Universal healthcare is a topic that often sparks passionate debate. Some people see it as a human right that everyone deserve, other see it as an expensive luxury that no one is entitled to. California would be the only US state to offer coverage for all, and it has met with some stiff opposition. CELEB takes a look at what we know about the fight for universal healthcare in California and where enterprising travelers and people considering immigration will find universal healthcare around the world.
California Eyes Universal Healthcare
California is often considered the most progressive state in the country. With sky-high tax rates, strict laws protecting individual rights and a welfare system that offers more aid than any other, California is a love-it or hate-it state. Now, the legislature is debating the development of a universal healthcare program that could provide a blueprint for the rest of the country – or a warning.
Currently there are two proposals for universal healthcare in California. One proposal comes from Governor Gavin Newsom and the other from Assemblymember Ash Kalra, a Democrat from San Jose, CA. Here’s what the two proposals offer:
- Newsom: Newsom’s proposal is an expansion of the currently existing Medi-Cal program. This doesn’t cover all residents of the state but does extend it to all low-income Californians regardless of immigration status. The cost is expected to be $614 million to start with, then $2.2 billion a year thereafter. Newsom’s goal is to roll this into the yearly budget process.
- Kalra: Kalra’s proposal is a true universal healthcare option. This expands single-payer, government-funded coverage to all California residents. This proposal mimics the one made by Senator Bernie Sanders when he ran for president in 2020 and proponents of the plan suggest that streamlining and standardizing care will lower costs across the board. This would also eliminate networks so any California resident regardless of income or immigration status would be able to access any doctor or service. The program could cost as much as $222 billion a year, and Kalra has proposed tax hikes to pay for it. SFGate reports, “The four proposed tax hikes are: a 2.3% excise tax on businesses after their first $2 million in income, a 1.25% payroll tax on employers with more than 50 workers, another payroll tax of 1% for employees that earn more than $49,900 annually, and finally, a new 0.5% income tax for Californians making more than $149,500 annually, which increases 2.5% for residents making more than $2.5 million annually.” Approving these hikes would require a constitutional amendment. The battle for Kalra’s proposal is a stiff one, and even some Democrats are hesitant to go all-in because of California’s already significant tax rates.
The legislature is debating two bills: Kalra’s proposal to create the system, and another bill to increase taxes to pay for it. It’s hard to say at this point whether the bill has any future. Although Newsom ran for re-office in 2018 on the promise of creating a single-payer system, he’s currently focused on his small expansion and hasn’t shown a lot of support or priority for Kalra’s proposal. The tax hikes are a serious concern. California is already losing some big tech giants to places like Austin, Texas – appealing because of its low corporate and income tax rates. As the pandemic stretches into its third year and the entertainment industry suffers, much of what built California is in flux. While a good portion of California residents may support the adoption of a single-payer system, there are serious roadblocks to making it reality. Currently the state has a $31 billion surplus. Significantly higher than most other states, but far short of what they’d need to fund the universal program for even a single year. Universal healthcare may not be possible unless the entire country converts, even in a state as populus and fruitful as California. However, Kalra and other progressives aren’t giving up the fight any time soon.
Countries Where Universal Healthcare Exists in Asia and Africa
If you’re tired of waiting, there are other countries around the world where universal healthcare already exists. Some may surprise you, others may not. But what’s interesting is that most westernized countries offer some level of universal healthcare. The United States is definitely an outlier. Here are some of the countries across Asia and Africa you may be surprised to learn in your travels that offer universal healthcare:
- Algeria: Algeria provides a universal healthcare system through clinics, hospitals and dispensaries. However, the rates paid by the Social Security system haven’t been adjusted in over three decades, meaning there’s often a shortfall that citizens have to pay for out of pocket.
- Egypt: All citizens can receive free healthcare through clinics provided by the government. There are also private insurance options.
- Ghana: All citizens receive coverage and pay a small premium that adjusts depending on income.
- China: 98% of citizens receive coverage through one of three programs.
- Israel: Citizens receive universal healthcare and can choose one of four programs. To be eligible, a citizen must pay a healthcare tax.
- Kuwait: All citizens receive universal healthcare.
- Malaysia: Malaysia offers universal healthcare which has precipitously lowered rates of infant deaths from 75.5 per 1000 70 years ago to now 6.5 per 1000, a staggering improvement of over 90%.
- Pakistan: Universal healthcare is offered by province.
- North Korea: Claims to provide universal healthcare but defectors call this a lie and say it’s a pay-to-play system of the worst kind.
Europe and the Rest of the World
It’s not just Asia and Africa finding a way to care for their citizens. Travelers will be pleasantly surprised to find Europe and other parts of the world equally devoted to caring for the health and welfare of their citizens. Nearly all European countries offer some form of universal healthcare, to varying degrees. Here are some universal healthcare systems you’ll find in your world travels:
- Austria: Not only do citizens of Austria receive universal healthcare, but it’s available to all EU citizens as well.
- Belgium: Often considered one of the best systems in the world, Belgium healthcare is layered with universal social security provided healthcare, private doctors and hospitals, semi-private and university doctors and hospitals, and a separate system for research.
- Finland: Finland offers a universal system that covers 70% of care with a portion of patient contributions.
- France: Another one of the world’s top systems, France covers around 70% of its citizen care with patients providing a portion that varies depending on the care.
- Italy: Italy offers universal healthcare that is mostly free but some services have co-pays.
- Norway: One of the most comprehensive systems in the world, Norway has a high tax rate that provides thorough coverage for citizens.
- Sweden: Like Norway, high taxes offer comprehensive coverage for all citizens. Dental care is covered by the state through age 23.
- The Bahamas: This island nation has a fledgling universal healthcare system that has grown over the years to offer coverage to all citizens.
- Canada: Canada provides a system of universal healthcare that pairs with additional coverage citizens can purchase.
- Mexico: In 2020, Mexico established a universal care system that provides free care for all citizens regardless of work status and covers all uninsured citizens.
- Brazil: A great place for travelers because Brazil offers universal healthcare for citizens – and travelers. Regardless of your status while in Brazil, you can access free care.
- Australia: Like Canada and the UK, Australia has a universal system that has some private supplementation. Because of the standardized system, costs left to citizens such as prescription fee are generally significantly lower than in countries like the United States.
- New Zealand: Runs a program similar to Australia, often well received by citizens.
California could be the start of a snowball in the United States, creating a path for other states to start their own programs. Or it could be a death knell for the move to universal healthcare. Ultimately, every state will struggle to create this system in a vacuum – like every other country with single-payer healthcare, the United States will likely have to go all in, or stay out.