Ask Lemmy

A few reasons:

1. 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,

2. 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.

3. 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.

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.

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.

Can you imagine the influx of people to those states?

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.

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?

California had a bill like that pass the legislature in 2022, and Governor Newsom ~~vetoed~~ somehow 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

Lol, California unemployment is capped at 450/week. No chance we can afford universal medicare

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.

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.

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.

NYC has a very viable option in MetroPlus, the city healthcare option for Medicade

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.

ITT: people who don’t understand that Medicaid is not Medicare, and that means-testing means a service isn’t “for all.”

Editing to add: Medicaid is funded mostly by the federal government, 69% vs 31% funding from the state. So even if it wasn’t means-tested (one has to have an income below a certain amount, or be disabled to a certain degree before qualifying) it would not meet OP’s definition, a single payer health insurance system funded by the state.

To answer OP’s question, a state funded single payer health insurance program would likely run afoul of the Commerce Clause of the constitution which states the federal government has jurisdiction over interstate commerce. UHC, Aetna, and other nation-wide insurance companies would absolutely sue over the state programs interfering with their right to conduct interstate commerce, and they would almost certainly win, even without a hard right SCOTUS like the current one.

They can. Cali at least has a partial plan.

Hell even a city could.

Hawaii already does.

I mean cali is about double NY but add in a few other blue states like illinois, washington, new jersey, massachusetts, and colorado and you will have more than doubled cali. and even though other blue states may not be as big any additions help make for a more robust pool. The big problem is people going to red states while young and healthy and then going to blue states if they get ill.

What do you consider Medi-Cal to be? 🤨

Mostly because we're stuck supporting the red states that suck at the Federal titty.

Because they don't want to.

Full stop.

They can. The issue is people want everything to be federal and ignore their own state. Most Americans can't even tell you what the first article of their own state's constitution is about. Or their own state house rep.

NY has a bill floating around for this but it’s never gone anywhere.

Source: https://www.nysna.org/campaigns-healthcare-all/single-payer-system-new-york-state