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Originally Posted by East of the River
If you look at polling much like same sex marriage single payer healthcare keeps increasing in popularity. At this point I think a centrist could go either way on it. Polls show 44-55% of voters would support single payer and again depending on poll even 13-25% of republicans would support it.
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Nationally, the problem with single payer is that red state politics is all about denying social benefits to white trash, brown people, and African Americans. Single payer really doesn't work at the state level because all the sick people would just move from the red states to the blue states. Look at New Hampshire, for example. If you need services, you move to Vermont or Massachusetts. Live Free or Die, baby!
In my opinion, we should have single payer of last resort that's pretty bare bones. About 50% as good as blue state Medicaid. Most of us would supplement that with catastrophic health insurance that covers the expensive things. It would not be particularly generous for behavior-induced health issues. The lions share of expensive things have root causes like obesity, lack of exercise, tobacco, alcohol, and drugs. People have to take some personal responsibility for their health. If you have something expensive that is pure bad luck, the single payer system would be much more generous. I'd keep spending roughly what we spend today but change how it's being spent.
The Medicaid budget breaker is long term care. Right now, it's about 30% of the budget. The elderly poor who land in nursing homes. With our aging demographics and wealth stratification, that could very well be 50% of the budget in 30 years. This is an enormous national problem with no good solution. It's all labor costs. Nursing home staff already are very low wage so it's not like you can cut your labor costs.