4 ms·

It'll be a long time until the entire USA implements socialised healthcare (if it happens at all...) but are there any individual states which have something re

• phonon 10y ago
  Well, Medicare (health insurance for people 65+) is not that different, and is essentially a federal single pay program. (Though they don't pay salaries, but on care provided like regular insurance). The military health system (for veterans, the VA) mostly have their own facilities, but don't have the best reputation (and have had some scandals recently... https://en.wikipedia.org/wiki/Veterans_Health_Administration_scandal_of_2014 https://en.wikipedia.org/wiki/Veterans_Health_Administration... ) Medicaid (for poor people) is managed at the state level, and is 50% federal funded (and each state has different income limits for who is covered) All three of the above make up roughly half of all US health care spending. At the state level, some states have additional programs and subsidies, like https://en.wikipedia.org/wiki/Massachusetts_health_care_reform https://en.wikipedia.org/wiki/Massachusetts_health_care_refo... and Obamacare tried to create something similar for all states with uniform availability and coverages along with subsidies (and penalties for people who voluntarily decline to purchase health insurance). https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act https://en.wikipedia.org/wiki/Patient_Protection_and_Afforda... So yes, it's a complex kinda mess...but there are too many stakeholders in the current system for it to be easily changed.
• avar 10y ago
  My impression (as a European) of the US system is that in practice what we have with individual states here in Europe + EU isn't possible in the US, since the federal government taxes are proportionally so high, compared to what individual EU members contribute to the EU. Thus while individual states could implement their own health care system, it would have to be on top of everything that's federally mandated, which they're already paying for. The tax burden would be outrageous, so it just doesn't happen. It's also odd to see other Europeans dismiss the argument many Americans have for a smaller federal government, while in practice that's pretty much what we have over here in the EU. Could you imagine a EU-wide single-payer health care system? It would be a complete disaster. So in that sense I wonder if the better solution for the EU would be to roll back all federal health entitlements (Medicare etc.) and just implement this completely on the state levels, then states like California and the like could have European-like single-payer health care systems, while perhaps other states would opt for different systems.