California’s cap on health care costs is the nation’s strongest. But will patients notice?

[Greenbeard]

The approach pioneered in Massachusetts over the past decade or so has been slowly spreading to more states, and now California takes it the furthest of any state yet. Will it work for them? TBD, but the article is a good look at what they're doing and why.

California’s cap on health care costs is the nation’s strongest. But will patients notice?

California is moving to address their needs with a new cap on health care cost increases that experts consider to be the most aggressive in the nation. The cap does not mean that bills that patients such as Villegas and Rodrigeuz-Hernandez are charged would go down. It aims to limit how much consumers pay over time by first constraining how much the health care industry spends. Research suggests up to 30% of health spending is wasted on overtreatment and administrative inefficiencies.

By 2029, California hospitals, doctors and insurers cannot increase spending by more than 3% annually. This means they will need to find ways to cut costs to keep from exceeding the target. If they do exceed it, state regulators with the Office of Health Care Affordability have the authority to levy fines and other penalties “commensurate with the failure of the health care entity to meet the target,” according to state law. The law also has guardrails preventing health care entities from saving money by reducing services.

The cap, which was set in April, is modeled on the work of eight other states, including Massachusetts, that have tried to curtail runaway health spending. California went further by allowing the state to compel public testimony from health care facilities, require performance improvement plans and impose unlimited financial penalties on businesses that exceed the cost cap.

Related, on the experience of other states:

In States With Health Care Spending Targets, Spending Growth Moderated In 2022 But Still Exceeded Targets

 

[dmpi]

If no one notices then that's a good thing. A bad thing would be if medical providers decided to leave the state of CA and focus on more profitable states.

 

[tshade]

The approach pioneered in Massachusetts over the past decade or so has been slowly spreading to more states, and now California takes it the furthest of any state yet. Will it work for them? TBD, but the article is a good look at what they're doing and why.

California’s cap on health care costs is the nation’s strongest. But will patients notice?


Related, on the experience of other states:

In States With Health Care Spending Targets, Spending Growth Moderated In 2022 But Still Exceeded Targets

History shows that voters have extremely short memories.

 

[aociswundumho]

The affordability office also has authority to enforce penalties, including performance improvement plans and fines, for organizations that exceed the benchmark. It will not enforce penalties until 2029.

They won't even do it then. The fines are just a cost of business that will be passed on to consumers, resulting in higher prices. Or they can fine the "healthcare entity" out of business, which means a decrease of supply, and - you guessed it - higher prices for consumers. There's no fixing healthcare in the US. It is politically impossible.

The law also has guardrails preventing health care entities from saving money by reducing services.

lol, good luck with that.

The cap, which was set in April, is modeled on the work of eight other states, including Massachusetts, that have tried to curtail runaway health spending.

I believe nearly all of those states went over the caps.

Price controls are coming. They are the next step in the political left's playbook of failure.

 

[Peter]

If no one notices then that's a good thing. A bad thing would be if medical providers decided to leave the state of CA and focus on more profitable states.

Do you think medical companies refuse to work in Europe because it has socialised healthcare with spending limits?

 

[Noodlegawd]

The approach pioneered in Massachusetts over the past decade or so has been slowly spreading to more states, and now California takes it the furthest of any state yet. Will it work for them? TBD, but the article is a good look at what they're doing and why.

California’s cap on health care costs is the nation’s strongest. But will patients notice?


Related, on the experience of other states:

In States With Health Care Spending Targets, Spending Growth Moderated In 2022 But Still Exceeded Targets

After paying around eight grand for my daughter to get 5 stitches at the ER, I'm at a loss to notice anything.

 

[Phys251]

After paying around eight grand for my daughter to get 5 stitches at the ER, I'm at a loss to notice anything.

Sounds like the for-profit healthcare industry is working well for you. /s

 

[Noodlegawd]

Sounds like the for-profit healthcare industry is working well for you. /s

Strange that a state overwhelmingly under the control of Democrats, and the 5th largest economy in the world, hasn't fixed it yet.

 

[Peter]

After paying around eight grand for my daughter to get 5 stitches at the ER, I'm at a loss to notice anything.

Did they use unobtanium for the stitches?

 

[Phys251]

Strange that a state overwhelmingly under the control of Democrats, and the 5th largest economy in the world, hasn't fixed it yet.

And the for-profit health industry.

 

[Noodlegawd]

And the for-profit health industry.

I think there's an echo in here.

 

[Phys251]

I think there's an echo in here.

Yes, from your failing to recognize the big picture.

 

[Noodlegawd]

Yes, from your failing to recognize the big picture.

The big picture is that the cost of healthcare in CA is insane, because the government of CA hasn't done anything about. If that's because the Dems running CA are taking bribes from the for-profit health industry, it wouldn't surprise me in the least.

 

[Phys251]

The big picture is that the cost of healthcare in CA is insane, because the government of CA hasn't done anything about. If that's because the Dems running CA are taking bribes from the for-profit health industry, it wouldn't surprise me in the least.

The Most (And Least) Expensive States For Healthcare 2024

If you've ever felt the pinch of healthcare expenses, you're not alone. Unexpected medical bills and the cost of healthcare services are the top two financial worries for Americans this year, according to a recent KFF health tracking poll. The poll found that 45% of adults are very worried about bei

www.forbes.com

Your information is wrong. Many other states have much more expensive healthcare than California.

 

[Noodlegawd]

The Most (And Least) Expensive States For Healthcare 2024

If you've ever felt the pinch of healthcare expenses, you're not alone. Unexpected medical bills and the cost of healthcare services are the top two financial worries for Americans this year, according to a recent KFF health tracking poll. The poll found that 45% of adults are very worried about bei

www.forbes.com

Your information is wrong. Many other states have much more expensive healthcare than California.

The information in your link has exactly zero to do with my comments in this thread.

 

[Phys251]

The information in your link has exactly zero to do with my comments in this thread.

Facts don't matter to you. Got it.

 

[Noodlegawd]

Facts don't matter to you. Got it.

"Apples grow on trees" is a fact. That doesn't make it relevant to my comments.

 

[Greenbeard]

Strange that a state overwhelmingly under the control of Democrats, and the 5th largest economy in the world, hasn't fixed it yet.

What would "fixing it" look like? No out-of-pocket liability for an ED visit?

 

[Noodlegawd]

What would "fixing it" look like? No out-of-pocket liability for an ED visit?

How about universal single-payer healthcare? That's what Democrats want, isn't it?

 

[Greenbeard]

How about universal single-payer healthcare? That's what Democrats want, isn't it?

Some do. But that doesn't necessarily mean you would not have any liability when you go to an emergency department, Medicare patients certainly have copays, coinsurance, and deductibles to pay for after an ED visit.

Emergency department services

In emergency, get emergency room services coverage as part of your health insurance. Cover costs at Medicare.gov for sudden illness & injury.

www.medicare.gov

 

[Peter]

Some do. But that doesn't necessarily mean you would not have any liability when you go to an emergency department, Medicare patients certainly have copays, coinsurance, and deductibles to pay for after an ED visit.

Emergency department services

In emergency, get emergency room services coverage as part of your health insurance. Cover costs at Medicare.gov for sudden illness & injury.

www.medicare.gov

That's not how single payer should work.
In Europe treatment is free at the point of service.
I don't get a bill after I go to the hospital or visit the doctor.

 

[ALiberalModerate]

After paying around eight grand for my daughter to get 5 stitches at the ER, I'm at a loss to notice anything.

You are lucky. It isn’t unheard of in many markets to be over 20k for that.

 

[Mr Person]

After paying around eight grand for my daughter to get 5 stitches at the ER, I'm at a loss to notice anything.

You paid an amount you don't like, therefore the cap isn't doing anything? And to think you were trying to lecture someone else on relevance... derp...

 

[Peter]

You paid an amount you don't like, therefore the cap isn't doing anything? And to think you were trying to lecture someone else on relevance... derp...

That much money for 5 stitches is pure insanity unless the procedure was done in space by Goerge Clooney (as his old ER character) and using platinum thread.

There's no way the actual cost was anywhere even close to that.

 

[Mr Person]

That much money for 5 stitches is pure insanity unless the procedure was done in space by Goerge Clooney (as his old ER character) and using platinum thread.

There's no way the actual cost was anywhere even close to that.

I hear you. It's just that when I find a fatal flaw in someone's post, I usually don't bother with any further flaws. A dead argument can't get any more dead.