The year is 2019. California’s new governor, Gavin Newsom, recently elected on a platform that included support for the creation of a single-payer health-care system, now must figure out how to enact it. A prior nonpartisan analysis priced it at $400 billion per year — twice the state’s current budget. There appears to be no way to finance such a plan without staggering new taxes, making California a magnet for those with chronic illnesses just as its tax rates send younger, healthier Californians house-hunting in Nevada and big tech employers consider leaving the state.
But Newsom is not alone. Other governors have made similar promises, and Newsom calls together the executives of the most ideologically like-minded states — Oregon, Washington, New York, Massachusetts, Connecticut, Maryland. What if they banded to create a sole unified single-payer health-care system, spreading risk around a much larger pool of potential patients while creating uniformity across some of the country’s wealthiest states?