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Comment by pcwalton | Hacker News Reader

California already has among the most generous state-level medical benefits in the country. Here, it's hard to be in a situation in which one simultaneously can't afford insurance and doesn't qualify for Medicare or Medi-Cal (California Medicaid).

Singling out California for not taking the unprecedented step of rolling out single-payer alone--which is a difficult proposition to say the least in a country that guarantees freedom of movement--is bizarre.

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Honestly, I can't see why California is unable to roll out a single-payer plan. It's certainly larger than many of the countries that have one. In a single-party state, it should be a relatively straightforward thing to do.

My guess is that no one is serious about healthcare and that it's simply a get-out-the-vote scheme like abortion and gun rights.

"a difficult proposition to say the least in a country that guarantees freedom of movement"

Levels of benefits already differ considerably, no? If freedom of movement is a deal killer, than it seems to me that strict, highly enforced immigration laws would also be a precondition.

I believe the freedom of movement being mentioned here is between US states, not countries, so immigration laws aren't relevant.

Here's the thresholds: https://www.coveredca.com/PDFs/FPL-chart.pdf

Med-cal is basically poverty level coverage (138% FPL - $29k for a family of 3)

The main issues with can't afford (or more honestly can afford but it is very painful) healthcare are at the higher numbers as subsidies fade out. $83k for a family of 3 has no subsidies, but even high deductible insurance is going to go for $10k/year (meaning expected costs are realistically hitting above $13k). That's over 20% of take-home income.

Several countries in the EU (e.g. Nordic countries) offer single-payer healthcare services and the EU does have freedom of movement, so such a step wouldn't really be "unprecedented".

First of all, many more EU/EEA countries have comprehensive healthcare if not single-payer healthcare, so there is less of a divergence in policy in most places.

Secondly, EU freedom of movement isn't as strong. See Directive 2004/38/EC, such as the points reproduced below which AFAIK some countries already take advantage of:

"Union citizens should have the right of residence in the host Member State for a period not exceeding three months without being subject to any conditions or any formalities other than the requirement to hold a valid identity card or passport, without prejudice to a more favourable treatment applicable to job-seekers as recognised by the case-law of the Court of Justice."

"Persons exercising their right of residence should not, however, become an unreasonable burden on the social assistance system of the host Member State during an initial period of residence. Therefore, the right of residence for Union citizens and their family members for periods in excess of three months should be subject to conditions."

I agree with you, but I have to correct myself as well. I mean compare US to other countries where national free health care is available. These are basic human rights which simply ignord by the government in the US.

Workers need benefits which is understandable because they can't even go to doctors when they are sick.

Well, I would assume they offer healthcare to people who are working or are disabled and not able to work. It's not like you get healthcare in Europe for not putting anything back in the system. Freedom of movement is not a problem in this case.

Yes, you do, in countries with universal healthcare, such as Spain. Even to undocumented immigrants.

You are full of it. Germany, for instance, (and other European nations are similar) puts so many barriers in the way of a disabled immigrant that they'll never end up a resident.

You're telling me if I were disabled and could not work I could just move to Europe and live on the healthcare system? That's not at all true.

I don't claim it what so ever, that was the point of my comment. Only people who put the money in the system get the benefit of healthcare.

> Singling out California for not taking the unprecedented step of rolling out single-payer alone--which is a difficult proposition to say the least in a country that guarantees freedom of movement--is bizarre.

Given their political support of illegal immigration, I don't think it's bizarre at all.

They're among the richest, left-wing states in the country. Relative to other states, there's absolutely no shortage of political support or money. If they can't handle implementing their own utopian health care system, I don't know why any of us should trust that it can be done well at a federal level.

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