this post was submitted on 05 Apr 2025
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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:

  1. Doing Obama care half assed, when something like 80% people wanted a public option.

  2. 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.

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[–] [email protected] 5 points 1 week ago

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,

  1. 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.

  2. 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.

[–] [email protected] 1 points 1 week ago

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.

[–] [email protected] 1 points 1 week ago

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

[–] [email protected] 3 points 1 week ago

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.

[–] [email protected] 2 points 1 week ago

Can you imagine the influx of people to those states?

[–] [email protected] 6 points 1 week ago (1 children)

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.

[–] [email protected] 4 points 1 week ago (3 children)

Does this imply that a state funded health insurance for all will operate at a net loss?

[–] [email protected] 10 points 1 week ago

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.

[–] [email protected] -1 points 1 week ago (1 children)

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.

[–] [email protected] 0 points 1 week ago

They're called taxes, look it up

[–] [email protected] 4 points 1 week ago (1 children)

In the same way that the USPS operates at a loss

[–] [email protected] 0 points 1 week ago

It uh... actually doesn't.

[–] [email protected] 14 points 2 weeks ago

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.

[–] [email protected] 19 points 2 weeks ago (1 children)

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.

[–] [email protected] 1 points 1 week ago (1 children)

I'm very interested in reading about this. But not much comes up when I search. What did California find out?

[–] [email protected] 1 points 1 week ago (2 children)

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.

[–] [email protected] 1 points 1 week ago

It's honestly insane how expensive all this shit is.

[–] [email protected] 16 points 2 weeks ago (2 children)

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

[–] [email protected] 1 points 1 week ago

I was getting 450/week 10 years ago. It's pretty crazy they haven't raised it.

[–] [email protected] 8 points 1 week ago

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.

[–] [email protected] 6 points 2 weeks ago (1 children)

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.

[–] [email protected] 2 points 1 week ago* (last edited 1 week ago)

https://masscare.org/

At a glance, looks like it would cover anyone working 20 hrs/wk in MA

[–] [email protected] 5 points 2 weeks ago

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.

[–] [email protected] 2 points 2 weeks ago* (last edited 2 weeks ago) (1 children)

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

[–] [email protected] 2 points 2 weeks ago (1 children)

When a criticism is actually an admission. Well done, Donald.

[–] [email protected] -2 points 1 week ago

Not sure what you mean. Can you explain?

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