The LA Times reports that a state-level single payer health insurance system is being pitched for the state of California:
With President Trump now vowing to put forward a replacement for the Affordable Care Act in March, some California politicians and healthcare advocates are once again promoting the idea of a state-run “single-payer†system that operates like Medicare.
Backers say the uncertainty surrounding Trump’s promise to repeal Obamacare presents California with a chance to rethink how healthcare is delivered to its 39 million residents.
“Why wouldn’t we take this as an opportunity to create what we want in California?†Dr. Mitch Katz, head of L.A. County’s health department, said at a conference in December. He mentioned a single-payer system as a possible solution.
Maybe we should start a pool. When will California adopt its own single-payer system?
I also wonder what the actuarial assumptions would be for the viability of such a system.
If it were a separate country, California has the fifth largest economy in the world and a population that’s larger than Canada. If anyone can do it California can. However, I think the sticker shock will be severe.
California has a significant population of people with wonderful ideas. Its population of people who are willing to pay for the wonderful ideas is substantially smaller.
True, but they could always do what your state does and make a state constitutional requirement….
In a comment thread long ago, I had suggested that state-led health care reform was the way to go (that’s how Canada got to single payer).
I think there is justified skepticism, it would require someone who is politically ambitious, but have no federal ambitions, and strong one party control. California was a candidate, only with the right governor. I thought that could be Newsom if he wins in 2018 — but perhaps Jerry Brown can do it. I think the biggest challenge is Jerry Brown is a lame duck and if can push the legislators to roll the dice.
My home state of Colorado voted on this last year and it was decisively defeated. It didn’t have any mainstream support, however, not even among Democrats.
Until there are credible people who can talk about money, health, and fairness at the same time, we’re stuck with Obamacare. Nobody in their right mind who has experience with the American health care system would volunteer for a healthy combo of deregulation plus an HSA.
Watching the GOP flail should be a lesson to the Democrats. They wrote a law that is only wanted when it is about to revoked. And they built their idiot opposition into rivals.
Then I wonder why we voted to raise our own taxes in 2012 and extended it last year?
I call for a nationwide referendum on Calexit. We’d vote for it. And the Trumpanzees would vote for it, though I imagine New York and New England would be sad. Let’s do a Free State of the West: California, Oregon, Washington, Nevada and Hawaii. That’s about 3.5 trillion in GSP, which would make us about the same as Germany (using nominal GDP.)
You people could wallow in your nativism and racism and gloomy paranoias and superstitious bigotries, we could keep going forward. It would be a win/win.
“Annual income twenty pounds, annual expenditure nineteen [pounds] nineteen [shillings] and six [pence], result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery.”
California’s public debt is rising faster than its public income (the debt is about ten times larger than the $40 billion or so usually cited by state officials).
Michael,
There’s something I don’t understand. Last year you argued several times that the notion (and I’m working from memory here) of state an local government and authority was an anachronism. Now you are arguing the opposite. What’s changed besides Trump?
Calexit will go nowhere and, despite it’s relative wealth, California can’t afford it. Besides, the issue of secession has already been settled.
Andy:
That was before 46% of the American people lost their damned minds. I quite dislike getting shots, too, but if there’s an epidemic I’ll be right there in line.
Of course Calexit won’t go anywhere, but it’s absurd to say we couldn’t manage it. What exactly is the rest of the country giving us that we need? If we’re playing alternate history let’s bring some imagination to it. We could repudiate our share of the federal debt and ladida into the sunset. Just for starters. And I don’t recall California having any foreign entanglements or international commitments. And you think only the Chinese can artificially undervalue their currency? I’m going with the California Miguel. No reason, just seems like a nice name for a currency.
Michael,
As noted in a comment a week or so ago, it’s only about 19%, not 46%.
With enough sacrifice, and with no other option, I’m sure the people of California could manage it…but that would result in a much different California than you enjoy today.
“I also wonder what the actuarial assumptions would be for the viability of such a system.”
Faulty, given those for the Pension system. Maybe California should secede, what with it being so financially sound and all.
http://www.zerohedge.com/news/2017-03-01/calpers-threatens-slash-pension-benefits-63-some-unfortunate-east-san-gabriel-califo
Guarneri:
Zero Hedge, of course. What, nothing available on Infowars?
Is it a requirement now that Trumpanzees feed on nothing but Russian bananas? At least try the WSJ. Do you need a subscription?
https://en.wikipedia.org/wiki/Zero_Hedge