California residents with high income are already paying 50% income tax; if you include social security and medicare tax, it's even more. 20% sales tax is high, but if you're buying imported things that are being tariffed at high rates and then paying sales tax on that it's about there.

IMHO, if you look at European tax rates vs benefits, and US tax rates vs benefits; US taxes simply aren't efficient, our rates are a little lower and our benefits are a lot lower. Healthcare costs could be significantly reduced if the whole thing were managed as a whole. Do we really need every medical office to have an insurance billing expert whose only job is to interface between the chart and the various insurance rules? OTOH, if you cut out 10% of the cost, healthcare is still expensive, and insurance billing coders and the people who work the other side of that would all be out of work.

Managing healthcare as a whole, you'd be able to do systemwide interventions like increasing residency spots to increase supply of Doctors, and set standards for what care can be delivered by Nurse Practitioners to balance demand against supply.

OTOH, you'd have people complaining that life clocks are a lie, and carousel is a lie and that there is no renewal.