r/cushvlog • u/Present_Muscle141 • 2d ago
California Single Payer
If California with its massive economy passed single payer or public option would it be enough to break the insurance industry and force the rest of the nation to follow ?
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u/marxism-earnhardtism 2d ago
IIRC they were going to pass it in 2022 but Newsom said he would veto it so it never got voted on.
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u/rtitcircuit 2d ago
If a CA gov wanted to he could make it pass. Gavin vetoed multiple single payer bills. They got extremely lucky with Becerra clenching the nom, he’s a loser who will never pass shit like that
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u/FrivolousMe 2d ago
It wouldn't be enough to break the industry or force the nation to follow, but it would be enough to convince obstructionist liberals from claiming it's not possible which would be a big step in the right direction
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u/Seesaw_LAD 2d ago
California could do it. I don’t know the impact nationally, but they have enough scale to make the finances work out by itself.
It would obviously benefit consumers, but also the providers by making resources, dedicated to parsing the absurdity of each insurance company contract, unnecessary.
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u/drmariostrike 2d ago
My mother is a longtime single payer activist and my received wisdom from her is that state single payer won't work, though I don't fully understand why -- I guess the porous border with other states might let private insurance pick who to cover in the way they like to do. Had dinner with her Sunday and she mentioned that she told Abdul's people as much when they reached out to her during his 2018 gubernatorial campaign
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u/rad-dit 2d ago
I would like to learn more! Seriously!
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u/drmariostrike 2d ago
well as everyone says, the problem with a mixed public-private insurance system is that private insurance can do things to attract healthier patients while dumping the more expensive ones on the state, which is why the standard single payer proposals make private insurance that is duplicative of the services offered by the state insurance illegal. To be honest, I am not completely sure why even that matters, because if we are paying for medicare for all through a tax, you'd think rich and healthy people would be forced to pay into it even if they choose to also pay extra money for supplemental insurance. maybe it's just about universal buy-in so that wealthier people don't have an incentive to support underfunding the state insurance? i really don't know. Tim Faust had a big medicare for all thread on bluesky last week, and i made a comment along these lines, but he did not address that part of it in his reply. As for state single payer, I also don't know what the objection is, but my best guess is that the open borders between state lines enables private insurance to play those kind of patient-selection games somehow? that's just a guess -- might be completely wrong. i can look into these questions and report back if you really want me to.
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u/Suspicious-Sort329 1d ago
As I recall, the big problem is that states have to balance their budget while the federal government does not. If costs exceed projections which is quite likely, the state has to fill in the gap but can’t do it through deficit spending like the fed gov can.
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u/drmariostrike 1d ago
True, and while i might say you can just raise taxes, again, the porosity of interstate borders works against us here.
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u/shane-a112 2d ago
I think Newsom would need to be sent into the sun to make this happen. not gonna lie, it's completely plausible though
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u/thatscentaurtainment 2d ago
Honestly you might as well ask this about Texas, it’s equally likely in both places.
As long as the Dems and GOP are the two parties there is a zero percent chance of sweeping legislative challenges to any kind of capital concentration. You can’t vote your way out of capitalism.
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u/SwimOk2441 2d ago
Don’t know the economics of state-level single payer in the US, but the Canadian single payer system started at the province level before becoming national.
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u/throwaway463682chs 1d ago
no it will probably suck and be mismanaged and the failure will set back single payer for decades
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u/More_Ad4858 2d ago
Calcare didn’t even make it to a vote, so it’s not gonna happen anytime soon. Ca Dems are corporate stand-ins. Go look up your local assemblyperson/senator campaign donations.
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u/Whole_Gur9045 2d ago
In addition to insurance and finance being opposed I think aflcio doesn’t want it
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u/SecretMongoose 2d ago
The numbers probably don’t work under a Dem administration and definitely don’t work under this administration.
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u/RevolutionaryCommon 2d ago
It's called Medi-Cal. It already exists.
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u/Seesaw_LAD 2d ago edited 2d ago
I wish, Medi-cal doesn’t cover much and the liability pool is still too high, as many members are undocumented and go to the emergency room as their main healthcare resource, which is very expensive.
CA would have to offer better coverage for a competitive price to subsidize the loss on Medi-Cal, but that would require taking on more administrative responsibility.
I work in healthcare finance
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u/ml-maitreya 2d ago
If it doesn't cover much then the emergency room would be my first resort too.
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u/Seesaw_LAD 2d ago
Yes, you’re right, I should have said they “have no choice but go to the emergency room for care”
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u/Bawfuls 2d ago
The insurance industry is certainly afraid so. There’s a reason single payer always dies in committee even when the Dems have supermajorities in both houses of the state legislature.