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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

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
      Not now, but between 1947 and 1961 there absolutely was. That’s the point: it didn’t happen from the top-down at the Federal level, it happened province-by-province and there was a period of time when it was patchwork. It was fine for the Canadians, and it can be fine for Americans as well. Also, if I’m understanding your argument correctly, it’s that States can’t do this because borders are open, but there’s nothing stopping a State from applying its public insurance only for established residents of the State. This is how State university systems operate; you don’t get in-state tuition at UC Berkeley unless you can establish residence. In theory, someone at the borders could move across State lines in order to do that, but that’s probably a rounding error in the UC budget.
- rayiner 6y ago
  I’m curious why you think Canada couldn’t provide single payer health care. (For the record, I support a Canadian style system.) The biggest challenge I see is that people might rush to California to claim the benefits. It’s not clear that’s a real problem (and it’s not the problem Vermont and California actually ran aground on). The Supreme Court’s precedent in this area is a shambles. But if California offered state-run universal insurance, I bet the Supreme Court would approve measures to keep people from moving to California after they got sick.
  - tptacek 6y ago
    Adverse selection of people claiming residency benefits isn't the only issue I cited there, right? There are things countries can do to finance universal health care that states can't do.

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
    Not now, but between 1947 and 1961 there absolutely was. That’s the point: it didn’t happen from the top-down at the Federal level, it happened province-by-province and there was a period of time when it was patchwork. It was fine for the Canadians, and it can be fine for Americans as well. Also, if I’m understanding your argument correctly, it’s that States can’t do this because borders are open, but there’s nothing stopping a State from applying its public insurance only for established residents of the State. This is how State university systems operate; you don’t get in-state tuition at UC Berkeley unless you can establish residence. In theory, someone at the borders could move across State lines in order to do that, but that’s probably a rounding error in the UC budget.
rayiner 6y ago
I’m curious why you think Canada couldn’t provide single payer health care. (For the record, I support a Canadian style system.) The biggest challenge I see is that people might rush to California to claim the benefits. It’s not clear that’s a real problem (and it’s not the problem Vermont and California actually ran aground on). The Supreme Court’s precedent in this area is a shambles. But if California offered state-run universal insurance, I bet the Supreme Court would approve measures to keep people from moving to California after they got sick.
- tptacek 6y ago
  Adverse selection of people claiming residency benefits isn't the only issue I cited there, right? There are things countries can do to finance universal health care that states can't do.