I'm going to go out on a limb and say that it's because if that happened someone who's nest is currently being feathered by the inequity of the present system would receive less feathers for said nest.
this post was submitted on 24 Feb 2025
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This. The US has one of the biggest expenditures on healthcare on the country level and at the same time it's one of the most expensive for the consumer.
Meaning someone's packing really big on this and people with that much money tend to be powerful, rich and psychopaths.
One is Medi-Cal. The trouble ,from my uniformed opinion, is probably having to get funding through passing a proposition or law, establishing the personnel, making all the contracts with each provider and competition from private insurance companies.
You can’t just go get medi-cal though, you have to qualify by having an income of $20k or below (more if you have kids), are under 21 or over 65, permanently disabled or currently pregnant.
People on medi cal are constantly stressing about earning $1 too much and losing their healthcare. Covered California helps, but it’s still bad.
Massachusetts has one (I don't know details)
https://en.m.wikipedia.org/wiki/Massachusetts_health_care_reform
From what I've seen, it's actually pretty nice when held to US standards (but that's a low fuckin bar)
It's what ACA was based on isn't it? The eponymous Romneycare
Partially. ACA is mostly based on the compromise plan to appease republicans when Clinton was trying to do health care reform in 1993. It failed and led to the Republicans taking control of the senate for the fist time in 40 years.
It set the stage for the pattern of Dems ignoring the left portion of the party for a compromise proposal with the Republicans. The Republicans bail on the compromise and nothing happens.
Voters are pissed at the Dems for not doing anything and put the Republicans in power the next election. Basically the template for the pattern we still see today.
Every state that receives federal medicaid money administers their own state run health insurance
The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding. States are not required to participate in the program, although all have since 1982.
The percentage varies, but the federal government funds more than half.
Also it's only for people with limited income and resources.
Which also makes it more expensive, as insurance gets cheaper the more people are on the same provider
And thats why the one I was on went from 33 bucks to 155 bucks a month in a years time.
Lack of political will.
More like addiction to those sweet sweet insurance political donations and lobbying dollars.
Lobbying is only a small factor.
Momentum is the main cause.
A systemic shift is required and those who have good insurance are afraid that of ending up with less.
Yup, like generaldingus said, it's largely an economic barrier. There aren't many states that could pull it off properly.
It's definitely possible though, but you'd have to break through so many barriers to get any current legislative body to make it happen, that it won't.
Is that Mario brother guy available to help?
it can happen. especially in California, because they have the population size to motivate health providers and pharma companies to negotiate.
it's not likely in the short term with the way the system is. and the problem which prevents it is not the economics nor legislative lack of will.
it's the insurance companies' lobbying and political campaign contributions. many many California legislators' campaigns are funded by insurance companies. and historically there has been a lot of corruption in the state's insurance regulator agency.
also the state's population , for some reason, are easily swayed by political ads in certain issues. like the car-share/delivery gig drivers proposition. i think they flip flopped in successive referendums. apologies if in wrong in that.
I think hospitals and clinics have been operated by states and cities for a long time.
Hard to start, easy to teardown.
Vermont tried for a version of universal healthcare about 10 years ago, and they decided the cost was too high.
Every state has a program for poor people that's in part funded by Federal tax dollars.
You also have to address the free rider problem by vesting benefits in.
Money politicians want to spend on things their constituents want spent on better things.
Part of the problem is Medicare is already taxing for healthcare. A state creating their own system would have to tax on top of that, and duplicate the administration of it.
It's kind of like states trying to stop using daylight savings on their own. Technically they can, but only after getting all of congress and the president to agree.