Q. How do the
supporters of SB 840 plan to overcome/overpower the
resistance of
the insurance industry?
A It would be overcome by the huge grassroots support of all the
the residents
of California, like you, who support it. Almost
all the people
agree that our present health care system is broken
and needs to be
fixed.
Q. Could you please
describe, with as much specific information as
possible, the
impact of this plan on the self-employed?
A. The self-employed would receive the same high quality health care
as everyone
else. As the current bill reads, they would pay 8.17%
of
their payroll,
but excluding $7000 that they paid themselves.
Q. Preventive care is
much cheaper than trying to cure illness. Would
preventive care
(massage, acupuncture, reflexology, stress reduction
programs be
covered, without limits, under this program?
A. Any health care service, with emphasis on preventive care, that is
provided by a
practitioner who is licensed to practice that service
by
the State of
California will be reimbursed.
Q. What reason did
the Governor give for not signing the bill?
A. The Governor called the bill “socialized medicine.” SB 840 is NOT
socialized
medicine. The practice of medicine and hospitals would
remain private.
The government would just tax us and pay for it.
Q. 1. What will happen to Medi-cal? 2. Will this cover peoples care in
nursing homes?
3. Will it cover comprehensive home health care?
4. Will it
cover hospice? 5. Will it cover undocumented people?
A. 1. Medical recipients will get the same treatment as all others.
2. Nursing home
services will be covered for 100 days after dismissal
from a
hospital. All medical care will be covered after that
100 days
but not their
custodial care. 3. Yes, as long as recommended by
their
physician. 4. Yes. 5. Yes.
Q. What competing
proposals are there and how much “traction” or
support do they
have?
A. There are four other competing proposals at this time. Senator Perata
and Assemblyman
Nunez together with Governor Schwartznegger
have plans that
are forces to be reckoned with. They are meeting
together to try
to get something that can be approved by all.
Q. How many doctors
(percentage wise) are in favor of single payer
health care?
Are they afraid of “state control” of their fees like
Medicare is
already doing?
A. It is hard to know the exact number. California Physicians Alliance
(CAPA) shows
strong support and are working to secure its
passage. The
California Medical Association (CMA) does not
support it but
many of its’ member doctors do.
Q. What would a
business with few (5 or less) employees have to pay
for health care?
A. At present 8.17 % of payroll. This might change as the bill goes
through the
legislature.
Q. What would our
school district save by the state going into this
plan?
A. We haven’t calculated it for any of our local districts but Salinas
Unified High
School District would save from $4,000,000 to
$6,500,000. The
Los Angeles Unified School District would save
from
$127,000,000. to $279,000,000.
Q. Will long term
care services and programs be included?
A. No, only the health care part. Not the custodial care part.
Q. Will community
based programs be covered and available to those
in need, rather
than nursing home care placement?
A. Health care will be provided regardless of the setting. Custodial care
is not included.
Q. Are there any
plans underway to introduce incentives for better
care?
A. At a minimum, methods to improve quality of care would include
preventive care,
evidence based standards of care to help doctors
make decisions,
mandatory reporting of errors, teams to evaluate the
effectiveness of
new techniques and technology, funding for the
development of
electronic medical records and compatible computer
systems. SB 840
would stimulate innovation and reward
outstanding
services through a reporting system and bonuses.
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