$37,000,000,000 annually.

its annual budget.

It may be worth it but we're talking about substantial tax increases.

How much does the employer pay? How much of the population is covered under employer-based?

In Colorado, which is economically very similar to California, just smaller, the average person pays about $12000 a year in payroll deductions, split between employee and employer. About 70% of people are covered under employer plans. Another 10-15% are covered under individual plans, Exchange or not. The rest are either Medicare, Medicaid, or both. The Colorado portion of the Medicaid budget (HealthFirst) was $9.1 billion in 2016. Colorado is roughly 1/7th the size of California in population, so assume California is already paying about $63 Billion for MediCal. Medicare is actually quite easy to convert to a state-based single payer, since it's already a single payer system. It just becomes a single payer, single provider system. Total California Medicare spending in 2015 was $64.5 Billion.

California has 39 million people. Using the same rough estimates of population distribution, Employer based already costs about $327 billion a year. We just don't see it, because it comes out before we get our paypackets, even before we get paid or negotiate our salaries. That won't change. So roughly -- add the already allocated MediCal funds, plus the Medicare funds, plus what we're already paying in employer based costs, and the $400 Billion a year number doesn't look unattainable at all.

At which point, costs do come down, because the state has the ability to negotiate for better wholesale drug prices, and with the large provider groups, and set standard reimbursement rates. There's no reason an appendectomy or an aortal shunt should vary by a factor of 3 depending on if it's performed in Sacramento or San Diego. So boo-hoo. Some cardiologist will just have to make do with last year's BMW. The neurosurgeon won't be able to go to Gstaad twice a year. The anesthesiologist may have to settle for a 5000 square foot house and a 40 foot boat instead of 10K and 80. The hospital administrators will have to justify their salaries. I'm sure they'll live, and maybe we can start paying first and second year mental health providers as well as we pay first and second year elementary school teachers.

What does worry me about establishing a single payer system is the insurance company jobs. Those are good careers and mostly women, often from working class backgrounds, often women of color. Insurance claims service is one of those stepping stone jobs between the retail service economy and the professional economy. Most of that workforce will be absorbed into a state-wide single payer, but not everyone. It's mostly the middle and senior management that will be redundant, but those are still middle class careers. We have to consider that in our calculus.

It seems like it won't do any good since they already made up their minds. I'm crestfallen.

Apparently single payer was in the works before the ACA was implemented. At that time it was tabled to see how the ACA would work.

When the Republicans were saying they were completely repealing the ACA, the California single payer plan was brought back out, but they have tabled it again until they see what is passed which makes sense. They need to know exactly what the federal government will be doing and how much money the states will get and how it must be used before they can craft a plan or create a budget for it.

The points you raise are reasonable. However, tabling it in Rules leads those with more knowledge than I to fear it's going there to die. Advocates on DKos feel if it were tabled in Health, Tax or Insurance committees, it stands a better chance of being fleshed out. I've emailed my Assembly representative and plan to call the Speaker's office tomorrow to voice support. I'll also contact my State Senator. I don't believe the bill is hopeless. I believe our elected representatives need to get to work. There are examples and solutions. With the AHCA staring us down we need to work on this for California and, ultimately, for the country. In California we control the State Senate, the Assembly and the governorship. No excuses.

Also, the proposition route which would offer political cover is full of pitfalls. Industries and interested parties write a bill that suits them rather than what suits the electorate. Also, opposition frequently writes a similar but problematic version to muddy the waters for voters. I'd like to see our legislators legislate.

The points you raise are reasonable. However, tabling it in Rules leads those with more knowledge than I to fear it's going there to die. Advocates on DKos feel if it were tabled in Health, Tax or Insurance committees, it stands a better chance of being fleshed out. I've emailed my Assembly representative and plan to call the Speaker's office tomorrow to voice support. I'll also contact my State Senator. I don't believe the bill is hopeless. I believe our elected representatives need to get to work. There are examples and solutions. With the AHCA staring us down we need to work on this for California and, ultimately, for the country. In California we control the State Senate, the Assembly and the governorship. No excuses.

Also, the proposition route which would offer political cover is full of pitfalls. Industries and interested parties write a bill that suits them rather than what suits the electorate. Also, opposition frequently writes a similar but problematic version to muddy the waters for voters. I'd like to see our legislators legislate.

So I'll believe it when I see it.

I wish Californians luck to get the best healthcare system possible.