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Don’t make California health care worse than it already is

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Don’t make California health care worse than it already is


California legislators want the state to provide free health care to every resident, including undocumented immigrants.

Assembly Bill 2200 would make CalCare the state’s single-payer health-coverage provider. Under the act it would be illegal for any resident to pay a doctor privately for any medical treatment covered by CalCare.

To accomplish this goal, the legislators hope to convince the federal government to turn over all California Medicare funding so they can force every senior into the new system. Ditto for Medicaid. Employer-provided health insurance would also vanish. Instead of paying premiums and medical bills for private coverage, employers and their employees would have to pay taxes to CalCare

More taxes. Even if the federal government forced Medicare beneficiaries into CalCare, and CalCare collected all Medicaid and employer insurance payments, it would still need additional revenues to replace out-of-pocket spending by individuals.

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In 2023 a bill to fund California single-payer care, ACA 11, was tabled. It would have imposed higher individual payroll taxes, higher income-tax rates with a top marginal tax rate of 18.05 percent, and taxes on gross business revenues. The Tax Foundation estimated it would increase taxes by $12,250 per household, doubling the current tax burden.

“Medicaid for all.” If everyone had to be in the same health plan, what would the system look like? Almost certainly it would spur a race to the bottom.

Wherever we look in the world, we find that government-run health care tries to control costs by squeezing the providers. In California, that would mean paying doctors and hospitals Medicaid rates – or perhaps even less.

According to Urban Institute researchers, California’s average Medicaid payments to providers are already significantly lower than in other states, amounting to about three-quarters of Medicare’s average payments.

And Medicare pays physicians and hospitals less than cost. Hospitals lost 12 percent on Medicare inpatients in 2022. Private payers currently pay 143 percent of Medicare rates for physician services and 189 percent for inpatient hospital care.

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In 2017 only 48 percent of private California physicians  accepted new Medicaid patients, so they wait months or years for appointments. Under CalCare, everyone would be waiting.

Rationing by waiting. During the COVID-19 pandemic, California met the surge in medical needs by paying traveling nurses as much as $5,000 a week to attract them from out of state. Under CalCare no hospital could afford to do that. On the contrary, doctors and nurses would leave the state seeking better pay (and lower taxes).

What would happen when demand for care surged (because it was free) and supply shrank (as the providers left for greener pastures)?  The answer has almost always been: rationing by waiting.

According to the 2023 edition of the Fraser Institute’s Waiting Your Turn, Canadians on average wait more than 6 months from referral by a general practitioner to treatment by a specialist. Patients, including women showing symptoms of breast cancer, wait more than three months for an MRI scan.

Unable to get the primary care that Americans expect, Canadians frequently turn to overcrowded emergency rooms, where some die waiting for hospital beds.

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England’s National Health Service (NHS) staffing and bed shortages are so bad that almost 14 percent of planned hospital surgeries are canceled on the day scheduled. Ten percent of canceled patients had suffered previous cancellations. Recently, a woman with a severe skin condition waited four years to see a dermatologist.

Covering up failure. Governments rarely like to admit their mistakes. Over 20 years of structural failures in NHS maternity centers injured or killed thousands of babies. Those infant deaths were hidden by the bureaucracy. Each scandal uncovered since the 2015 Morecambe Bay report has been investigated. Reforms have been announced, but the systemic failures remain.

In the United States, Veterans Administration (VA) officials were caught covering up failure by falsifying waiting–list datain 2014. They were forced to reduce wait lists by paying for private care. Subsequent comparisons of VA and private surgical outcomes found no adverse quality differences as a result of using private services to obtain prompt care.

No exit. Eliminating private payment for covered services is such a bad idea that even Canada has given up on it. Canadians who had been enduring up to two years of pain waiting for hip surgery can now pay privately and wait only two months.

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Bad as you may think California health care is now, passing CalCare will make it much, much worse.

John C. Goodman is a senior fellow at the Independent Institute in Oakland, Calif., and president of the Goodman Institute. He is the author of A New Way to Care: Social Protections that Put Families First. Linda Gorman is the director of health care policy at the Independence Institute in Denver, Colorado.



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‘Sneaker wave’ sucks California fisherman out to sea

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‘Sneaker wave’ sucks California fisherman out to sea


A fisherman was pulled from the ocean and rushed to a hospital in critical condition after a powerful “sneaker wave” swept him off the shoreline at Baker Beach in San Francisco.

The dramatic May 29 rescue unfolded around 1 p.m. in the Presidio, where emergency crews responded to reports of a person sucked out to sea.

According to the San Francisco Fire Department, witnesses said the fisherman was standing along the shoreline when a sneaker wave suddenly surged ashore, knocking him to the ground and into the ocean, leaving him incapacitated.

Bystanders quickly called 911, helping launch a large-scale rescue effort that included San Francisco firefighters, an SFPD police boat, drone units and a helicopter.

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Within minutes of being dispatched, three rescue swimmers from SFFD entered the water and reached the victim, officials said in a post on X. The crew conducted an open-water rescue and brought the fisherman safely back to shore.

Paramedic rescue swimmers and additional emergency medical personnel immediately began advanced life support measures and rushed the victim to a nearby hospital in critical condition, fire officials said.

Officials said the harrowing ordeal serves as a reminder of the dangers posed by sneaker waves, which can strike with little or no warning.

Unlike typical waves, sneaker waves can surge much farther up the beach than expected, even on days when ocean conditions appear calm. The powerful waves can easily knock people off their feet and drag them into the water before they have time to react.

Fire officials urged beachgoers to stay off wet sand and rocks, keep a constant watch on the ocean and never turn their backs to the water. Anyone who sees a person swept into the surf is asked not to enter the water, but instead to call 911 immediately and throw the victim a flotation device if one is available.

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“Early calls to 911 save lives,” fire officials said.



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California reports one of largest drops in homelessness in past year, Hud reports

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California reports one of largest drops in homelessness in past year, Hud reports


California reported one of the largest decreases in homelessness over the past year, according to a new report from the US Department of Housing and Urban Development (Hud).

The Golden state recorded a total unhoused population of 181,934 in 2025 – an almost 3% decrease since the year prior, placing it among the five states with the largest decreases from 2024. However, more significant drops were recorded in Illinois (44%), Hawaii (41%), Florida (11%) and New York (8%).

The new data signals at least some success on the part of Gavin Newsom, the California governor who has intensified his crackdown on homelessness over the past year. In May 2025 he announced a new model ordinance for cities and counties to address “persistent” homeless encampments, as well as $3.3bn in voter-approved funding to increase housing and drug treatment programs.

California, along with New York, had the largest population of unsheltered people recorded in 2025. Homelessness has been a key issue in this year’s gubernatorial race, as well as in the Los Angeles mayoral race.

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The data also showed that the national homeless population decreased for the first time since 2016, coming down 3% from 2024. The Trump administration attempted to downplay the small one-year decrease, instead highlighting the fact that homelessness has increased 27% since 2013.

“The data is clear that the status quo of ‘housing first’ has failed to meaningfully reduce homelessness, resulting in crisis levels of people living on the streets,” Scott Turner, the Hud secretary, said in a press release. “HUD is restoring its programs to advance recovery and self-sufficiency and to ensure that taxpayer-funded benefits serve American families.”

As the administration attempted to downplay the drop in homelessness, it also sought to connect the success to its immigration policies, stating that the 2025 decrease was “attributable to decreases in Sanctuary Cities”.

The data comes from the federally mandated homeless point-in-time count, which tallies people sleeping in shelters and outside on a given day. On a single night in January 2025, there were 745,652 homeless persons in the United States.

While anti-homelessness advocates cited the decrease in homelessness as a “relief”, they also pointed out that the Trump administration’s policies may erode the progress that has been made.

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“So much of the progress reflected in the 2025 PIT Count is due to targeted housing and service resources that were available in 2024 to rehouse people, including the highly successful Emergency Housing Voucher program, and new funds to address rural and unsheltered homelessness,” Ann Oliva, the CEO of the National Alliance to End Homelessness, said in a statement.

“Unfortunately, the Trump Administration has largely deprioritized these tools and worked to dismantle the very systems that drove these reductions.” Oliva pointed to the administration’s proposed cuts to permanent housing programs, which the organization found would “force at least 170,000 formerly homeless people back on the streets”.

The government has also mandated treatment for recipients of federal housing vouchers, and penalized jurisdictions that employed harm-reduction strategies such as safe consumption sites. In April 2026, Hud introduced a proposed rule that would require federally funded shelters to house prospective tenants based on their birth sex alone.



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I moved from Germany to the US for my career. The high cost of living in California shocked me, but it’s worth it to live here.

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I moved from Germany to the US for my career. The high cost of living in California shocked me, but it’s worth it to live here.


This as-told-to essay is based on a conversation with Christiane Schroeter, a 49-year-old professor of innovation and entrepreneurship and leadership strategist in San Luis Obispo, California. The following has been edited for length and clarity.

I moved from Limburg, Germany, to the US in 1999 as an exchange student for my M.S. degree before returning to Germany to complete additional graduate work. I returned to the US in 2001 as a Fulbright Scholar to pursue my Ph.D. at Purdue University.

After I earned my Ph.D. in 2005, I decided to build my career and my life in the US rather than return to Germany. I had met my husband during my graduate school years, and together we chose to put down roots on the West Coast.

I joined the faculty at Cal Poly in September 2007 and gave birth to my daughter in December of that year. I started a new job, pregnant, while moving across the country. Building a career and a family at the same time, far from my home country, shaped everything I came to understand about the real cost of relocating.

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Today, I’m a leadership strategist, professor of innovation and entrepreneurship at Cal Poly, San Luis Obispo, author of several books about leadership, and a podcaster.

The new country feels last longer than you expect

I was 23 years old when I first moved to the US. I expected the obvious expenses, such as flights, paperwork, and the starter purchases you don’t think about until you need them.

What surprised me was how long the newness stayed expensive. Even when your income is objectively higher, fixed costs rise so quickly that it takes very little to feel financially stretched.

I spent hours learning basics I had taken for granted in Germany, like opening bank accounts, building credit from zero, and figuring out what to do when you’re asked for a Social Security number before you have one.

I also had to learn how rental contracts, deposits, phone plans, and transportation work in places where you need a car, including registration, insurance, and DMV requirements. Time becomes money fast when you’re studying, working, and trying to build a future at the same time.

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In Germany, I knew how life worked. In the US, I had to rebuild that knowledge piece by piece.

Housing in California made me realize how quickly additional money gets absorbed

Many people underestimate how dramatically living in California can affect their budget.

For me, one of the highest unexpected monthly costs was the mortgage. Housing was not slightly more expensive. It became the financial anchor that shaped everything else. My husband and I had to make monthly decisions around that number.

Living in California was a genuine upgrade with bigger houses and bigger yards. California’s abundance of fresh produce, gorgeous weather, and proximity to the ocean fit my lifestyle better than Germany ever did. The cold, rainy days and a culture I never fully connected with were not the life I wanted.

I would honestly say I live in a “Goldilocks place.”

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The cost of childcare changed how I thought about security

The hardest trade-off was realizing how expensive support can be when you live far from friends and family. After I delivered my first child, I faced the childcare scramble almost immediately. I remember touring childcare centers and wondering how families afford monthly costs for multiple children. I spoke with mothers who realized that their earnings would nearly match what they were paying for childcare.

At the same time, I was adjusting physically and emotionally to becoming a mother, and when you’re far from family, there’s no built-in safety net for the unpredictable moment, such as a sick day, a last-minute meeting, or an emergency.

I learned that many US families create a fragile patchwork of childcare and babysitting. If you have children, distance from family is not only emotional but also logistical. It can become one of your highest monthly costs, and one of your biggest mental loads.

On a lesser note, one bill shocked me: our cellphone bill. Our family plan with four phones, two watches, and two iPads is about $300. That may sound routine, but over a year, it feels like a luxury purchase hiding in plain sight.

Healthcare and benefits reshaped my definition of stability

Healthcare in the US introduced another layer of financial awareness. Even with insurance, you still have to pay premiums, deductibles, co-pays, navigate provider networks, and prepare for potential surprise costs.

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I remember debating whether to schedule a specialist appointment because I wasn’t sure how much it would count toward our deductible. In Germany, that decision would have been straightforward. In the US, it required reviewing the provider network, estimating out-of-pocket costs, and preparing for an unexpected bill.

The upside is real, but so is the pressure

I built the life for which I came here. I built a stable academic career. I built a business. California became home.

In Germany, Sundays were true rest days. Life paused by design. In California, Sundays easily became catch-up days. I realized I had to intentionally create what I now call “Serenity Sunday.” It is my way of honoring the German philosophy of working to live while living in an American culture that often feels like living to work.

I don’t think I’d move back to Germany now. When I visit, I enjoy it more like a tourist looking in than a native who feels at home. For me, the cost of living in California is worth it, because what I’ve gained is hard to put on a spreadsheet: independence, a career I couldn’t have built anywhere else, and a family rooted in a place I chose.

The price is real, but so is the payoff.

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