What about trying universal healthcare on a state level?

In the U.S. there are some, especially on the Left, who want a single payer hospital system run by government.
And they keep pushing for the entire country to have this type of system.

Here's a question: Why has this never been implemented on a state level?
I do not think I've even heard any calls for this to be tried on a state level.

Maybe in New York, Massachusetts, California, or Vermont, politically these seem the most likely states that would want to implement this.

For those who want a universal healthcare system, can you think of any reasons why it would not work on a state level? Why would you think the system needs to be implemented all across the entire country, rather than being tried in a small number of states first?

What is stopping you? Why aren't you advocating for your individual state to do this?

 

Good question. Probably because healthcare is a federal responsibility. Health of the Citizens and all of that.

Hey, aren't Medicaid and Medicare programs federal government healthcare already?

 

There have been several threads on this topic in years past. There IS an actual answer to the OP's question. First though, there have been many State attempts to do just that. Colorado, Vermont, and California to name three States that actually had bills to that effect. The ultimate answer is cost. If you do it as at the State level, you have to actually...you know...pay for it out of State coffers. If you get some sort of federal program, it will simply be rolled into annual budget deficits and no one will pay for it until, at some point, we all do.

Of course some States plans were dumber than others. California's proposal was basically a State level Bernie Sanders version of Medicare for all. No copays, or deductibles. The price tag (which no doubt would have been much higher) would double, yes that's right DOUBLE the California State budget. If we had a federal balanced budget amendment, the ardor would cool for a federal version too since the tax increases required for that would be tough.

I of course would welcome any state to start their own Universal health plan. The rest of the country could take notes as we watch it blow up in their faces.

 

I understand that answer, and you are probably correct, but I do not believe that reasoning is very logical.

As we all know, it's not like the federal government has extra money sitting around. Paying for a universal healthcare program is going to require taxes to go up. Why would it be any different if those taxes were federal rather state taxes?
I mean, I don't think the total tax rates in a state would be any different in that state if the federal government paid for it, rather than the state.

But I suspect you may be right, there's a mentality on the Left that just wants to run up all the expenses on a credit card and not pay the bill now. It's much more difficult to do that when it's a state government doing the spending.
Either that or perhaps the intellectual leaders of the Left fully realize that high tax rates would start making some states uncompetitive with other states that maintained lower rates, but do not want to admit that rationale to the common followers of the Left.

I think there's also a lot of tendency to view things in terms of one-size-fits-all solutions, as if solutions can only be sought in the form of a nationwide policy.

Or perhaps they know that this universal healthcare system would end up having problems, it would become clear to the public that it's far from perfect, and they do not want to actually implement that system in a state like California or New York because then the whole plan would be exposed to criticism from their opponents in the rest of the country, and besides from that, it would be one less thing to laud over the public to get votes in national elections. Dangling the promise of "free" healthcare is a big thing, helps get many to lean to the Left. That influence would no longer be there if most of these people already had that type of healthcare system.

 

the more people on it, the cheaper per person it is

though right now, with our current obesity epidemic from our high carb\seed oil fast food diets - all healthcare is having issues, even universal health care

 

has to be co-pays to prevent people that are hypochondriacs or just go for attention

we see for-profit failing... so has to be other options

today when you get sick, you can lose your job... just when you need insurance most

 

Tax increases at the State level are related to some degree of reality. Tax increases on the Federal level are not since, as we saw with Obamacare, most of the tax increases attached to that were not laid at the feet of people, but third parties like hospitals and insurance companies. They were really just for show; to get class enemies. But there was no pretense of paying for the entire plan via taxes. It all went on, as is everything else, on the national credit card. States don't have the option to pay for new vote-for-me programs by charging it.

 

You must encourage the people to visit the doctor, not prevent them. Prevention is much cheaper than emergency surgery. People who aren't sick don't go to the doctor, it's boring. Hypochonders need to inform healthy persons about their sicknesses, at he doctor's, their aren't those. And if, they don't cost money. Sick people cost money, not healthy.

You got it! Fix this problem, and rest will be easy.

In God's own country this is a must.

 

Sounds like a cop out, FreshAir.

Economics of scale may be a thing, but I highly doubt things are going to be any cheaper per person if the entire United States does it than just New York and California, states with a combined population of 47.7 million. At some point, continued increase in numbers stops bringing costs down very much.
I could make the same argument about electric cars.

 

ask any insurance company if they make more profit the more people they cover....

course in the current USA, so many are eating too many Carbs and seed oils and becoming obese, so it's gonna cost more... public or private as time goes on if we keep going this direction

 

The United States already has a government-provided plan in the system called COBRA to address this, which can last for 18 months. It has been around since 1985.

 

not cheap, not cheap at all

 

That's a disingenuous argument, FreshAir.
We're talking about per unit, not total.
For very gigantic insurance companies, it's very doubtful their profit margins (profit per customer) will increase if they have more customers.
For smaller to medium sized insurance companies you might be right. Since not all of the administrative costs would increase with more customers.
That still does not usually affect the price paid by the customer.

 

insurance has to be taken on a total as that reduces risk, that is the way insurance works

 

Stupid argument. That is not applicable in this situation.
When you have even ten thousand people, that is enough to spread the risk around for something like healthcare.

 

very applicable, if you insure 5 people and all of them get seriously sick, you in the hole. but if have thousands and 5 get sick you make a profit, that is the way insurance works

you're not selling a widget, you're spreading the risk

the more people, the less the risk

 

I'm sorry, I'm not wasting my time arguing with stupidity.

You'd be right if we were talking about going from 5 people to 100 people.

 

you got nothing but insults it seems

 

FreshAir, do you really believe that if there is already a pool of 47 million people, that expanding that pool to 330 million people will really make any difference in reducing risk?

For you to even think this suggests you have a very poor understanding of how statistics works.

 

ask any insurance co if they thought increasing the number they insure reduces risk, or at least spreads out the risk would be more accurate - thus increasing profits

that is unless society eats the Standard American Diet for generations and more than half are unhealthy

and you end it with personal insults again, lol

 

You're just being dumb.
I don't mean to put up an ad-hominem attack, but some arguments are so stupid they're not worth arguing with.

Risk in health insurance is already plenty spread out once you reach 1000 or 10,000 people. Going from a million to ten million will barely lead to any reduction in risk at all.

 

and more personal insults again, lol

 

Well, sometimes you have to call out dumb arguments for what they obviously are.
Other people reading this can decide for themselves whether what I'm saying is just an ad-hominem logical fallacy or whether your argument really is obviously stupid.

 

sure, whatever....

 

I'd explain the math to you, in detail, except I suspect the effort wouldn't be worth it. You probably wouldn't have the attention span to read and understand it.

When you have a pool of 1000 people, the medical risk isn't substantially different from a pool of 10,000 people.
As you approach a bigger population number, the risk approaches closer and closer to a certain range. At some point, increasing the population size isn't going to lead to any significant change in the risk. Even if you increase the population size by 100 times.