this post was submitted on 08 Nov 2023
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No one has said that states can't pass laws about healthcare. Obviously states can run their healthcare, that's within state jurisdiction.
What you are either not understanding or refusing to grasp is that there are gigantic hurdles with being the only universal healthcare provider in a country where everything else is privatized. (Just think about integrating medicare into that.) Simple hypotheticals though: I live in Oregon, don't pay insurance and am diagnosed with a long term cancer, the bill for which would be in the millions. Why don't I just move somewhere cheap in California and let the system handle it?
Universal healthcare works for the same reason insurance works, the healthy subsidize the sick. But, if you have a system that incentivizes the expensively sick to come, you are begging for trouble.
That's not to say anything of the nightmare of either state-lizing the hospitals, which are currently privately owned and usually part of large networks. The doctors are also employed privately. So you either take them over or need to train an entire new crop. You also have just created an entire new system for a single state that somehow needs to integrate with the framework that serves the other 88% of the population. You also worry about your best doctors fleeing for better paying opportunities (unless you think the public sector will in this one instance, and contrary to everywhere else in the world, offer the same wages) etc.
Ahhhhh, I get it. You're not dumb, just young. Unsure how old you were in 2008, but had you been old enough to be paying attention, the Democrats ran on this goddamn promise in 2008 and were stymied by Republicans, leading to Obamacare.
As you get older, you will learn that things are actually pretty complex. It's worth learning about how systems work so that when you advocate change, it's not just stupid slogans and silly examples that again, are like saying "why don't these idiots just sprint all the time."
You're arguing all the same tired points that the Republicans do against public healthcare and using condescension as a crutch. The countries surrounding the US all have public or mixed healthcare as well as all the other G20 nations. You of course know that a US state can verify whether someone is a resident, as they already do, but the more wrong you are the more you have to rely on being disingenuous and condescending.
No one said they couldn't. Again, a really basic question, what's to stop cancer ridden folks who can't afford treatnent from moving (and thus becoming residents) to California?
And yes, thankfully my country has public healthcare. Which is why I understand the issues with having a public system intermingled with a private one. (Hint, it doesn't work)
It works in that you have healthcare and aren't broke because of things beyond your control. The places where it doesn't work are due to underfunding and inefficiencies. You don't recommend voting for people who want to fix this though, you want to vote for people who impose tax schemes that basically soften certain people from the exploitation inherent in the system.
"What's to stop people from the bad place moving to my good place" is a disgusting way to think about people. Obviously "cancer ridden folks" and their families contribute to society. If you believe in the tenants of socialism you would love for sick people needing care to move to and contribute to a better society that cares about them, that's the whole point. I'm glad you revealed your way of thinking about this in such a blunt and dehumanizing way.
So, that's an "I don't actually have an answer to this very basic problem" then.
People should be treated for all their issues, that's why I'm in favour of universal healthcare. But there is no way California can simply be the "come here if you need free expensive medical treatment" place for all of America.
Reality is important. While reality can be blunt, it is important to acknowledge it. It's just a very simple example of why one state cannot on its own go ahead with universal healthcare, despite it being a lofty and nice thing to have happen. Because then universal healtchare in California turns into no healthcare in California.
There are two choices, demand nonsense that doesn't work and never improve anything OR to be realistic and think how to actually improve things. I know which I'd prefer.
That's why nobody is saying this, obviously being a resident implies you live and pay taxes and contribute to the pool, and are likely generating income for someone else who's being taxed on it, and have families who will also be doing the same thing. This is how countries work and why people get upset at immigrants "taking what's ours" and BS like that. The cost of treatment is brought down when the government can negotiate with providers in a fully public framework, that's why care is so expensive in the US for the same things vs all the other G20 countries. The exact same drug in the US will cost many times more than in Canada for instance, because in Canada the government will negotiate with drug companies on the prices, same with NIH in UK etc. In the US you just have a tax scheme that covers the differences for certain people, but it's incredibly wasteful and upholds the exploitative price structure. You were also wrong before about hospitals in the US operating on a for-profit basis, most of them are owned by non-profits. Insurance companies and providers want the cost of care to be as high as possible, medicade enables this as a stop-gap "solution."
So you're making two false assumptions: People moving to the good place to take all the good stuff will ruin the good place (completely fucked opinion on humanity, doesn't match reality else there'd be no good places), and the cost of care in the US currently reflects the actual cost to provide that care (it doesn't, it's set by providers to maximize profits).
Oh and the whole condescending "we have to be adults and think about reality" bit is completely nullified by the fact that the reality I'm proposing is already the status quo in most of the world. You're the one building the fantasy land here, all I have to do it point at any G20 country to have my reality reaffirmed. I also think the whole "we have to keep things shitty here on purpose because it will be too good" thing is hilarious.
Yours is a country where people go bankrupt because of millions of dollars of medical debt. Instead of that, if I'm facing millions of dollars in long term treatment why wouldn't I just move to California and thus become a resident? Sure, pay taxes on whatever job but it's not going to come close to my medical expenses.
So, how do you deal with that? It's a very simple question.
No other country has this problem because they have universal healthcare for the whole country, the scenario I described is impossible elsewhere. Non residents generally have to pay or opt into an insurance scheme that the rest of us don't.
That's why this "California could do habe universal healthcare if it wanted" is childish nonsense.
This is an incredibly basic issue to which you seem to have no answers besides misunderstanding how healthcare works in the rest of the world.
Americans would just become expats already if that's how it worked. The idea anyone can just move to California on a whim and somehow afford to live there is hilarious. People largely move based on where they can find employment. There's also very obvious ways to prevent this at the same level it's already regulated at, every country with a public health plan has ways to prevent non-residents from using expensive resources. It's not a profound or even novel issue in the slightest. The GDP of California is larger than many countries who have public healthcare, and I already made the point about prices being like 10x and higher than comparable jurisdictions who's governments can negotiate them with providers.
Lol, is that an actual thought you have? You know all the countries with universal healthcare provide it to their citizens. It takes years but more importantly an application process where you have to disclose pre-existing medical conditions.
Oh? So I work a minimum wage job in Oregon without health insurance. Find out I will incur millions in medical expenses which is more than I can make in a lifetime. Why not move somewhere cheap like Eureka and have those bills taken care of?
You really don't understand the problem do you? Universal healtchare works because expensive illnesses are (relatively) randomly distributed amongst a population. But in your California case, that would no longer be the case. You've created an incredible incentive for the most expensive people to be a part of the system.
It's really not difficult.
As you get older you'll (hopefully!) learn that in cases like this, it's way better to just admit you're wrong. Believe it or not, people will respect that more than someone arguing increasingly sillier and sillier ideas. At this point, you're just making the left sound like a bunch of stoned goofs who have very kind albeit completely nonsensical ideas.