I want to know why I’m wrong- because this question has been eating at me for years- and I secretly blame the Democrats for all of the health insurance problems.
Why can’t California and New York bind together in an interstate compact, and create medicare for all of their citizens?
California and New York have GDP’s above most other countries in the world. In general, democrats hold majorities. Tell me why I shouldn’t blame the democrats for:
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Doing Obama care half assed, when something like 80% people wanted a public option.
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Not just doing it themselves. For instance even NYC by itself has a GDP above Denmark, and NYC is filled to the brim with the super rich.
A few reasons:
- States are not currency sovereigns in that they do not create and control their own currency. All the money the state uses come from revenues they collect in taxes, fees, sales, etc. This is not the case for a national government, which creates all the money it needs for whatever it wants to spend money on. This gives the national government a lot more spending power than any state could possibly have, regardless of the state’s GDP.
More importantly, though,
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All states except Vermont have statutory or (state) constitutional requirements to have a balanced budget every year. This means they cannot run a budget surplus or deficit. Any surplus has to be spent or returned to taxpayers and any deficit needs to be resolved that year. This makes it incredibly difficult to run large programs like a M4A over time. When the state runs into a budget shortfall, the M4A system would be the first on the chopping block.
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Insurance companies fight HARD against anything that hurts their business. This is specifically why Obamacare (the ACA) didn’t include a public option despite Obama campaigning hard for a public option in the 2008 election. Insurance companies got their stooges in the Democratic Party to kill the public option when the ACA debates were going through Congress. They do the same in states when states try to do something about the healthcare industry. And if insurance companies publicly talk about a proposed bill causing them to raise rates or pull out of a market, that’s a huge political stick to swing.
It may sound unbelievable, but I got the closest to MC4A after moving to a deeply red state. I thank the coop that was able to hook it up with it! But the type of coverage I have currently should be available to everyone without the need for a lucky expert.
Can you imagine the influx of people to those states?
Short answer : Neoliberals
Longer answer : the Democratic Party apparatus in both those states is FULLY controlled by the 1980s-Republican-Party-esque wing… and they have ZERO interested in anything economically meaningful. Their role is to act as a backstop against “the left.”
The best you’ll get from Nancy “let me grab some more gelato from my 2nd dedicated Sub-Zero brand freezer” Pelosi and Gavin “I want to do more podcasts with Steve Bannon” Newsom is kneeling in Kente Cloth and military weapon contracts covered with 🏳️🌈 decals.
This is literally why I rename “centrist” Democrats to Republicrats.
The federal government can print its own money and therefore can pay for its debt with modest and predictable increases in inflation. The states cannot.
Does this imply that a state funded health insurance for all will operate at a net loss?
The state isn’t a business. Services don’t lose money, they cost money.
Instead of paying your insurance and having them take a profit out of it before providing the service, you pay taxes and the money goes more directly into the service.
Yes, of course. Health care generates revenue for health care providers, not the state. For the state it’s just another expense on the balance sheet.
The problem with universal health care is that 70% of expenses go to treat 10% of the population. These are often very sick people near the ends of their lives. Frequently the money doesn’t appreciably improve their health or well-being, it merely provides many expensive (and often painful) treatments that extend their lives.
This is the really ugly side of health care that we don’t like to think about because it involves difficult discussions about quality of life and death. We would much rather not think about these things and instead throw more money at the problem. Unfortunately, medical technology has advanced a lot in these areas and so there is an ever-growing array of treatment options to extend life without restoring quality of life.
They’re called taxes, look it up
In the same way that the USPS operates at a loss
The political will within those states isn’t there. The two states have very large socially liberal rich populations which are a large part of Democrat support in the states. A lot of poor districts in those states are Republican, which will fight a state based Medicaid for all program tooth and nail.
I don’t know about New York, but California calculated that they can’t afford it on their own and need federal funding. Problem is, the politicians at federal level is beholden to for-profit medical sector.
I’m very interested in reading about this. But not much comes up when I search. What did California find out?
It has been years since I have read about it. I can’t find it now either. However, my search did mention that having single payer healthcare will cost California $500 billion annually, double the state’s entire annual budget as of 2024. https://www.wordandbrown.com/NewsPost/Single-Payer-2024
For now, California has been subsidising healthcare costs through existing programmes.
California’s annual budget is $60 per person? Healthcare would cost $125 per year? What are these numbers?
Lol, California unemployment is capped at 450/week. No chance we can afford universal medicare
You should look up what benefits were set at in the '70s. California has absolutely slashed the amount they are willing to spend on community welfare.
I mean cali is about double NY but add in a few other blue states like illinois, washington, new jersey, massachusetts, and colorado and you will have more than doubled cali. and even though other blue states may not be as big any additions help make for a more robust pool. The big problem is people going to red states while young and healthy and then going to blue states if they get ill.
At a glance, looks like it would cover anyone working 20 hrs/wk in MA
They can. The issue is people want everything to be federal and ignore their own state. Most Americans can’t even tell you what the first article of their own state’s constitution is about. Or their own state house rep.
Because for all the big talk and anti-rich/anti-corporate talk that many Dem politicians preach–they aren’t really willing to do anything other than talk about it in order to get votes.
Republicans aren’t out to help you. Democrats aren’t either. And most of Lemmy is too busy playing PokemonGO, to actually do anything close to a revolution that would change anything. They’ll talk about it, upvote it, but they won’t actually do it. lol
When a criticism is actually an admission. Well done, Donald.
Not sure what you mean. Can you explain?
Mostly because we’re stuck supporting the red states that suck at the Federal titty.
California had a bill like that pass the legislature in 2022, and Governor Newsom vetoed it. I don’t remember the details but he basically didn’t want to upset the insurance industry, which I would have thought was the whole point of such a bill. He later backed some kind of watered-down bill which as far as I know did nothing.
https://calmatters.org/commentary/2023/10/newsom-resurrect-single-payer-health-care/
ITT: people who don’t understand that Medicaid is not Medicare, and that means-testing means a service isn’t “for all.”
Editing to add: Medicaid is funded mostly by the federal government, 69% vs 31% funding from the state. So even if it wasn’t means-tested (one has to have an income below a certain amount, or be disabled to a certain degree before qualifying) it would not meet OP’s definition, a single payer health insurance system funded by the state.
To answer OP’s question, a state funded single payer health insurance program would likely run afoul of the Commerce Clause of the constitution which states the federal government has jurisdiction over interstate commerce. UHC, Aetna, and other nation-wide insurance companies would absolutely sue over the state programs interfering with their right to conduct interstate commerce, and they would almost certainly win, even without a hard right SCOTUS like the current one.
Also, people who are just going, “eh, fuck the commerce clause, the states should just do their own thing!” totally forgetting the absolute shitshow this would unleash, both from private companies and conservative states.
Yeah but we’re clearly no longer using the Constitution
Yeah, look at any number of things (including Medicaid implementation) that have been left up to the states and what a complete dumpster fire they are.
The conservatives justices (if you buy into the whole conservative/liberal justices thing) would 100% be eager to up hold a state healthcare law if it meant getting to strike down Wickard v. Filburn and allocating more power to the states.
But thanks for being at least one person in this thread who appreciates that Medicare and Medicaid are not synonyms.
That was then, this is now. The Nazis don’t respect the law, nor court decisions, and do whatever the fuck they want. The law no longer exists, and states can do anything they want. If the serial killing insurance companies want to sue over interstate commerce, then the states can simply prohibit them from doing business in the state - problem solved.
Besides, who cares if they sue? Ignore them, ignore the decisions (unless its a win), and do what serves the PEOPLE, not the corporations. Then raise the state corprate taxes to 100% of revenues.
Fuck the corporations, fuck the Sociopathic Oligarchs who own them, and any MAGA Nazi traitor that supports them. They are the enemy, and we have no obligation to do anything that serves their interests in the slightest way.
that’s crazy, it in no way affects interstate commerce to provide a service for free…
affecting interstate commerce would be something like having racially segregated restaurants
Because they don’t want to.
Full stop.
Why not half stop? Or double stop?
Correct answer.
