Is the introduction of a complete public health system possible for a single state of the US? Has a single state enough sovereignty to introduce this system on its own adding new taxes to its citizens?
Thank you

You're going to have to do better at defining "complete public health system." Arguably all the states already have this; there are state-run and county-run hospitals everywhere, and subsidized health insurance (most of it via the federal Medicaid program).

And yes the states are each empowered to levy whatever taxes they wish to.

Absolutely, a state is free to do almost anything it wishes to do.

Inconveniently, a state cannot print money, so it needs to get the money to do that from somewhere.

Before Obamacare, there was this thing called Romneycare, and Republicans loved it. Massachusetts.

Read up on it.

casinterest wrote:

and Republicans loved it.

That's a lot like saying before Trump there was the 2006 fence authorization act and Democrats loved it.

On topic: The 10th amendment is a beautiful thing. No reason an US state could not introduce their own health system, or many other issues not explicitly granted to the federal government in the US Constitution.

Flighty wrote:

Inconveniently, a state cannot print money, so it needs to get the money to do that from somewhere.

I was having a conversation about this just the other day. There was a time when not only states printed their own currency, but banks, and if you were wealthy enough, you too could print your own. There was even a time when our own government purposely ordered the counterfeit printing bills in order to devalue and harm the economy of another nation.

Of course states can, but everyone from tiny Vermont to huge California have thought it through decided they couldn’t afford it. Clearly, our total economy can’t afford it either.

GF

Yes. Many states have in fact in recent years proposed and voted on developing single-payer health schemes (California, Colorado and Vermont being the notable ones). All were either scrapped or went down in flames at the ballot box when voters saw the state tax increases needed to fund them.

I don't know why people are so scared of the new taxes? Adding new taxes to pay for government-controlled single payer system while eliminating payments to the private healthcare providers will leave everyone much better off. The problem is so many Americans overlook the fact that their health insurance companies are for-profit businesses whose main objective is to make as much money as possible just like banks, oil companies, etc..., that's the reason why the US' healthcare cost is the highest in the world.

L0VE2FLY wrote:

I don't know why people are so scared of the new taxes? Adding new taxes to pay for government-controlled single payer system while eliminating payments to the private healthcare providers will leave everyone much better off. The problem is so many Americans overlook the fact that their health insurance companies are for-profit businesses whose main objective is to make as much money as possible just like banks, oil companies, etc..., that's the reason why the US' healthcare cost is the highest in the world.

New taxes should not be required; just a different software for the money already paid in. Germany gives its people _universal_ care for that amount per person.

The amounts being contemplated are much higher than other countries budget per person.

L0VE2FLY wrote:

I don't know why people are so scared of the new taxes? Adding new taxes to pay for government-controlled single payer system while eliminating payments to the private healthcare providers will leave everyone much better off. The problem is so many Americans overlook the fact that their health insurance companies are for-profit businesses whose main objective is to make as much money as possible just like banks, oil companies, etc..., that's the reason why the US' healthcare cost is the highest in the world.

It depends what the person actually sees. In most cases, it's the business/employer that swallows the bulk of the cost, and hence the employees do not see it. Second, full single payer system will probably be like zero co-pay, zero deductible policies, which cost 2-3 times more than even descent employer group health plans with $2K deductibles. And what's more - a no-deductible health plan costs per year easily $3000 - $4000 more than the one with 2K deductible. This is where the huge increase comes from.

L0VE2FLY wrote:

I don't know why people are so scared of the new taxes? Adding new taxes to pay for government-controlled single payer system while eliminating payments to the private healthcare providers will leave everyone much better off. The problem is so many Americans overlook the fact that their health insurance companies are for-profit businesses whose main objective is to make as much money as possible just like banks, oil companies, etc..., that's the reason why the US' healthcare cost is the highest in the world.

Not necessarily - 80%-90% of premiums collected the insurers are paying out in coverage. Sure, there are a lot of inefficiencies compared to a true single payer system (such as too many people are employed figuring out who whom for what how much), but also incentives to seek more cost-efficient care (e.g. if you have a deductible, you'd go to an urgent care clinic for $250, as opposed to emergency room for $2500, for the same thing largely).

Among reasons - too many to mention. Doctors are beginning their jobs towards 35 years of age, and with $200K debt. First years their salary isn't that big, and 10 years they pay their student loans (e.g. my friend has a wife who is a dentist - they pay all her salary towards her student loans, and this is the expectation for the first decade of the career). Then - they need to buy a home and save for retirement. And all in all that leaves a doctor with 25-30 years of useful career, as opposed to realistically 40-45 in nearly any other occupation, to accomplish the same goals.

Don't worry, US doctors are still earning much more money than in most other countries.

But in the end I don't think doctors' wages matter much.

Drug companies' profits, that's another story.

In countries where there is single payer, the state has a lot of power to negotiate drug prices down. It will simply not pay for too expensive drugs.

And patients will have shorter lives without those drugs. If pharmaceutical companies are so obscenely profitable, how come their stock prices and P/E lag well behind the S&P 500 over the last 6 years and their margins are less than beverage and electronic companies?

GF

GalaxyFlyer wrote:

And patients will have shorter lives without those drugs.

Then why don't citizens in those countries have a shorter life than the US?

Tugg

Because societal outcomes do not equal individual outcomes of people with cancer, AIDS, heart and vascular diseases. US life expectancy is lower due to very non-medical reasons—accident rates, drug abuse, and yes, crime.


GF

GalaxyFlyer wrote:

Because societal outcomes do not equal individual outcomes of people with cancer, AIDS, heart and vascular diseases. US life expectancy is lower due to very non-medical reasons—accident rates, drug abuse, and yes, crime.


GF

And don’t forget obesity.

GalaxyFlyer wrote:

And patients will have shorter lives without those drugs.

In practice we get the drugs, just at a fairer price.

Cheaper, yes; fairer, maybe not because it’s not a free exchange, it’s dictsted by the government. Would those medications exist if not for the possiblity of profits? Do American patients, insurers provide the economic profits (look up economic vs. pure profits) so others may have cheaper drugs. There’s lots of ways to look at the economics of it. We do know lots of “lifestyle” drugs exist due to profitability as do many elective procedures.

GF