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NY Senate Bill S5474 proposing a universal single payer health plan for NYers
- masterof0 4y agoWould this raise the tax rates for NYers?
- endisneigh 4y agoIt would be shocking if it didn’t
- ceejayoz 4y agoNo, it wouldn't. The European single-payer systems pay half what we do per-capita, factoring in private and public spending in both systems. The US system is wildly cost inefficient. See the chart at https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm
- rootusrootus 4y agoOf course it'll raise tax rates. That money does come from somewhere. The real question is whether employers will raise salaries enough to compensate for the additional taxes, once they're no longer providing insurance as a benefit.
- ceejayoz 4y agoIf I pay $10 in tax to save me $20 in costs, I'm not inclined to see that as a tax hike.
- endisneigh 4y agoIt’s still a tax hike, regardless of your rationalizing
- ceejayoz 4y agoThen a focus on tax rates instead of total cost is entirely disingenuous.
- endisneigh 4y agoNot really, there are people who get great health care for free from their employer, and others who get a greatly discounted rate. Their employers will not necessarily savings with their employees. The result for these employees could be more taxes for the same or worse care they’re already receiving. In aggregate I believe it’s the right move but let’s not act like everyone wins here.
- DaveExeter 4y ago> Not really, there are people who get great health care for free from their employer It is not 'for free' it is part of your compensation! It's like saying your employer pays 6.2% + 1.45% in SS/Medicaid taxes 'for free'. That is part of your compensation.
- endisneigh 4y agoI meant free in that you don’t pay a premium, but fair point.
- ceejayoz 4y ago> Not really, there are people who get great health care for free from their employer, and others are a greatly discounted rate, who will not necessarily share savings with their employees. Then require that savings be shared. Make it a legal requirement that any company that has employer-provided healthcare must rebate employees the premium costs if they opt-out.
- endisneigh 4y agoThat makes no sense, salaries would simply be adjusted to compensate. The kind of bureaucracy you’re proposing is why things are already so complicated to begin with.
- rootusrootus 4y agoThat assumes you get the cost saving. If my company stopped paying for my insurance benefit and instead gave that money to me directly, and then I bought the cheapest plan I could find on the insurance exchange ... I'd be paying more, not less. By a fair amount.
- ceejayoz 4y agoThat seems readily fixable; make it a legal requirement that companies that provide employer-provided healthcare pay the premium to the employee if they opt out.
- rootusrootus 4y agoIn my case the premium wouldn't even come close to the marketplace cost. I'd be losing overall.
- ceejayoz 4y agohttps://www.peoplekeep.com/blog/which-health-insurance-costs-more-employer-coverage-or-aca-plans https://www.peoplekeep.com/blog/which-health-insurance-costs... > Nationally, the analysis found that individual ACA Marketplace premiums are 10 percent lower than the average employer-sponsored insurance premium, after the adjustments. (Which makes sense; it's a very large risk group.)
- rootusrootus 4y agoOkay, then congratulate my employer for beating the odds, I guess.
- mypalmike 4y agoNumbers, please. This kind of claim is just mythology unless you have numbers to back it up.
- mattmcknight 4y agoIs this because your employer is paying part of the cost for the plan?
- daenz 4y ago>The real question is whether employers will raise salaries enough to compensate for the additional taxes, once they're no longer providing insurance as a benefit. I don't think that's even a question. The answer is no, they won't.
- xienze 4y ago> The real question is whether employers will raise salaries enough to compensate for the additional taxes, once they're no longer providing insurance as a benefit. Spoiler: they won’t. They’ll spin not having to pay a premium as a pay raise.
- donatj 4y agoI think the idea that anything that worked in Europe would work here as well as there without inherent corruption and rent seeking is laughable.
- ceejayoz 4y agoThe idea that the US is uniquely corrupt and rent-seek-y seems laughable. There's no corruption in Italy? Eastern Europe?
- endisneigh 4y agoThe amount paid per capita and whether you would pay more taxes are not exclusive things. I’m not sure why people keep bringing up Europe - the USA is not Europe. For one doctors are paid more in the USA compared to Europe, medicine is more expensive here, more of the R and D originates here, etc
- Ekaros 4y agoMaybe good question to ask is what makes it more expensive? Is it bloated administration and insurance system? Or is there some fundamental other difference?
- deleted 4y ago[deleted]
- _-david-_ 4y agoOne reason is it is expensive to fund the research and testing and so the companies need to recoup that cost. They cannot in Europe and Canada due to price controls which means people in the US offset the cost. The US is basically subsidizing other Western countries.
- nceqs3 4y ago^This guy gets it. Also, in nearly every parliamentary system the state's ability to quickly invalidate patents by an act of parliament gives them even more leverage in the negotiations with drug companies.
- heavyset_go 4y agoA lot of that R&D is already funded with our taxes via the NIH.
- bdzr 4y agoA significant portion is not. Clinical trials are unbelievably expensive, see https://www.science.org/content/blog-post/drugs-come-comprehensive-look https://www.science.org/content/blog-post/drugs-come-compreh....
- newaccount2021 4y ago
- FinNerd 4y ago
- settrans 4y agoYou and I have different definitions of "billionaire".
- FinNerd 4y agoI had to add a /s, Jesus
- TMWNN 4y agoConsistently having trouble identifying sarcasm in print—without the "help" of idiotic illiterate marks like "/s"—is one of the signs of autism (<http://www.healthcentral.com/autism/c/1443/162610/autism-sarcasm/ http://www.healthcentral.com/autism/c/1443/162610/autism-sar...>).
- aqme28 4y agoThe better question is whether NYers will pay more or less under this plan, not whether that payment is a tax or a premium.
- ffggvv 4y agoi think the original question was better
- tomatotomato37 4y agoSummary says it includes a "payroll assessment, similar to the Medicare tax"
- ldayley 4y agoWith California and New York both exploring statewide single payer healthcare it looks like the Overton window is moving closer to legitimate discussion of a nationwide single payer plan in the US. It’ll be interesting to watch, since this is such a hot-button topic here on many levels.
- vmception 4y agoas long as these plans can negotiate and also use their market power to reduce the prices that healthcare services charge to Americans, but starting within their jurisidction a significant portion of the consensus failings have been because simply having insurance for all is just a bandaid, and this has been an accurate criticism of one party's tax and spend trend whether that seems like a conversation derailing political statement or not
- lotsofpulp 4y agoIt is dead in the water. The Republicans show no sign of supporting broad non means tested or non age gated taxpayer funded healthcare, and they hold the cards in the US Senate. On the state level, any broad based benefit that does not discriminate is also futile because benefit recipients can move into the state and payers for the benefits can move out of the state. See Vermont for the previous trial of this: https://en.wikipedia.org/wiki/Vermont_health_care_reform https://en.wikipedia.org/wiki/Vermont_health_care_reform It the same problem with homelessness, education, and mental healthcare (a subset of healthcare). Without a border to limit the ratio of net benefit recipients to net payers, the numbers will not work out.
- irrational 4y agoYou really think people are going to flee NYC and the large cities in CA over this?
- gleenn 4y agoAnecdata but I personally know more than a few people who moved to Nevada to avoid California taxes, so yes.
- rootusrootus 4y ago"Died in committee" I assume will be the final result, official in a couple weeks.
- vmception 4y agoha lol, one sponsor, in committee yeah I don't consider this kind of thing news, but it did open a conversation that I wanted to have
- susanasj 4y agomaybe I'm misunderstanding but I see at least 4-5 cosponsors that are members of the health committee? not saying I think this will come to pass necessarily but there's like 30 cosponsors listed and the NY State Senate is 63 members.
- VWWHFSfQ 4y agoIf this is anything like the ACA then the vast majority of New Yorkers will end up paying twice for insurance. Once in taxes to subsidize the single-payer marketplace, and then again for their own employer-based insurance. Have to start somewhere though, I guess.
- baggy_trough 4y agoIf doing something is going to make the situation worse, it is better to do nothing instead.
- irrational 4y agoIt may only appear to make things worse. Sometimes you have to take drastic measures, like amputating a limb, to make progress on saving people.
- jimbob45 4y agoYou seem to believe employees wouldn't be able to opt out of their own employer-based insurance. Why is that?
- a_t48 4y agoFor the employee it doesn't matter. Either I keep my existing insurance or I opt out and take the state provided one, but I don't get any more money the money I'm saving the company.
- paulmd 4y agoYeah, the penalty for ACA non-compliance is zero at this point, so I think they could just opt-out entirely without cost, right? I looked at it last year in terms of whether I'd need to pay for COBRA to cover the tax penalty and... nope. You can retroactively opt into COBRA for 90 days after the fact (iirc, check this yourself before using), so you can job hop and then if you happen to smash every bone in your body during that one week then just sign up for retroactive coverage.
- kevindong 4y ago
- aserdf 4y agoit will be interesting to watch NY (and/or CA) put something like this in place and observe from afar. i strongly feel that states should be much more aggressive running policy experiments if their constituents desire them, and at the national level we all get some benefit of seeing how things turn out in real time. all that said, assuming there is some tangible tax increase, NYC high earners are going to be knocking on the door of 60% combined rates (city, state, federal). tax avoidance and/or relocation services are going to be booming if so.
- outside1234 4y agoRemember that this expense is also reducing the cost of employers. One of the best ways to finance this would be a payroll tax that is basically equal (in aggregate) to the insurance the company is (usually) already paying.
- lr4444lr 4y agoThere is nothing stopping NY employers now from just giving people enough cash to buy a plan on the ACA marketplace. You're assuming this upcoming plan will have offerings employees will want, and charges employers whether or not this is the case.
- endisneigh 4y agoIf you think employers will share the savings with their employees, think again.
- drm237 4y agoI don't think they're saying that at all. I think the point was, a payroll tax won't necessarily increase costs for a company because it would be offset by eliminating the current healthcare costs.
- endisneigh 4y agoRight, but my point is that to keep the relative advantage they’d have to pay. For example imagine a company attracts talent by paying median + healthcare, and another that just paid median. For the latter they would have more costs, no? The savings aren’t offset unless they were already offering the incentive.
- goatcode 4y agoComing from a country that has this, there should be caution: it gets more affordable, but you get what you pay for. In my country of origin, you get a partially-paid-for ride to the emergency room, where you pay for things like casts, non-ward rooms, dental care out of pocket. There is no prescription coverage. There is no optometry coverage. I would wait significant chunks of a year for procedures and diagnostics. To cover the things that aren't covered, most have private insurance through work or also out of pocket. Since moving to the US, it is more expensive (than next to nothing), but I actually get good care. Several conditions that were ignored or misdiagnosed for me are now cured. My life might be significantly shorter had I not come here. If NY does this, the near zero chance of my moving there ever would go to absolute 0. It is a terrible system for any place that does not have infinitesimal state or national government expenses and more-than-60% kind of taxes (e.g., Scandinavian countries).
- seandoe 4y agoInteresting, from where do you hail?
- frozenport 4y ago>> but you get what you pay for. Americans are already paying more than most places for healthcare but not getting a good return.
- space_fountain 4y agoIs this true even for individuals? I think one version of the problem might be that we pay too little for some peoples healthcare and too much for others, but do the people who pay the most still end up with worse results?
- frozenport 4y agoThe same procedure costs magnitudes more in the USA. It is true for everybody. An adjacent issue is that certain groups don't receive preventive care due to financial issues leading to increased long term costs. But note, even in all cases we're paying way too much.
- humanwhosits 4y agoIt's not rocket science, plenty of other countries manage to provide healthcare. Just remove the age limit on Medicare.
- GiorgioG 4y agoBut won't you think of the administrators at all of these private health insurers that would be out of their cushy jobs? I consulted for a "non-profit" Blue Cross Blue Shield franchise 15 years ago. It was rampant with nepotism and outright incompetence. A good chunk of our health-care "system" is just a giant jobs program.
- bdzr 4y ago> A good chunk of our health-care "system" is just a giant jobs program. Yes, and government systems are peak efficiency without the slightest semblance of a jobs program.
- susanasj 4y agoit appears that this bill does not actually deal with the funding mechanisms for single payer, which will undoubtedly be contentious. From the Campaign for New York Health: > this legislation can be passed outside of the budget as a standalone bill - the #NYHealthAct is intentionally written to first pass on human rights principles - that care should be equitable and available to all. Then we pass the funding mechanisms in the following session - that is when NYHA becomes part of the budget battle) - begins implementation of systemic long-term change to guarantee universal, comprehensive, single-payer healthcare to everyone who lives or works in New York from: https://www.nyhcampaign.org/ https://www.nyhcampaign.org/
- deleted 4y ago[deleted]
- colechristensen 4y agoSeems a bit pointless to pass a feel good bill that will cost billions and ignore the whole money situation hoping to solve it.
- starkd 4y agoElections are coming up.
- chmod600 4y agoI'm skeptical, but I'd like to see it pass. Such a debate in this country and it would act as an experiment. It would probably take a while for the consequences (good and bad, as I don't believe it would be purely one or the other) to become apparent.
- colechristensen 4y agoOne of the arguments for the federal system is that states do get to experiment and the ones that work go national.
- ParksNet 4y ago50% of health resources are used in the final 5 years of life. The young should not pay for the healthcare of the elderly. Society should be apportioned into different age categories, and funded separately, with a 'base' tier for all citizens and legal residents, and a higher tier for those with private or employer insurance.
- simulate-me 4y agoWho funds the more expensive tiers?
- caboteria 4y agoAnyone who hopes to someday be elderly should pay for the healthcare of the elderly.
- Krasnol 4y ago> The young should not pay for the healthcare of the elderly. Why?
- notch656a 4y agoI think funding the elderly is a lofty goal, but I don't see a good intellectual argument for FORCING our children to pay for our healthcare. You shouldn't view your child (nor your neighbor's child) as your own personal piggy-bank to extract from when you get ill. IMO our goal should be to hand down resources from parent to child, not the opposite direction. If I made this story a bit more personal and wrote ("I am too ill to work anymore, so I drove to my son's house and took $200 off his counter to buy my medication) HN would be reacting with outrage.
- notreallyserio 4y agoWhat alternative do you propose? Suicide booths?
- notch656a 4y ago
- lr4444lr 4y agoYeah, that'll be great for the state with one of if not the highest costs of doing business in an age of remote work: another payroll tax.
- GiorgioG 4y agoThere's too many jobs at stake for existing health insurers. This will go exactly nowhere.
- TuringNYC 4y agoIt would be great if they could handling things already successfully resolved in other places, like Balance Billing https://en.wikipedia.org/wiki/Balance_billing#United_States https://en.wikipedia.org/wiki/Balance_billing#United_States When I was with a Virginia employer, it was WYSIWYG on billing. In NY, you never know since there is the co-pay, and then there is the surprise 2nd bill that comes in the mail. It is a solved problem, not sure why such obvious solved problems cannot be implemented in NY.
- ceejayoz 4y agoBalance billing was banned federally. https://www.dfs.ny.gov/consumers/health_insurance/surprise_medical_bills https://www.dfs.ny.gov/consumers/health_insurance/surprise_m...
- TuringNYC 4y agoSort of. But if you read the article: """Consumers in New York are protected from surprise bills when treated by an out-of-network provider at a participating hospital or ambulatory surgical center in their health plan’s network. Additionally, consumers with health insurance coverage provided by an insurer or HMO are protected from surprise bills when a participating doctor refers them to a non-participating provider. Consumers in New York are also protected from bills for emergency services in hospitals, including inpatient care following emergency room treatment.""" Note that part of balance billing is from in network providers who are billing the difference, that doesnt seem to be covered in the above ban from what I'm reading.
- mostertoaster 4y agoCrazy healthcare costs are the result of government intervention back in the 30s, and I’m doubtful they will actually be able to lower overall costs. Single payer has the advantage of being able to negotiate the costs for a much larger volume, but my guess it won’t be enough to cover the cost of bureaucrats to administer it. Still I’m all for them trying it, if it fails miserably and the “free” healthcare leads to never being able to see the doctor and costing more, then everyone else can stop trying to emulate it. If it succeeds and actually saves money and still provides good healthcare, then we might be able to try it at a larger scale.
- Certhas 4y agoThe US pays vastly more to administer it's health care than any other OECD country. Your assertion that the cost of government bureaucracy should exceed the cost of private markets at this task is emphatically not backed by data. A good place to check your assumptions on these kind of basic things is the OECD data. Healthcare is here: USA 1.4% of GDP on governance of healthcare Germany 0.5% (competing public insurance schemes) UK 0.2% (single payer) US style healthcare is an ideologically driven luxury.
- mostertoaster 4y agoWell maybe our bureaucrats are simply better at getting paid. Still the healthcare issues being fixed with more government intervention is like someone breaking your leg then giving you crutches and saying “where would you be without me”.
- chmod600 4y agoOne thing I don't understand is how you can make healthcare "equal" in the sense that it will stand up to court challenges in the U.S. Free speech is a self-service right, so the government can just step out of the way and everything is fine. But healthcare requires the government to do a lot. Not doing something equally (like stepping out of the way of free speech) is easier than doing something (like healthcare) equally.
- kevin_thibedeau 4y agoThe SC is trying its best to devolve all powers to the states. They can't have it one way for a contentious issue and then be hypocrites for anything else.
- ceejayoz 4y agoWho’s gonna stop them?
- windows2020 4y agoPerhaps 'restore' would be a better choice of word.
- xyst 4y agoIf only we can get the other 48 states to have a single payer health plan initiative or adopt a nationalized single payer health care system. Health care should not be limited to just living in CA or NY or the rich. side note: this site for tracking bills at the state level is kind of nice. Wish other states had this. This is what I have to deal with in TX https://capitol.texas.gov/MnuLegislation.aspx https://capitol.texas.gov/MnuLegislation.aspx
- jimmygrapes 4y agoI wish all advocates for single payer systems could experience the Veterans Health Affairs (plus or minus the "Community Care" system) just to see what it they are in for. Give it a trial period of 2 years. Have fun.
- arkades 4y agoAny chance whatsoever they’re going to actually reimburse doctors for their massive school loans, while forcing them (“no network restrictions”) to work for this insurance plan? Especially if it’s anything like Medicaid, and reimburses physicians and hospitals -below cost-.
- matt321 4y agoThe country is run by the rich, and this will only pass if its good for the rich. Lets hope its good for the rich and the not-rich alike.
- exabrial 4y agoI really want the government deciding what it considers "covered". Didn't get your Vaccine? Too bad, Democrats voted they won't cover your health care costs of a hospital visit. Unprotected Sex? Too bad, Republicans decided they won't cover your Plan B the next day. Your health choices are your business. Both sides have an agenda they will leverage and hold you hostage with. Leave the government out of healthcare. They can't get make a functional driver license system, or a post office that doesn't dump billions of tons of C02 into the atmosphere delivering spam while being open between 11a-4pm, or run an airline security service like the TSA that actually stops threats and doesn't take away your Grandma's nail trimmers.
- nanliu 4y agoThe private sector also established they will value profit above all else like pre-existing conditions they won’t cover, what’s in vs. out of network, who I need approval before I go see a specialist, limits on overall coverage, an ambulance ride that costs more than a first class plane ticket. I want a system that measures outcomes that doesn’t sap double digit GDP, but the incentives are not structured in a way for success in this country (private or public).
- deleted 4y ago[deleted]
- et2o 4y agoI’m an MD who trained in NYC. I have also had emergency surgery in the NHS at one of their most prestigious hospitals in London and so I feel like I’ve seen the system a little bit from the inside. It was far cheaper for me than it would have been as a Brit in the USA, but the standard of care was lower. They didn’t have some technical and staffing resources late in the afternoon that would be a baseline in any of the hospitals I’ve been at in the USA. The English doctors were just kind of apologetic and bashful about it, talking to someone they knew was an American doctor who knew what kind of specific diagnostic algorithm was appropriate. The NHS hospital did have really excellent amounts of ancillary staff. Someone brought coffee and tea to me like 3-4 times a day, it wasn’t hard to get my luggage delivered to my bed, etc. Not like that in the USA from what I’ve seen. The NYC hospitals are somewhat financially strained as it is. Especially the public hospitals (Bellevue, Elmhurst, Metropolitan). Also related would be care at the VA hospitals, which is slower/worse than care at NYC flagship hospitals. But as a society we don’t want to prioritize or pay for good care for veterans, so it is what it is. I predict this will continue to basically just produce a more two-tiered system in the US. Most doctors who have a choice (large group practices) will take the wealthy patients with private insurance, and the big hospitals and whomever else who don’t have a choice will be forced to accept the NY single payers (basically the existing model, where the poor and 65+ are already covered under Medicaid and Medicare already). It will likely strain these systems even further, as reimbursements from Medicaid/Medicaid are insufficient to run large health systems which depend on higher rates from private insurers (payor mix). Good luck there. In NYC even more physicians and group practices will try to go to alternate models such as cash-only. Try being on Medicaid or Medicare and finding an outpatient psychiatrist in NYC now as it is. This will extend to more PCPs, chronic disease specialists, etc. Some patients will get better and more affordable care, but some will also get much worse care. It will be interesting to see what happens. I’m not necessarily opposed, but this is absolutely not going to be a clear and decisive win on all fronts as some commenters are suggesting. The US healthcare system, if you have private insurance, is the best in the world already in terms of level of service and access to rapid specialty and high-end care.
- docstryder 4y agoIf we go by data, the US healthcare system is the most expensive (not arguable) and is not even in the top 5 among developed countries in the most important measures. Also a doc, though that is not really relevant for this discussion. one of these references is from an US insurance company who you would think would be biased for US healthcare https://www.cignaglobal.com/blog/healthcare/top-10-countries-best-healthcare-system https://www.cignaglobal.com/blog/healthcare/top-10-countries... https://www.washingtonpost.com/world/2021/08/05/global-health-rankings/ https://www.washingtonpost.com/world/2021/08/05/global-healt... https://www.internationalinsurance.com/health/systems/ https://www.internationalinsurance.com/health/systems/
- gbronner 4y agoThe problem here is that you are going to get regulatory capture by the healthcare unions. So we'll get worse service at higher cost, not to mention incredible fraud
- liminal 4y ago"Private insurance that duplicates benefits offered under New York Health could not be offered to New York residents. (Existing retiree coverage could be phased out and replaced with New York Health.)" That is an important paragraph. If you want good public health care, you need to make sure the rich use it too. Canada does it by not allowing doctors to work in both the public and private systems. This law takes a different approach, instead barring the insurance companies from competing. Wonder if it will hold up in court. Without this paragraph I don't think it could be a good system. With it, there's at least some hope.
- docstryder 4y agoIf we go by data, the US healthcare system is the most expensive (not arguable) and is not even in the top 5 among developed countries in the most important measures. These kind of experiments are welcome (if they come to pass). People deserve better for what they pay currently. one of these references is from an US insurance company who you would think would be biased for US healthcare https://www.cignaglobal.com/blog/healthcare/top-10-countries https://www.cignaglobal.com/blog/healthcare/top-10-countries... https://www.washingtonpost.com/world/2021/08/05/global-healt https://www.washingtonpost.com/world/2021/08/05/global-healt... https://www.internationalinsurance.com/health/systems/ https://www.internationalinsurance.com/health/systems/
- techsin101 4y agoI pay 100k+ in taxes, if this happens I'll be actually happy even more.
- techsin101 4y agohttps://www.youtube.com/watch?v=kBsNvGyfM8Y https://www.youtube.com/watch?v=kBsNvGyfM8Y
- jmyeet 4y agoCue the Republican challenge arguing the state has exceeded its authority and this is a Federal issue (just like how Ajit Pai removed net neutrality saying it wasn't a Federal issue but then turned around and challenged California's net neutrality as being within the FCC's authority). As for the NY bill, I'll be interested to see what this looks like. There are many variations on single-payer. For example, the NHS in the UK has many medical professionals (including primary care physicians) as government employees. In Australia, Medicare works by government rebate. The other aspect will be how this will impact coverage out-of-state, employment coverage and employment insurance premiums. You see many reactionaries argue "but it will raise taxes!". Welll... yes and no. You're already paying for your employer health insurance. This just shifts that cost to the government (sort of) but now health insurance isn't tied to employment.
- pkt_nspktr 4y agoData point of n=1: I think this effort by NY is exactly where the experiment of single-payer health care in the United States should occur, as per the 10th Amendment. According to Third Way[1], (which advocates for federal-level universal healthcare), three other states which have tried single-payer health care have ended up discontinuing their programs: Colorado, Massachusetts, and Vermont. Perhaps New York has identified where those states have failed and its proposal will address those shortcomings. [1] https://www.thirdway.org/report/single-payer-health-care-a-tale-of-3-states https://www.thirdway.org/report/single-payer-health-care-a-t...
- Alexbades 4y ago
- mattmcknight 4y agoThey don't even have to make it single payer if they just say- no one is allowed to charge any patient more than they charge Medicare. You get the pricing power without forcing everyone into a state run plan.
- ngcc_hk 4y agoThe original Obamacare came from the republican state experiment (the guy also went up to compete as potus as well). Experiment is good. But can you accommodate difference on lower level, so it is not one size fit it all. Having said that by and large USA as a whole is a experiment of non-single payer.