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With California leading the charge, NY, NJ, RI, and Mass are all throwing around the idea of a single -payer health care system in their legislatures.  It sounds so good – A majority of Americans feel the government should guarantee some kind of healthcare to citizens.  And we all wonder how we pay so much more, and get so much less?

But California is a state with an underfunded pension debt of $1 Trillion, according to a recent Stanford study.  The state budget is reported $290 billion, the estimate of what people pay for health care in the state is $367 billion – and the estimated price tag for a single-payor system is $400 billion!

So how are they going to pay for this?  112/193 House Democrats have signed a bill that would raise the taxes on “the wealthy.”  Another evaluation says that a 15% increase in payroll taxes would be needed.

A similar proposal in NY would require doubling, or more, that state’s current tax burden.  Vermont tried and the costs were too high, and Colorado voters rejected it when they learned of a 10% higher payroll tax.

The reason California’s is SO expensive is that it would “…pay for almost all of its residents’ medical expenses—inpatient, outpatient, emergency services, dental, vision, mental health, and nursing home care—and Californians would not have any premiums, copays, or deductibles.” Undocumented immigrants would be covered too.

And the outcome?  It’s easy to present the big insurance companies as the evil demon – and they are to some extent.  But in this model, the government would decide what is, and is not, covered.  Hospitals and Doctors will have no choice but to accept whatever reimbursement rate the government decides on.  Physicians are already leaving Medicare and Medicaid because of reimbursement rates, and a shortage of physicians is already felt in many areas – and it’s going to get worse.  IMHO the Veterans Administration, Medicare, Medicaid and the efficiency of healthcare.gov have shown me its better in the private sector.