Unless you actually think illegal immigrants should just be left to die when they have medical issues? I sure hope not.
Suppose you do the later - whoops (!) - as soon as the workers are citizens, and employers have to pay full benefits, and worry about unions ... then they'll dump such new citizens and hire actual illegal workers!
Point being: the price of that cheap labour is a function of their illegal status more than anything.
It's a false dynamic.
Just enforce basic laws. Americans will do many of those jobs for higher wages, the jobs that can't support higher wages will leave for Mexico and help them out down there, even in that scenario, surpluses come back to the US as well.
The real 'long term' answer is just to enforce basic citizenship and employment laws.
The answer on healthcare is much more complicated, but probably has more to do with regulating prices etc. than it does expanding medicare/medicaid, which is actually very inefficient compared to other nations, because prices are so high.
Single payer, as someone below mentioned, gives the gov the power to negotiate better deals, but you don't necessarily need single payer for that.
I'm generally against any kind of real socialization because it always ends up a mess, but in healthcare it seems it's going to be needed to stop the '100 aspirin' problem, among others.
More medicare just means more '$100 aspirin' unless it's combined with some other, heavier kind of action.
I hope it works out.
Anyway, policing businesses will always be easier than policing individuals... smaller numbers, immobile, already registered with the state, and they have stronger incentives to obey the law.
Asking people to follow very basic and normative laws is the central social artifact of any civilization. Without it ... it's going to be bad.
Just enforce the laws.
If laws or policies need to be changed, then change them! Say for example, if there's 'very low unemployment' in Cali, and they really need workers, then maybe 1) allow more immigration. 2) have a temporary worker system that's reliably enforced.
But otherwise, don't create two sets of laws, two economies, two classes of people.
Also, the US should be making considerably more material effort to develop adjacent economies, right across the border - and I mean more than military aid for the federales, and more than just economic aid which is inefficient. A major US investment initiative for example in Baja, in the South, focusing on travel, manufacturing, that ensured physical security, financial security etc.. and maybe a lot of money and effort would come flushing in. Aside from historical narratives of colonialism etc. it could be done, and done well, and it'd be a huge win-win. And FYI this means considerably better healthcare for those living there as well, frankly, probably almost as good as American healthcare for pennies on the dollar. If it were up to par ... you'd even see a boon of medical tourism, for which there is a huge unmet demand simply because it's very risky for folks to go to 'some random place' in Central America they've never heard of that may have no standards. Imagine a set of hospitals and clinics with a high operating standard, and some brand equity, with cheap prices? Now that's a business! But it can only be facilitate with core civic stability which the US (and Canada?) could feasibly help provide.
When NAFTA was re-negotiated, I wish they'd have addressed these new, 21st century issues instead of rehashing tariffs on steel and milk ...
No, neither of those are things California can do instead of providing healthcare.
> More medicare just means more '$100 aspirin' unless it's combined with some other, heavier kind of action.
No, it doesn't. Moreover, this is more Medi-Cal (i.e., Medicaid) not more Medicare. Which also doesn't mean that, but it's a completely different program with different policies.
However will we survive without our slaves?
Sorry, I jest ... but that's the essential nature of the argument.
If you make those illegal workers citizens ... then they will be immediately 'too expensive'.
Either people are citizens with rights, or are not.
Let's not create two systems.
and you should pay your bill because the hospital will sue you for it. it's only when the debt is finally uncollectible that it gets absorbed.
Also, I agree with you, but likely from a different place. No individual should be paying a hospital bill, it should be included in a tax on my income. If I have lots of income I pay for lots of people, maybe an astounding amount, if I have little to no income I depend on my wealthy neighbors to cover me. Seems to me like the only way to go, that or I guess the rich get eaten.