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:
-
Doing Obama care half assed, when something like 80% people wanted a public option.
-
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,
-
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.
-
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.
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.
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.
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.
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.
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.
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.
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.
Funny thing: insurance companies donate to both parties ;).
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
Can you imagine the influx of people to those states?
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
It uh… actually doesn’t.
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.
deleted by creator
It’s honestly insane how expensive all this shit is.
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?
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.
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.
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.
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?
Your problem are the big healthcare companies that make absurd amounts of money of patients. Here in Germany we have many health care programs and MidiCare and I believe the state looks. The prices of medicine and treatment aren’tOver the top, inflated. Just look at the prices of some medicine In the states to the rest of the world.
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 was getting 450/week 10 years ago. It’s pretty crazy they haven’t raised it.
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
NYC has a very viable option in MetroPlus, the city healthcare option for Medicade
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.
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?
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?
