I think it could be within the budget, especially considering how much is currently spent by employers, which could be turned into a tax and funneled into "California health care". The bigger issues would be negotiating with medical providers, the hospital systems and multiple levels of US medical bureaucracy. Even then, for example medicare/medicaid, look how much fraud if often found around over paying / unnecessary procedures etc. In my opinion, because of how much traction and jobs exist at multiple levels of pharma to insurance to medicine in the US, I almost think it's an intractable problem, but I wish it wasn't.