I live in California on purpose. I have lived here for more than 20 years, staying first for graduate school, then jobs, now family and the lifestyle it affords. I like southern California, South Bay Los Angeles, mostly because it's not freezing for 3 months of the year, like where I'm originally from.
There's one big thing missing in California, well beyond the affordable housing issues that have been getting worse, but which something that literally every other economy (excluding the United States as a whole) of its size has; universal healthcare. Every other economy ranked on the top-25+ GDP countries in the world have some level of universal healthcare that neither the United States, nor California has decided to do for its citizens.
Massachusetts has MassCare. Other states have provided similar options for ultimately the same reason: universal healthcare saves money. Like about half the money of the system we've got going on now. Not only would it cost about half as much, but you don't need to charge any copays, deductibles, etc. Everything is paid for by the money you already pay, because you don't have a group of executives telling you no, just so they can have another yacht. Audits and checks still happen, but because it's not a conflict-oriented system, but a "what service was performed, what is the comp rate on that service, can we verify the service was performed, and does the patient have any feedback WRT the service?", the process goes much more smoothly.
No, that doesn't mean people can walk in and be like, "give me an x-ray". It means that surgeons aren't called in the middle of surgery to hear from an insurance company, "the hernia repair is not covered". Or 2 months into chemo that it isn't covered under your plan, and you'll have to pay $20k for what is already halfway killing you. None of this is okay. And it it is stupid to pretend that it is okay when it is broken at its core.
When we treat people and their care like a business, then the business folks naturally optimize for that business profitability. But if we treat it like a service, where the purpose of the money is not to fight over who gets coverage, or how money can be saved so someone can get a bigger bonus, but instead how to allocate the money to best help the health of the community. Then instead of talking about restricting care, you talk about preventative care. You talk about proper nutritional programs, about ensuring expectant mothers get the food and supplements they need for the healthiest possible babies.
Whenever this comes up, there is always a disingenuous voice that pops out and says, "you can't force someone to do the work". But here's the deal: no one is forcing folks to work those jobs, they continue to get paid, exactly like before. Just because it's universal, doesn't mean they don't get paid. You pay a tax, a little more than you already do, less than half as much you do explicitly or implicitly via your employer. You get better care and more choice in doctors. No more "are you in-network for whatever" questions, the answer is "yes, I take the universal package".
Anyway, California should provide a universal healthcare option for people, being the 4th largest economy itself. It would save so much money and would raise the quality of life of every Californian.
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