The conversation of a state-based single payer health system continues:
Congruent with reality was a clever and accurate turn of phrase. However, when I read her article, I paired it with what I know, about what’s going on, and how people behave. It’s not some vast conspiracy on the part of the 1%. But just as with corporations, the sum total of many small decisions result in a general trend towards greed, towards consolidating power, towards amoral and unethical choices, towards grinding the poor underfoot. I happen to think she’s very much — but not solely — right.
Yes. Sometimes I wonder if these individuals who continually are looking to make more money, or consolidate power, might fall into the OCD category of mental illness. Not all of them, of course, but at least some of them. I mean, I’m not impressed with Bill Gates or Sheldon Adelson or George Soros or Warren Buffet – not for their money.
As for state-level single payer, sure, there’s lots of hurdles. I can’t speak for California, not knowing the complexities of their laws. But where there is a will, there is a way. Minnesota could do it alone, perhaps, but a state with 5.5 million people is pretty small potatoes to swim against that current. Clearly any state is NOT going to simply pay for it out of current revenues (hence the example of California that Kevin Drum is really bogus). But if a state said “we cover everyone at a very modest *means-tested* rate” and increased general taxes (income, primarily, but perhaps sales and excise) to do so, it might work.
While I appreciate the impulse of … where there is a will, there is a way, literally it’s not true, and it’s worth recognizing that some dreams are out of reach – and maybe this is one of them.
And I disagree that Kevin’s example is bogus. If you have to double the state budget, as Kevin suggests, that implies a hefty tax jump. A really hefty tax jump. And while I think it’s a proven case that taxes, to a certain point, enhance the economy, there’s also a point where they’re a drag.
If just one state did it successfully, the rest would become dominoes and the Feds would be helpless to stop it.
And turn that around. If one state tried and failed, would that not provide ammunition to the forces opposed to single payer? That would worry me.
I’d like to use the example of the ACA to prove that getting people better care reduces the cost of medical care per capita, and then evolve towards single payer.
