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when has California's government recently shown any capability to successfully implement big projects or spend tax payer money efficiently? How is the high spe

when has California's government recently shown any capability to successfully implement big projects or spend tax payer money efficiently? How is the high speed train project coming along?

cobrabyte 5y ago
This is my thought, as well. When your private insurance company stinks, you find a new insurer. When you're forced to pay the government for health insurance, you're stuck without options. Health insurance isn't one of the services that I trust the government to be able to run well. They don't have a particularly great track record where efficiency, customer service, and speed are concerned.
- Drunk_Engineer 5y ago
  In theory, single payer should offer more choices. With private insurance, you are stuck with certain doctors and hospitals, and can only change plans at years-end.
- larkost 5y ago
  Here is the breakdown from this article for 2020: https://www.census.gov/library/publications/2021/demo/p60-274.html https://www.census.gov/library/publications/2021/demo/p60-27... 8.6% are uninsured Of the insured: - 54.4% of the ensured on employer based insurance - 10.5% purchase theirs directly - the rest get theirs from one government program to the other (Medicare 18.4%, Medicaid 17.8%, TRICARE 2.8%, and VA and the like 0.9%) So your comment only covers less than 10.5% of people at the moment... a little more than the number of people who have no health coverage (a good portion not out of real choice). And that does not even cover how horribly this sort of market functions: you never know how good or bad your coverage actually is until you go to use it for a particular problem, and then you don't really know that until it is over and you are maybe bankrupt. Health insurance is the worst place to try and use market forces to regulate it... well maybe after military, fire, and police...
- jjav 5y ago
  > This is my thought, as well. When your private insurance company stinks, you find a new insurer. You can't, because the health insurance is provided by your employes so you get whatever they give you. My health insurance (blue shield) is absolutely terrible (right now I need some medicine they refuse to let me have because it cuts into their profit margins) but there's nothing I can do about it. And that's after paying $2500/month for the privilege.
  - cobrabyte 5y ago
    Sorry to hear that. My experience with government insurance has been with Medicare, Medicaid, and the VA, and to say I've been unimpressed is an understatement. I guess I should be thankful my insurance is ~$1000/mo, and hasn't left me with the horror stories some seem to experience.
  - jimbob45 5y ago
    >You can't, because the health insurance is provided by your employees so you get whatever they give you. That's not true, is it? You could decline coverage and then go purchase a policy of your own elsewhere. Yes, that might be expensive but the original claim was "Y'all actually have one of the best systems in the world, it's just way too expensive." and that still tracks. Even better, you could purchase a policy through the Obamacare exchanges. If the government offers you bad medical care, you turn to the black market or you fly to the US to get the procedure done because the government has banned alternative care. This is a very normal Conservative talking point and the inherent competition in US healthcare is arguably the biggest benefit of its current system.
    - jjav 5y ago
      > That's not true, is it? You could decline coverage and then go purchase a policy of your own elsewhere. What other choices exist, there's only a few giant insurers anyway. > Even better, you could purchase a policy through the Obamacare exchanges. I have no direct experience, would love to be wrong, but what I've heard is that even the top-tier plans are extremely limited in what they cover and where they are accepted so it's even worse than company-provided plans.
- beej71 5y ago
  I have the best insurance available in my area, and it stinks. What are my options?
reghtlkjlkj 5y ago
cal5k 5y ago
If you want an extreme example of how bad a single payer system can get, look at Canada. Not only do we have a single-payer system, we've actually banned private pay of any kind for "medically necessary" services. The net effect is predictable - Canada consistently ranks very poorly in international health system comparisons. We have far fewer ICU beds, doctors, imaging machines, etc. per capita than peer nations, and the entire country is in varying degrees of harsh lockdown because our hospitals were already overwhelmed during a normal flu season. What states should do is encourage more competition as a way to lower healthcare costs. Y'all actually have one of the best systems in the world, it's just way too expensive.
- aaomidi 5y ago
  > Y'all actually have one of the best systems in the world, Germany has more ICU beds than the US.
  - sokoloff 5y ago
    > Germany has more ICU beds than the US. That would be shocking if true, which it does not appear to be. Germany has around 32K ICU beds. US has around 96K ICU beds. Germany has slightly more per-capita than the US. (387 vs 294 per million inhabitants) https://en.wikipedia.org/wiki/List_of_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_countries_by_hospital_...
    - kirill5pol 5y ago
      To be fair per capita is the only relevant comparison.
    - pintxo 5y ago
      your "slightly" is a 30% difference ...
      - aaomidi 5y ago
        30%. which is the difference between hospitals shutting down vs hospitals being able to treat patients normally during times like this. Not sure what the original poster is talking about, but America's healthcare system is fucked. And it's not just fucked because it's expensive.

when has California's government recently shown any capability to successfully implement big projects or spend tax payer money efficiently? How is the high speed train project coming along?

cobrabyte 5y ago

This is my thought, as well. When your private insurance company stinks, you find a new insurer. When you're forced to pay the government for health insurance, you're stuck without options. Health insurance isn't one of the services that I trust the government to be able to run well. They don't have a particularly great track record where efficiency, customer service, and speed are concerned.

Drunk_Engineer 5y ago
In theory, single payer should offer more choices. With private insurance, you are stuck with certain doctors and hospitals, and can only change plans at years-end.
larkost 5y ago
Here is the breakdown from this article for 2020: https://www.census.gov/library/publications/2021/demo/p60-274.html https://www.census.gov/library/publications/2021/demo/p60-27... 8.6% are uninsured Of the insured: - 54.4% of the ensured on employer based insurance - 10.5% purchase theirs directly - the rest get theirs from one government program to the other (Medicare 18.4%, Medicaid 17.8%, TRICARE 2.8%, and VA and the like 0.9%) So your comment only covers less than 10.5% of people at the moment... a little more than the number of people who have no health coverage (a good portion not out of real choice). And that does not even cover how horribly this sort of market functions: you never know how good or bad your coverage actually is until you go to use it for a particular problem, and then you don't really know that until it is over and you are maybe bankrupt. Health insurance is the worst place to try and use market forces to regulate it... well maybe after military, fire, and police...
jjav 5y ago
> This is my thought, as well. When your private insurance company stinks, you find a new insurer. You can't, because the health insurance is provided by your employes so you get whatever they give you. My health insurance (blue shield) is absolutely terrible (right now I need some medicine they refuse to let me have because it cuts into their profit margins) but there's nothing I can do about it. And that's after paying $2500/month for the privilege.
- cobrabyte 5y ago
  Sorry to hear that. My experience with government insurance has been with Medicare, Medicaid, and the VA, and to say I've been unimpressed is an understatement. I guess I should be thankful my insurance is ~$1000/mo, and hasn't left me with the horror stories some seem to experience.
- jimbob45 5y ago
  >You can't, because the health insurance is provided by your employees so you get whatever they give you. That's not true, is it? You could decline coverage and then go purchase a policy of your own elsewhere. Yes, that might be expensive but the original claim was "Y'all actually have one of the best systems in the world, it's just way too expensive." and that still tracks. Even better, you could purchase a policy through the Obamacare exchanges. If the government offers you bad medical care, you turn to the black market or you fly to the US to get the procedure done because the government has banned alternative care. This is a very normal Conservative talking point and the inherent competition in US healthcare is arguably the biggest benefit of its current system.
  - jjav 5y ago
    > That's not true, is it? You could decline coverage and then go purchase a policy of your own elsewhere. What other choices exist, there's only a few giant insurers anyway. > Even better, you could purchase a policy through the Obamacare exchanges. I have no direct experience, would love to be wrong, but what I've heard is that even the top-tier plans are extremely limited in what they cover and where they are accepted so it's even worse than company-provided plans.
beej71 5y ago
I have the best insurance available in my area, and it stinks. What are my options?

reghtlkjlkj 5y ago

cal5k 5y ago

If you want an extreme example of how bad a single payer system can get, look at Canada. Not only do we have a single-payer system, we've actually banned private pay of any kind for "medically necessary" services. The net effect is predictable - Canada consistently ranks very poorly in international health system comparisons. We have far fewer ICU beds, doctors, imaging machines, etc. per capita than peer nations, and the entire country is in varying degrees of harsh lockdown because our hospitals were already overwhelmed during a normal flu season. What states should do is encourage more competition as a way to lower healthcare costs. Y'all actually have one of the best systems in the world, it's just way too expensive.

aaomidi 5y ago
> Y'all actually have one of the best systems in the world, Germany has more ICU beds than the US.
- sokoloff 5y ago
  > Germany has more ICU beds than the US. That would be shocking if true, which it does not appear to be. Germany has around 32K ICU beds. US has around 96K ICU beds. Germany has slightly more per-capita than the US. (387 vs 294 per million inhabitants) https://en.wikipedia.org/wiki/List_of_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_countries_by_hospital_...
  - kirill5pol 5y ago
    To be fair per capita is the only relevant comparison.
  - pintxo 5y ago
    your "slightly" is a 30% difference ...
    - aaomidi 5y ago
      30%. which is the difference between hospitals shutting down vs hospitals being able to treat patients normally during times like this. Not sure what the original poster is talking about, but America's healthcare system is fucked. And it's not just fucked because it's expensive.