California has a history of disaster when it comes to setting up and running computer systems for any level of government.

LAUSD was trying to fix a computer glitch for over a year that didn't pay some people and paid others too much.

I forget what it was for, but a couple weeks ago the state fired a computer contractor that was three years behind, tens of millions of dollars over, with an error rate of 100 times the acceptable level.  

There are so many stories that I can't even begin to recall them all.  

The state is currently setting up a program that will start to enrol up to 5 million people starting October 1st, with benefits to start January 1st.  The program has to be accessible by government (state and fed), patients, doctors, hospitals, pharmacies, and insurance companies.  It will be signing up millions of people, hopefully without duplications and/or fraud.  The regulations that will govern the system are not fully established, so they don't know what to program.

While other government programs come in two or three years late, this has to be set up in 9 months.

I will post October 1st and we can see who well it is going.

Don't stop at Detroit.  Try Illinois.

Los Angeles Mayor Villaraigoso said that Los Angeles would not go bankrupt under his reign, but he only has another year to go.

CA's new "budget" just came up short  billlions, so after raising taxes three months ago, they want to raise them again.  In the meantime, we are building a bullet train that will never be finished.

I have many very liberal friends who work in SF.  The second they have kids, they move out of the city.  SF is becoming a child free city, unless you are poor, because it is too expensive for families and a terrible place to raise kids.   (SF has a vast tourist business and Tech, which is super rich young people who can afford a luxurious life style, until they have kids.)

The list of cities in L.A. in serious finiancial trouble it too long to list.  

And NY city is just doing so well.

probably have run on a promise to address the debt. One of his first bills will be to cut back entitlements including the Medicaid expansion.

      So, as Snowman points out, there is a real possiblity that the feds will either run out of money or will cut this cost to reduce the debt.

      And remember the expansion is not about covering the poor - the expansion covers adults who make up to 138% above the federal poverty level.  I'll help the truly poor but why should I have to pay for these guys?.

What % Federal Budget go towards health care?

You could say the same for big oil and banks. Oil companies posting record profits year after year and controlling the price of gas as a group.

Medical care keeps getting better.  When my parents friends started having mobility problems they would get a case at Schwabs, the local drug store.  Now they get a new hip or knee.  The wait for knees and hips in Canada, France, and the UK is muck longer than here, which means people are in pain for that much more time.

A few years ago, I had a medical condition that required me to take a drug that was "semi-experimental."  The reason it was "semi" was it was an improvement on the previous generation of drug.  I was on it for 9 months.  By the time that I finished, the NEXT one was being tested.  They are constantly researching how to make it (read them) better, and the one I took had to be paid off in nine months because it was getting obsolete.

Finally, look at hospital rooms 10, 20, or 30 years ago.  The biggest expense when i was a kid was sheets.  Now everyone is hooked up to computers.  And each year every machine gets better.  It is a constant stream of research that costs a fortune and has to be recouped very quickly because next year it will be improved again.

When I was a kid my father did house calls.  He could carry every piece of equipment that he used in a bag the size of one I take to the gym.  His office lab was a centrifuge and a microscope about the same level as the one in my junior high school science class.

The same thing that happens to your cell phone or I-pad or TV is happening at every level in medicine.  It is 1000 times better.  It costs.

Of course, the State could pay for the research and cut out the companies, but it would still cost so it would have to be covered in taxes. And that creates other issues.