Cost of single payer in Cali would be more than entire general fund budget

[Mr. Morden]

It's funny how there are healthcare systems so much better practically everywhere else; yet, somehow in the US, it's impossible. Yeah, right.

It's impossible for path dependent reasons.  If the US had adopted a different system in the 60s, then we'd be in a very different place.  But because we've built up this infrastructure of an extremely expensive system, it's now impossible to unmake the system without creating major financial losers.  E.g., you want a health system in which doctors have salaries comparable to that of Belgium?  Great!  Who's going to tell them that they're getting a pay cut?  Or as Megan McArdle put it:

https://www.bloomberg.com/view/articles/2014-04-30/single-payer-would-make-health-care-worse

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And of course, similar electoral logic applies to coverage.  The electoral incentives run against any changes that would result in any fewer procedures being covered by insurance compared to what people are currently used to.  And I think this is a bigger problem in the US political system, because power is more diffuse.  Angry citizens can wield leverage against a few members of Congress who aren't obligated to tow the party line a way that they would be in a parliamentary system.

[Mr. Morden]

https://www.bloomberg.com/view/articles/2014-04-30/single-payer-would-make-health-care-worse

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And of course, similar electoral logic applies to coverage.  The electoral incentives run against any changes that would result in any fewer procedures being covered by insurance compared to what people are currently used to.  And I think this is a bigger problem in the US political system, because power is more diffuse.  Angry citizens can wield leverage against a few members of Congress who aren't obligated to tow the party line a way that they would be in a parliamentary system.

http://www.gallup.com/poll/191504/majority-support-idea-fed-funded-healthcare-system.aspx

If single-payer was a single issue presented to voters, it would pass fairly comfortably. The electoral argument is the least credible in any opposing viewpoint to a national healthcare plan.

It would clearly need to be accomplished at the federal level if we're talking about costs and setting in place regulations to ensure the system remain soluble, but the point stands that if we can scrounge together a budget with surplus room for endless defense spending, there is little doubt our wealthiest country in the world can spare the cost to cover everyone with essential health needs. Even if that means *shudders* a tax increase on the wealthy.

No, what I'm saying is that even things that have majority support (like gun control) can be politically difficult if there's a determined minority of opposition who make it their #1 issue.

And I'm not saying that single payer itself would be the politically hard part.  I'm saying that a single payer system that contains costs and is as cheap as it is in other countries is politically hard, because spending less $ on health care means an economic hit for a large # of people making $ off the current system.  Yes, other countries have much smaller amounts of health spending, but they *always* had smaller amounts of health spending.  Taking money out of the system is difficult.