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.
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.
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.
In the same way that the USPS operates at a loss
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
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.
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.
Lol, California unemployment is capped at 450/week. No chance we can afford universal medicare
I was getting 450/week 10 years ago. It’s pretty crazy they haven’t raised it.
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.
California had a bill like that pass the legislature in 2022, and Governor Newsom
vetoedsomehow stopped it from making anything happen. 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/
solri
New York State Medicaid is basically that, if you make under $28,000 a year or something like that. I was on it for a while. It’s good. everything is free.
The only problem is that not every provider accepts it. But most in the city do.
Yeah I think every states Medicaid is similar. It’s partly funded by the feds but only covers the lowest incomes
You need to figure out how to include all those of us paying into expensive private healthcare - including employer contributions
I hate those arbitrary cut offs for aid. Oops, you got a raise and now make $28,100 sorry no more medicare. It locks people into low paying jobs because if they make too much, they instantly loose all the benefits that their little raise doesn’t match.
if we’re not going to do free-for-all, it should at least be on a very large scale,
make less then 28k = 100% covered,
29, 99% covered
30, 98% covered
…
All the way up to when 128k = 0% covered
(You’d have fix healthcare prices too, procedures/medicines are priced so insurance looks like they are doing you a favor “you only had to pay $700 for this $25,000 procedure and the $600 follow up medicine will only cost you $100 a week”)
Agreed. All cut-offs for everything should have a ramp-down rather than full to zero. Lose $1 of benefit for every $X above the threshold. You should never be worse off for making a few bucks more.
There is something of a welfare cliff for medicaid, but aren’t there also means tested subsidies/discounts on the health insurance market for when you make more than that but are still poor?
Yes, but didn’t red states reject that?
They rejected expanded access to medicaid, but afaik the health insurance marketplace system established by the ACA is still accessible.
Same with Washington and I think Oregon too. They call it by different names.
Washington’s Apple Health is great. Easy and accessible. The state could definitely expand that to everyone.
Support Whole Washington! That’s basically exactly what they are trying to do. I try to volunteer anytime I can.
Are they closer to a public option than NY? NY really isn’t a public option.
No, it’s similar to NY. You have to be at a certain income level. Washington State is a rich state of billionaires and millionaires with Costco, Microsoft, Amazon, Boeing, etc that have headquarters here or are a major presence, but they don’t pay their fair share of taxes. That’s one of the biggest problems.
It’s “basically that.” But it’s not “actually that.”
A public option would provide necessary health care at zero cost. Without regard to your income. Without regard to your job.
This creates a situation, where if you earn a little bit more, you get “taxed” a lot. And quite frankly, sometimes it’s better to earn less and get healthcare than to earn more and lose it.
Also, I’m under the impression, and could be wrong about this, but I believe NYC gets the funding for the NYC state of health from the federal government. So it can be held as ransom, by bullies like Adams or Trump.
I’m suggesting that NYC should do an actual public option not using federal money. Instead binding together with other states to increase leverage and lower costs.
The people overall want it, but the r’s shut that shit down any chance they can. Take a look at Canada if you want to see the far rights trying to take down their public option. Right now, the administration is trying to take away Social Security and Medicaid.
But Democrats have majorities in California and NYC and other blue states. The republicans aren’t necessary for this to happen. I think?
Yeah Dems say they want this stuff on TV, but when push comes to shove, they do whatever they can to prevent it from actually passing. Case in point was the ACA where they bailed on the single payer option in order to maintain the private insurance scheme with a plan written by Mitt Romney. They claimed they did this to “reach across the aisle” and gain Republican support but they had a super majority and didn’t need Republican support. Zero Republicans voted to support this plan.
Yep. And even tho Lemmy gets mad at people who point this out, you are 100 percent right.
Funny thing: insurance companies donate to both parties ;).
I know in Washington State, everyone thinks it’s a blue state. Yes, we vote blue overall, but the actual politicians lean right as they cater to the oligarchs that have set up shop here. The oligarchs don’t pay their fair share in taxes.
Our governor, which I held my nose to vote for btw, is a POS. He’s a republican in democrat clothes. Every state has a different political climate.
The oligarchs basically act like mob bosses. That’s why Boeing left for Chicago, they didn’t like that there were so many unions and regulations here. The workers would never have stood for the shit that passed through inspection because they had decades of experience. As soon as they separated the white collars from the blue collars, you could see the disasters coming. It actually took a bit longer than I personally expected.
What I’m saying is, it’s complicated. The greeds run everything, not sure how to fix it.
I’m certain that none of this is correct
Funny story, if it cuts off at a certain income level, it’s not for all.
I can’t imagine making a survivable go of it in New York for 28k/year.
This is probably a red vs blue thing too. There are plenty of rural conservative parts of NY with much lower cost of living than NYC
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
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’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 restaurantsThat 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.
California and New York have GDP’s above most other countries in the world.
But Cali and New York do not reap the tax revenue of a country with the GDP of their size; they can only reap part of it, both because Federal taxes remove a portion of that taxable income, and because states are necessarily more limited in their options for taxation than national governments.
It’s possible, don’t get me wrong, but significantly more difficult.
Tell me why I shouldn’t blame the democrats for:
Doing Obama care half assed, when something like 80% people wanted a public option.
Bruh, do you not remember how Obamacare was passed?
But Cali and New York do not reap the tax revenue of a country with the GDP of their size; they can only reap part of it, both because Federal taxes remove a portion of that taxable income
I’d love to see people like Newsome, Kotek, Ferguson, and Hochul grow some balls and start co-opting Trumps rhetoric on these trade deficits but with federal taxes instead. Currently most blue states pay more to the federal government than they receive and those dollars that they do receive are just returning the very tax revenue they sent out but with Trump’s ridiculous conditions tacked on. He currently has his base of useful idiots talking about how uninhibited islands like the Mcdonald Islands are “ripping us off” so they should strike while the iron is hot and threaten to seize federal tax revenue generated from the workers and industries in their respective states just the same. If Trump is going to gut every federal office and program that actually impacts people’s lives, what are we even sending them money for?
As far as the first part of your response: Hmm, that’s interesting.
As far as the, “Bruh, do you not remember…”
Yes, I remember how Obamacare was passed.
Do you you remember how it seemed like a public option should pass- it had a ton of support- people were rallying behind it.
And then DroopyDog Senator Lieberman had that touted “meeting with Obama” and the public option was scuttled.
From the moment that happened, I thought, “Lieberman’s the fall guy. The democrats don’t want the public option, and Obama isn’t any different from everyone else before him.” (think Flint, think Guantanamo, think Bank bailouts, think Bank Bailouts again). If Obama had wanted it, he could have done it. I mean, look at Trump. He didn’t.
At the time I was furious with Lieberman and Obama- now, just Obama.
https://www.latimes.com/archives/la-xpm-2009-dec-15-la-naw-health-senate16-2009dec16-story.html
If Obama had wanted it, he could have done it.
Lord.
Yeah.
I also think he could have closed Guantanamo.
And I even think he could have bailed out the people that lost their houses and not the people that owned (banks, through predatory loans) the houses.
I still think he should have nationalized the banks that failed and renamed them to “Bank A” and “Bank B.” But no, no consequences for the rich under Obama just like everyone else.
Crazy huh.
I also think he could have closed Guantanamo.
Apparently you don’t remember how that went either.
And I even think he could have bailed out the people that lost their houses and not the people that owned the houses.
Oh, sure, just pass an executive order for it, right?
I still think he should have nationalized the banks that failed and renamed them to “Bank A” and “Bank B.”
Jesus Christ man.
Crazy huh.
In desire, no; in perceptions of what the president has the power to do, yes.
I see a lot of refutation, but if the year has taught us anything it’s that the rules of the game are about as rigidly enforced as the rules of monopoly. Every single politician in my life could have chosen to just ignore the rules for the benefit of the people, instead the first one that does is the one that’s out to hurt us.
Obama won in a landslide. The democrats owned both houses.
People at the time really thought Obama would be on the the side of the people- not the rich. I mean, come on, he was our first black president; you would have thought he would at least be on the side of the blacks.
If he had been, then Bernie wouldn’t have been such a sensation. If he had been, and Hillary was like, “Obama and the DNC has anointed me his successor, and I will continue to do all the great things he has done,” Bernie wouldn’t have existed. Bernie was the message that Obama had actually failed. Flint was real.
Anyway. If Trump has one Lieberman senator stopping him from getting some signature item, you can bet that their meeting isn’t going to end with that signature item being scuttled, it’s going to be that Lieberman would be afraid he’ll lose everything.
Trump is extreme, but Obama could have made the final push. Same with our black torture rendition site.
For me, seeing Obama is cringe. I wonder if that viewpoint is radical. I mean, Obama is a saint when compared to Trump, but…
Perhaps I am unjustified.
If you mean just rely on state-level taxation, it’d create a incentive to work in (low tax) states that didn’t provide state-subsidized health care, then retire in a state that does.
You want any kind of intergenerational wealth transfer to happen at the federal level, else you will tend to get those misincentives.
You need healthcare for all your life, not just when retiring. Why wouldn’t you want to live and work in the state with healthcare if it actually works out cheaper for you and less risky? It’s a completely false economy to live in the other state with no healthcare but have to pay high insurance rates and have high deductibles?
The elderly have much higher per-capita healthcare consumption than do people during other points in their life.
One element of the ACA was capping insurance premiums for seniors at an 3:1 ratio, where seniors couldn’t be charged more than 3 times the premiums of people at other ages in life.
Damn, they should do this to CEO:Employee compensation too
The elderly population has greater healthcare spending per cap than the 20-30 year old population. Getting old sucks.
Maybe that could be a plus. Make a large death tax. People die off in your state, and fund the next set of people coming and and more?
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.
Mostly because we’re stuck supporting the red states that suck at the Federal titty.
They can. Cali at least has a partial plan.
Hell even a city could.
Hawaii already does.
I’m looking for a public-option health care in Hawaii. Haven’t found yet. Do you have a link? If I find I’ll post a link
Ok, I went to that page, and took the “are you eligible test” putting in a few different sets of numbers. This is definitely not a public option.
edit -> Thanks for the link!
It’s for low income. As I said in another comment in this thread, rich state but people don’t pay their fair share of taxes.
Because they don’t want to.
Full stop.
Why not half stop? Or double stop?
Correct answer.
