Here’s your question for today. At the end of 2019 will any state have its own single-payer system? I say “No”. Hawaii is the best candidate for such a system and it backed off from the system its legislature passed a decade ago.
Also, I think that politicians would rather run on a national single-payer system, e.g. “Medicare for All”, than have a couple of state single-payer systems that people are watching for signs of success (or failure!). Consequently, any state’s plans will receive only lukewarm support from the national Democratic Party.
Can’t stabilize such a health system with constitutional requirements to run balanced budgets. Got to have your own currency. That’s why the Federal government is the only thing keeping private health care from blowing itself apart.
You can’t stabilize such a health system without a commitment to cost control which means saying “No” to some people for some care. The moment one of those to whom “No” is said is the member of a minority or a woman there will be accusations of racism or sexism which politicians will not be willing to accept.
The Robert Wood Johnson Foundation reports blacks and latinos encounter significantly higher barriers to obtaining health care, and I don’t see any outcry over it at all, either in media or among politicians.
“barriers”
Do they make it a priority? Are they proactive about their own health?
A very Black man I know has started himself a two truck trucking business. Hires drivers, then works evenings at UPS for the health insurance. Easy? Nope.
While I agree no state will implement a single payer system, the opportunity to posture, preen and find work for campaign workers exists and will soak dollars that could used for say increased social disease treatment.
Sexism the charge politicians want to dodge. Imagine the outrage when moribund stage IV breast cancer patient is told by the state only palliative care will be paid for. Cries of racism seem to come up as included grievance compared to aggressive policing.
No state will do this. Too easy to cross state borders. Lets go out on the limb even further and predict that no state will adopt a market based health care system that will attempt to cover everyone in their state.
” Imagine the outrage when moribund stage IV breast cancer patient is told by the state only palliative care will be paid for”
We already tell Medicare patients that all of the time. I missed the big outrage. What was it like?
Steve
“A very Black man I know has started himself a two truck trucking business. Hires drivers, then works evenings at UPS for the health insurance. Easy? Nope.”
What does the above statement have to do with obtaining health care? And just what is a ‘very Black’ man? Does your ‘very Black’ man have health insurance? Are you saying he works two jobs to pay for it? Or that he works so many hours he doesn’t have time to go to the doctor? Are you saying that most black people don’t go?
Because all I see is your racist remark.
Uhh, I think he is saying that even though he has his own company, he works at UPS so he can have health care coverage.
“Do they make it a priority? Are they proactive about their own health?”
“I am a Black. Hath not a Black eyes? Hath not a black hands, organs, dimensions, senses, affections, passions; fed with the same food, hurt with the same weapons, subject to the same diseases, healed by the same means, warmed and cooled by the same winter and summer as a Christian is? If you prick us, do we not bleed?”
Steve
The fear of patients jurisdiction shopping can be mitigated by residency requirements. Canadian provinces require 6 months of residency before providing coverage.
Watch California — Gov Newsom is young, ambitious but is too “California” for national politics. The state is safely democratic. That’s the best political mix for an ambitious single payer program at the state level I can imagine.
I say again, in Canada it started at the provincial level — I think it shows it is a viable path politically given similar federal systems, similar issues with regional differences, etc.
Mary:
Sharp of you to see right through conservatism to the underlying racism that’s always there.
Despite superficial similarities Canada has much stronger social cohesion than we do. As an example, Canada’s immigration restrictions are considered absolutely outrageous and racist by some in the U. S. Canadians see them as completely reasonable protections for Canadians.
Canada had other advantages over the U. S. in setting up their health care system: they had two excellent examples of what not to do in the U. S. and Britain.
None of course – no state can afford to pay the bill. Every time the electorate has had a chance to see what the actual costs would be, they’ve voted it down.