French economist Gabriel Zucman has come to California bearing a familiar French solution to a fiscal problem: another tax.

Once based at the University of California, Berkeley, Zucman is back and campaigning for Proposition 40, which would impose an allegedly one-time 5 percent tax on the net worth of Californians worth more than $1 billion. Zucman, who coauthored the proposition, estimates that the tax could raise about $100 billion and claims that 90 percent of the proceeds would go to health care.

The California Legislative Analyst's office is far more cautious, saying it would raise only "tens of billions" and could cause a long-term loss of income-tax revenue as wealthy people leave the state with the companies they created.

I've written plenty about why wealth taxes are economically destructive, administratively nightmarish, and unlikely to achieve anything close to what their advocates promise. But Zucman's prescription is wrong for a more fundamental reason, as his (and my) native country shows: Raising taxes to fuel ever-larger demands for government spending is a recipe for disaster.

Unless you've been living in a remote cave recently, you've likely seen all the protests and destruction in France. But do you know why it's happening?

As another economist, Paul Krugman, rightly noted back in 2017, "France offers a social safety net beyond the wildest dreams of U.S. progressives: guaranteed high-quality health care for all, generous paid leave for new parents, universal pre-K, and much more."

For decades, France has answered any perceived desire with government spending, then responded to the resulting fiscal problem by seeking new revenue sources. Today, French government spending consumes roughly 58 percent of gross domestic product (GDP).

Krugman gloated that France wasn't suffering social collapse and speculated that it was due to all the spending. He certainly can't say that anymore. In fact, he is now worried that France may be on the precipice of a debt crisis. The truth is that France hasn't done well for some time, even when Krugman cheered its spending.

One of the groups in the street today, young people, has faced widespread unemployment for a long time. The youth unemployment rate in France (ages 15-24) has hovered between 17 percent and 27 percent since 2000. In the second quarter of 2026, it was 21.6 percent, against 14.8 percent in the Eurozone and 9.9 percent in the U.S.

French people also pay some of the highest taxes in the developed world, and they're not happy with the return. The government already takes more than 52 percent of the country's output in revenue, runs deficits exceeding 5 percent of GDP, and has accumulated debt approaching 120 percent of GDP. Nonetheless, French students complain that the government is shortchanging schools, while everyone sees that it is shortchanging its army and police.

The students aren't wrong to feel left out. At The Two Cents Substack, Hoover Institution scholar Hanno Lustig calculates that, between 1995 and 2024, spending on social protection and health (most of which benefits older people) rose from 53.1 percent to 58.7 percent of all French government spending. The share devoted to education, defense, and public order fell from 15.2 percent to 13.7 percent. Transportation fell from 5.3 percent to 3.8 percent.

In other words, France has built an enormous welfare state, much of it devoted to older citizens, while letting other state capacities and basic services fall apart. As transfers of wealth swallow a larger share of the budget, everything else gets squeezed.

That is the fiscal ratchet Californians should worry about when Zucman tells them Proposition 40 is necessary to "save" health care. Proponents claim Washington "cut" Medicaid, but that language is misleading. California's deficit started long before any Washington spending reductions. Besides, federal Medicaid spending isn't falling—not even close. The Congressional Budget Office estimates it will reach $708 billion in 2026, 8 percent more than in 2025. What Washington did in the 2025 budget reconciliation law was reduce Medicaid's future growth relative to previous projections, partly by changing eligibility and enrollment rules and financing arrangements.

This is how the ratchet works. Once the government projects a spending increase, anything less becomes a cut. And once Washington fails to finance the entire projected increase, Californians are told that Sacramento must backfill the missing money. And how should it do that? Conveniently, by creating an entirely new tax.

France has run this experiment for decades. It has an incredibly generous welfare state paid for with very high taxes; it's even tried a wealth tax and has a value-added tax, yet somehow it's never enough. Its welfare state has not eliminated scarcity. It has merely transferred the job of rationing scarce resources to politicians.

Zucman looks at California and sees hundreds of billions of dollars of private wealth waiting to solve a public finance problem. Californians should look across the Atlantic and ask a different question: What happens after politicians decide that every spending adjustment can be delayed until tomorrow by finding another pot of private wealth?

France should not be sending California tax advice. It should be sending a warning.

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The post France Is a Warning to California's Tax-the-Rich Crowd appeared first on Reason Magazine.

Like most of American healthcare, kidney care has for decades been plagued by red tape. The Trump administration says it wants to change that. On Tuesday, Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced his department's Kidney Care National Plan, which promises to introduce more competition, reduce regulatory barriers, expand patient choice, and overhaul America's kidney transplant system.

Much of the plan focuses on barriers to entry in dialysis care, which treats nearly 558,000 Americans. While dialysis can be performed at home, most patients receive treatment at specialized facilities, which must comply with federal certification requirements governing equipment, staffing, water quality, and patient safety in order to participate in Medicare.

Kennedy argues that regulatory barriers have discouraged competition and innovation, leaving patients with fewer dialysis treatment options. "Dialysis technology is an extraordinary technology," said Kennedy at the press conference, but "because of monopolies in the system and the barriers to new entrants, we have not seen any real improvements in that technology."

Of course, the existence of large or even monopolistic companies is not in itself evidence of a problem, but government regulation can often entrench those companies' positions in the market. "I like the fact that they're recognizing that a lot of regulatory…barriers are contributing to the problem, and that's refreshing to hear," says Jeffrey Singer, a practicing general surgeon and senior fellow at Reason Foundation, the nonprofit that publishes Reason. Singer says that removing barriers that prevent new companies from competing with established providers could not only increase choice but also drive down prices.

HHS says that two companies, DaVita and Fresenius Medical Care, control approximately 74 percent of the American dialysis market. As of 2019, roughly a third of Americans lived in areas where the only available dialysis provider was one of those two companies, according to the agency. The administration argues that government regulation has helped entrench this dominance by making it difficult for new providers to enter the market.

To address this, the Kidney Care National Plan suggests a number of reforms, including simplifying certification requirements. HHS also plans to investigate whether dominant dialysis providers have used payment arrangements and legal strategies to secure higher reimbursements without delivering better care.

The 17-page report calls for a review of existing requirements, but it does not specify which regulations will be repealed, nor does it establish a timeline for doing so. It also does not propose any significant reduction in the government's role in financing the distorted market. Instead, the plan largely seeks to make existing government-financed systems such as Medicare more competitive and efficient.

Kennedy has also correctly identified the need for reform regarding kidney donations. Nearly 90,000 people are waiting for a kidney transplant at any given time in America, and 11 people die every day waiting for a kidney. The transplant process is currently managed by Organ Procurement Organizations (OPOs), which are federally certified nonprofits responsible for recovering organs from donors and coordinating their transfer. There are currently just 55 federally designated OPOs operating in the United States, and HHS argues that they behave as "regional monopolies." Since no new OPOs have been approved in the last year, the Kidney Care National Plan suggests fast-tracking certification.

The plan also seeks to make living kidney donation easier by reducing financial barriers. Following the passage of the Honor Our Living Donors Act in February, HHS revised federal reimbursement rules so that a donor's eligibility for financial assistance is no longer determined by the transplant recipient's income. Eligible donors can receive up to $6,000 to cover expenses, including travel, lost wages, and childcare.

However, the reforms proposed stop short of allowing kidney donors to receive direct compensation for the organs themselves, which remains prohibited under federal law. "I can sell my blood. Why can't I sell my kidney?" Singer asks.

Peter Jaworski, director of the Georgetown Blood and Plasma Research Group, feels similarly, arguing that financial incentives are available to nearly everyone involved in kidney transplantation except the donors themselves. "According to this plan, it's OK to use incentives to encourage them to be more productive, to actually do a better job," Jaworski tells Reason, referring to transplant surgeons, hospitals, and organ procurement organizations. "The only exception, once again, is the donor who is offering a kidney."

Better solutions exist, according to Jaworski, who points to the proposed End Kidney Deaths Act. The bill, which was introduced by Rep. Nicole Malliotakis (R–N.Y.) last year, would offer living kidney donors a $50,000 refundable tax credit, distributed over five years. "We have those systems in order to make sure that we can treat patients. That's the point of blood donation. That's the point of plasma donation. That's the point of kidney donation too."

America's plasma market is an excellent example of financial incentives encouraging donation. Unlike many other countries, the U.S. allows plasma donors to be compensated, and despite accounting for just over 4 percent of the world's population, it supplies approximately 68 percent of the plasma collected globally for manufacturing medicines.

"Why do you think America does it? Is it because in America there's way more altruism than in France or Italy or Belgium? No, it's because in the United States you can be paid to donate plasma," argues Jaworski.

The Trump administration appears to recognize that government overreach has stifled competition and restricted patient choice. It also recognizes that living adults donating kidneys will be part of the solution to the long, deadly waiting lists. But its plan leaves the government's outsize role in kidney care largely untouched. For patients facing years on dialysis or waiting for a lifesaving transplant, recognizing the problem is not enough.

The post RFK Jr. Wants To Cut Red Tape in Kidney Care. He Should Go Further. appeared first on Reason Magazine.

The U.S. Supreme Court has denied an emergency petition from the Trump administration, which sought a stay on a lower court’s injunction on a policy that would have denied gender-affirming care to federally incarcerated transgender people.

That policy was implemented by the Bureau of Prisons (BOP) after President Donald Trump signed an executive order in January 2025 that denied the existence of transgender people. The order also directed federal agencies to take steps that would be consistent with that view, and included specific instructions for the BOP.

“The Attorney General shall ensure that the Bureau of Prisons revises its policies concerning medical care to be consistent with this order, and shall ensure that no Federal funds are expended for any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex,” the order reads.

After the BOP conformed to the order, a group of incarcerated trans people who had been receiving gender-affirming care sued the administration. The group is being represented by the American Civil Liberties Union (ACLU), which argued that their Eighth Amendment protections against cruel and unusual punishment were being infringed upon.

A federal judge agreed, and, in August, ordered the policy to be blocked. The Trump administration challenged that finding, but the U.S. Court of Appeals for the District of Columbia Circuit upheld it, prompting Solicitor General John Sauer to submit an emergency appeal to the Supreme Court.

The court has regularly ruled against transgender people, allowing state bans on trans athletes’ participation in sports, ruling in favor of a ban on transgender people in the military, and upholding state laws that bar gender-affirming care for trans children and teens. Yet on Wednesday, the court denied the Trump administration’s request.

“The application for stay presented to The Chief Justice and by him referred to the Court is denied,” the order read, giving no further explanation. Two justices for the court — Samuel Alito and Clarence Thomas — would have granted the Trump administration’s request for a stay, the document said.

The ACLU heralded the high court’s denial of the emergency petition, stating, “This ruling affirms that federal prison officials can’t deny transgender people essential health care.”

Around 1,000 federally incarcerated trans people have also been diagnosed with gender dysphoria. The ruling means these individuals can continue receiving gender-affirming care while they remain in federal prisons or jails and the case moves forward in the lower courts.