4 ms·

If you look at why they fail, it can typically be followed back to interventions made by the right.

rayiner 6y ago
Sorry, no, that excuse is toxic because it provides cover for bad government that doesn’t work. We’re talking about states like California and New York that don’t have a meaningful “right.” California’s attempt at universal healthcare managed to self-destruct with Democrats having the Governorship as well as super-majorities in the state legislature. Every now and then these states will elect a moderate Republican just to get a reprieve from the repeated waves of failure of public services, but those failures can’t be blamed on “the right.” People in blue states should be madder about the fact that their public services are bad. That just means that people get less than what they pay for, and people in need do without. If it cost Europeans as much money to build subways as it does New York or SF they probably wouldn’t do it! And even when it doesn’t like (like California HSR) and is merely 5-10x more expensive than it should be, that just means 1/5 or 1/10th as many people get the service.
- tptacek 6y ago
  People should be mad about the quality of public services in the states but "delivering universal health care" seems like a weirdly high bar to set.
  - rayiner 6y ago
    It’s just the latest example of something European countries a lot less wealthy than California have managed to do that California can’t manage to do.
    - tptacek 6y ago
      Right, but those are countries, and California is not. They control their borders, heavily restrict residency, and have their own central banks.
      - votepaunchy 6y ago
        Europe has free movement of people throughout the Schengen Area and a common currency plus European Central Bank. It's not quite federalism but there is nothing here to disqualify California from providing universal healthcare.
        tptacek 6y ago
        Citizens of members states can, for instance, travel through Germany and remain there indefinitely so long as they're financially independent or actively looking for work, but they are not automatically residents of Germany. The two situations, EU member states and California compared to its peer states, are obviously not comparable. There are clear reasons why individual US states haven't been able to provide universal health care. It's not because the idea is unworkable at a national level; it's because you can't do it state-by-state. (I oppose single-payer health care, for whatever that's worth to you. I just think the bar Rayiner set for this discussion is silly.)
        bhupy 6y ago
        > There are clear reasons why individual US states haven't been able to provide universal health care. It's not because the idea is unworkable at a national level; it's because you can't do it state-by-state. How do you figure? This is exactly how Canada's single payer system came about: province-by-province. Saskatchewan was the first Province to offer single payer in 1947, followed by Alberta in 1951, etc. By 1961, all Provinces had some form of a single payer healthcare system. To this day, Canada's single-payer system is Provincial, not Federal.
        tptacek 6y ago
        Is there a state in Canada that doesn't provide single-payer health care? Because every state surrounding California would not be.
        bhupy 6y ago
    - dragonwriter 6y ago
      California would, in practice, need a variety of permissions from the feds to do approximately single-payer, which still wouldn't be actually single payer. Both the ACA and Medicaid would be major federal issues (in principal, it could opt out of Medicaid, but that would lose a lot of federal health care funding California is being taxed for). And it would still have the interface-to-other-systems problems single-payer is designed to avoid, because Medicare and VA would still exist and require coordination of benefits. No European country would have similar problems, because they are independent nations.
  - krupan 6y ago
    Then maybe the left shouldn’t be clamoring for it?

Sorry, no, that excuse is toxic because it provides cover for bad government that doesn’t work. We’re talking about states like California and New York that don’t have a meaningful “right.” California’s attempt at universal healthcare managed to self-destruct with Democrats having the Governorship as well as super-majorities in the state legislature. Every now and then these states will elect a moderate Republican just to get a reprieve from the repeated waves of failure of public services, but those failures can’t be blamed on “the right.” People in blue states should be madder about the fact that their public services are bad. That just means that people get less than what they pay for, and people in need do without. If it cost Europeans as much money to build subways as it does New York or SF they probably wouldn’t do it! And even when it doesn’t like (like California HSR) and is merely 5-10x more expensive than it should be, that just means 1/5 or 1/10th as many people get the service.

tptacek 6y ago
People should be mad about the quality of public services in the states but "delivering universal health care" seems like a weirdly high bar to set.
- rayiner 6y ago
  It’s just the latest example of something European countries a lot less wealthy than California have managed to do that California can’t manage to do.
  - tptacek 6y ago
    Right, but those are countries, and California is not. They control their borders, heavily restrict residency, and have their own central banks.
    - votepaunchy 6y ago
      Europe has free movement of people throughout the Schengen Area and a common currency plus European Central Bank. It's not quite federalism but there is nothing here to disqualify California from providing universal healthcare.
      - tptacek 6y ago
        Citizens of members states can, for instance, travel through Germany and remain there indefinitely so long as they're financially independent or actively looking for work, but they are not automatically residents of Germany. The two situations, EU member states and California compared to its peer states, are obviously not comparable. There are clear reasons why individual US states haven't been able to provide universal health care. It's not because the idea is unworkable at a national level; it's because you can't do it state-by-state. (I oppose single-payer health care, for whatever that's worth to you. I just think the bar Rayiner set for this discussion is silly.)
        bhupy 6y ago
        > There are clear reasons why individual US states haven't been able to provide universal health care. It's not because the idea is unworkable at a national level; it's because you can't do it state-by-state. How do you figure? This is exactly how Canada's single payer system came about: province-by-province. Saskatchewan was the first Province to offer single payer in 1947, followed by Alberta in 1951, etc. By 1961, all Provinces had some form of a single payer healthcare system. To this day, Canada's single-payer system is Provincial, not Federal.
        tptacek 6y ago
        Is there a state in Canada that doesn't provide single-payer health care? Because every state surrounding California would not be.
        bhupy 6y ago
  - dragonwriter 6y ago
    California would, in practice, need a variety of permissions from the feds to do approximately single-payer, which still wouldn't be actually single payer. Both the ACA and Medicaid would be major federal issues (in principal, it could opt out of Medicaid, but that would lose a lot of federal health care funding California is being taxed for). And it would still have the interface-to-other-systems problems single-payer is designed to avoid, because Medicare and VA would still exist and require coordination of benefits. No European country would have similar problems, because they are independent nations.
- krupan 6y ago
  Then maybe the left shouldn’t be clamoring for it?