How many times have I heard from folks claiming "conservatism" that they don't want progress, in any form-- individual, mutual, societal...
"replacing what works with what sounds good" --T.Sowell
offtopic rant, but on the subject of politics; to me it seems underhanded to pursue experimental federal programs eg for healthcare- why not demonstrate it works in a few test states.. wouldn't california love to pass something like that? if only there were a way to pass the buck to the federal government for the homeless...
not that the 'red team' political machine hasn't been pulling on the middle as well, claiming to be 'good guys' while corrupting for their own aims; what grinds my gears is either side claiming any kind of moral highground without referencing empirical positive impact
It's tough to do some things at the state level because there's less money at the state level vs the federal level. It's a lot easier for a business to move from a state to avoid taxes meant to pay for healthcare by rerouting fund from the private market to the public market than it is to leave the US entirely.
The federal government gets it's taxes first from income taxes then payroll taxes, I checked a couple states and most are income then sales/use tax which is a big difference. Not being able to reroute money from employer based systems into the single payer system is a huge hole in any state level attempt at single payer. Also just having more people means a federal level system will have more bargaining power than even the largest states.
> "I been sleeping all my life. And now that Mr. Garvey done woke me up, I'm gon' stay woke. And I'm gon help him wake up other black folk."
So if anything, it means to me that we need to work on increasing roles of individual states and decreasing federal powers.
Some states have scoped this out, and Vermont passed a law to pursue it. The problem has to do with financing (individual states can't print money) and the freerider problem, which isn't about the homeless, so much as more...libertarian states paying all of their diabetics to move to California to get treated.
Even without a Machiavellian "muahaha we'll ship all our sick people to X" good cheap healthcare will attract sick people to a state. It was a problem with the ACA where if enough healthy people weren't paying in [1] insurance companies could go belly up from having to cover sicker people they could previously refuse. That's why there was an individual mandate and a backstop for companies that lost too much money on plans.
[0] https://www.theguardian.com/us-news/ng-interactive/2017/dec/...
[1] In the case of a single state doing a single payer system it's older or simply sicker people who may make less money because of chronic debilitating illness.
If you think that the debate over healthcare has anything to do with the substantive merits of one system over another, you're viewing it through the wrong lens. It is purely a power struggle between a class of potentates who have become obscenely wealthy from selling insurance, and the vast majority of the public in whose interest universal healthcare is.
Medicare for All being a success in one state would change little by just adding more evidence to the existing mountain because, again, it is not a struggle between differing points of view, but between monied interests and the masses. The colossal propaganda apparatus wielded by corporate interests would continue to wage relentless war against any expansion of such programs.
at least it would prove to work here- it's not like the US is in the exact same position as the EU
eg, I'm not sure how they're connected, but it's obvious that the majority of medical research is being done over here, and I never see that mentioned in the comparisons between our systems and overseas; if the overpayment we're doing over here is necessary waste for that goal, that should to be made explicit! health insurance is probably taking more than their honest share of the pie, but complaints that our health care is 'too expensive' never seem to take into account that our (expensive) health care is the best in the world
am I wrong?
The EU and Japan, South Korea, Hong Kong, Bahrain, Brunei, Australia, and New Zealand. It works all over the world. Research on the US system accords with the overwhelming evidence from all around: it would work.
> eg, I'm not sure how they're connected ... medical research
Let's clarify. The repugnant gouging in the cost of hospital care, doctor's visits etc redounds mostly to the profit of private insurance who provide no social value in return. The exorbitant cost of medicine does indeed flow to pharmaceutical companies, but the particulars of how they would be affected depend on the details of how universal health care was implemented.
> complaints that our health care is 'too expensive' never seem to take into account that our (expensive) health care is the best in the world
I have no idea where you got that notion; the US is generally not ranked in the top 20.
https://www.who.int/healthinfo/paper30.pdf
https://healthcarechannel.co/how-australian-healthcare-ranks...
The profit margins of a health insurance company are ~5% per the SEC filings of the largest insurance companies, which is not a large profit margin.
Not necessarily at the same price though. The US healthcare system is crazy expensive because US salaries for high-skill individuals are crazy high (because tuition is crazy high?....). To fund an expansion might be more expensive.
I'm sure it's possible, but if you need more funding, you need more taxes. I'm not at all sure Americans would be okay with that. Remember that you have very low taxes compared to Europe or Japan.
* A third of US healthcare cost is assumed to be administrative overhead just caused by the current system. "Cutting U.S. administrative costs to the $550 per capita (in 2017 U.S. dollars) level in Canada could save more than $600 billion, the researchers say." [0]
* Median wage level for healthcare workers (everyone directly care-related, i.e. including nurses, technicians and MDs) is $68k, about 5.5M people alltogether. [1]
* With the efficency gain of $600B one could double the headcount of medical practitioners and still be better off as a society.
[0] = https://www.reuters.com/article/us-health-costs-administrati...
Cut new grad salaries in return for halfing their student loan, otherwise the outrageous cost of education is being subsidised by the sick and elderly.
One could stop all research for decades, and the US as a whole would still be better off if what was available now was distributed evenly.
https://data.oecd.org/healthstat/life-expectancy-at-birth.ht...
The healthcare industry does pour a lot of bribe money into preventing reform; see e.g. killing anti surprise billing legislation. However, the bulk of research into why the US doesn't have universal healthcare access points the blame at the blocking minority of Americans who'd prefer not have healthcare for themselves if the alternative is people lower on the social hierarchy (read: non-whites) having healthcare.
This is likely a far harder problem to fix than the already nearly insurmountable problem of excessive corporate influence over government policy.
Citation needed. This is quite an inflammatory statement to throw out there without a backing source.
My cynical short take is that the insurance/medical industry, sitting on a cash cow, will do anything to keep it being taken away. That seems to be a lot of the motivation for some people to support policies that only benefit corporations / status quo.
In absence of that, I would prefer to have public healthcare in one state, than not to have it at all.