hightor
 
  4  
Reply Fri 22 Mar, 2019 02:22 am
Don’t Make Health Care a Purity Test

There are multiple ways to achieve universal coverage.

Quote:
We’re now in the silly season of the Democratic primary — a season that, I worry, may last all the way to the nomination. There are many honorable exceptions, but an awful lot of reporting seems to be third order — not about the candidates, let alone their policy proposals, but about pundits’ views about voters’ views of candidates’ electability. It’s a discussion in which essentially nobody has any idea what he or she is talking about.

Meanwhile, however, there are some real continuing policy debates. They’re not mainly about goals: Whoever the Democrats nominate will profess allegiance to a progressive agenda aimed at reducing inequality, strengthening the social safety net and taking action on climate change. But there are some big differences about how to achieve those goals.

And the starkest divide involves health care. Almost surely, the eventual platform will advocate “Medicare for TK.” But what word is eventually chosen to replace the placeholder “TK,” and more important, what that means in terms of actual policy, will be crucial both for the general election and for what comes after if Democrats win.

On one side, there’s “Medicare for All,” which has come to mean the Bernie Sanders position: replacing the entire existing U.S. health insurance system with a Medicare-type program in which the government pays most medical bills directly.

On the other side, there’s “Medicare for America,” originally a proposal from the Center for American Progress, now embodied in legislation. While none of the announced Democratic candidates has endorsed this proposal yet, it’s a good guess that most of them will come around to something similar.

The big difference from a Sanders-type plan is that people would be allowed to keep private coverage if they chose — but they or their employers would also have the option of buying into an enhanced version of Medicare, with substantial subsidies for lower- and middle-income families.

The most important thing you need to know about these rival plans is that both of them would do the job.

Many people realize, I think, that we’re the only advanced country that doesn’t guarantee essential health care to its legal residents. My guess is that fewer realize that nations achieve that goal in a variety of ways — and they all work.

Every two years the Commonwealth Fund provides an invaluable survey of major nations’ health care systems. America always comes in last; in the latest edition, the three leaders are Britain, Australia and the Netherlands.

What’s remarkable about those top three is that they have radically different systems. Britain has true socialized medicine — direct government provision of health care. Australia has single-payer — it’s basically Bernie down under. But the Dutch rely on private insurance companies — heavily regulated, with lots of subsidies, but looking more like a better-funded version of Obamacare than like Medicare for All. And the Netherlands actually tops the Commonwealth Fund rankings.

So which system should Democrats advocate? The answer, I’d argue, is the system we’re most likely actually to create — the one that will play best in the general election, and is then most likely to pass Congress if the Democrat wins.

And there’s one big fact on the ground that any realistic health strategy has to deal with: 156 million Americans — almost half the population — currently receive health insurance through their employers. And most of these people are fairly satisfied with their coverage.

A Medicare for All plan would in effect say to these people, “We’re going to take away your current plan, but trust us, the replacement will be better. And we’re going to impose a bunch of new taxes to pay for all this, but trust us, it will be less than you and your employer currently pay in premiums.”

The thing is, both of these claims might well be true! A simple, single-payer system would probably have lower overall costs than a hybrid system that preserves some forms of private coverage.

But even if optimistic claims about Medicare for All are true, will people believe them? And even if most people do, if a significant minority of voters doesn’t trust the promises of single-payer advocates, that could easily either doom Democrats in the general election or at least make it impossible to get their plan through Congress.

To me, then, Medicare for America — which lets people keep employment-based insurance — looks like a much better bet for actually getting universal coverage than Medicare for All. But I could be wrong! And it’s fine to spend the next few months arguing the issue.

What won’t be fine will be if activists make a no-private-insurance position a litmus test, declaring that anyone advocating a more incrementalist approach is no true progressive, or maybe a corrupt shill for the medical/industrial complex. As you might guess, my concerns aren’t drawn out of thin air; they’re things I’m already hearing.

So Democrats should try to make this a real debate, one about the best strategy for achieving a shared goal. Can they manage that? I guess we’ll find out.

nyt/krugman
blatham
 
  1  
Reply Fri 22 Mar, 2019 04:52 am
@hightor,
Was just going to post that. Krugman deserves a medal for his scholarship and his persistence. He's produced an astounding body of work just as a financial journalist which doesn't even account for his economics work.
hightor
 
  3  
Reply Fri 22 Mar, 2019 05:25 am
@blatham,
I listened to an item on NPR this morning:
Quote:
For Democrats, one of the keys to winning control of the House of Representatives last year was convincing voters in formerly Republican districts that there's more than one way to be a Democrat.


Realists know that enacting meaningful, far-reaching reforms to our healthcare system, reducing our military presence around the world, addressing income inequality, ensuring voting rights, developing a green economy, and passing other progressive proposals will be hampered by institutional factors: the filibuster, the hostile court system, the need to command clear majorities in both chambers, etc.

It seems as if party activists could make this even more difficult and basically render this whole question moot. By trying to force Dems from conservative districts to run as Democratic Socialists they could very easily allow the GOP to recapture the House. They might want to think this through some more.
blatham
 
  1  
Reply Fri 22 Mar, 2019 05:47 am
@hightor,
Quote:
By trying to force Dems from conservative districts to run as Democratic Socialists they could very easily allow the GOP to recapture the House. They might want to think this through some more.
Purists don't leave themselves much latitude in their ideas and choices.
edgarblythe
 
  1  
Reply Fri 22 Mar, 2019 06:09 am
There is a poll showing 54% of Democrats approve of GW Bush. The guy ought to be in prison. I rest my case.
oralloy
 
  -3  
Reply Fri 22 Mar, 2019 06:13 am
@edgarblythe,
What crime did he commit?
0 Replies
 
blatham
 
  3  
Reply Fri 22 Mar, 2019 06:22 am
@edgarblythe,
Quote:
There is a poll showing 54% of Democrats approve of GW Bush. The guy ought to be in prison. I rest my case.
Do you have a link for that, edgar?

But in any case, I'm not sure what case you deem proved here. That 54% of Democrats polled are actually some sort of Republican or neoconservative or neo-liberal? And if they are, wouldn't that make the preferences of the majority of Dem voters - because they are the majority - what one ought to respect?

Past that, it is always the case that a president's popularity will rise after he's gone from office. Further, Bush is now seen in comparison to Trump and that comparison makes Charlie Manson look good.
0 Replies
 
hightor
 
  3  
Reply Fri 22 Mar, 2019 06:33 am
@edgarblythe,
His paintings are nice.
0 Replies
 
blatham
 
  2  
Reply Fri 22 Mar, 2019 06:39 am
Today's big surprise
Quote:
Fox “news side” anchor Shannon Bream is keynoting a fundraiser for a Koch-linked group alongside Ron DeSantis
MM
0 Replies
 
blatham
 
  1  
Reply Fri 22 Mar, 2019 06:45 am
More light and goodness from Fox.
Quote:
KILMEADE: Somebody's writing [Alexandria Ocasio-Cortez's] questions. I saw the questions at Michael Cohen and saw the questions at Wilbur Ross. And there is some forces behind her. I think there's a story there.

HUCKABEE: Well, there very well could be. I know there has been some allegations she that was almost like the Manchurian Candidate, recruited, prepared. You know, I don't know. But the point is that she got her voters out.
hightor
 
  4  
Reply Fri 22 Mar, 2019 06:54 am
@blatham,
Quote:
And there is some forces behind her.


Could be a witch hunt in the making!

Idiots. Like it really matters if some strategist helps prepare her list of questions.

Quote:
I think there's a story there.


Obviously not a particularly insightful one.
blatham
 
  4  
Reply Fri 22 Mar, 2019 07:10 am
@hightor,
I love the "some forces". It's so specific. And grounded in evidence. And certainly NOT framed that way so as to encourage paranoid conspiracy ideas.

Same with "there has been some allegations that she was almost like the Manchurian Candidate".

It is the level of integrity at Fox that gives rise to the exceptional quality of its journalism.
0 Replies
 
blatham
 
  3  
Reply Fri 22 Mar, 2019 07:24 am
Quote:
Alexandria Ocasio-Cortez
‏Verified account
@AOC
You know, instead of training children, teachers, houses of faith, & concertgoers to prep for being shot, we could just:

-Pass Universal Background checks (#HR8!)
-Disarm domestic abusers
-Mandate safe storage
-Ban bump stocks, semiautos, & high cap mags designed to kill people

Smart lady, this one.
maporsche
 
  2  
Reply Fri 22 Mar, 2019 07:26 am
@hightor,
I hope to god there is a strategist preparing and especially coordinating all of the Democrats questions.
0 Replies
 
Olivier5
 
  1  
Reply Fri 22 Mar, 2019 07:37 am
@blatham,
Tsk tsk tsk... Doesn't she know? Being smart is un-American.
0 Replies
 
hightor
 
  3  
Reply Fri 22 Mar, 2019 07:37 am
@blatham,
Yeah — I've only lately come around to the demand to include all semi-automatics. The gunbunnies love to play this game where they take an assault style rifle and compare it to a more traditional semi-auto and defy you to explain why one should be banned and the other is okay. Well they succeeded in convincing me that if they're both equally dangerous they're both getting banned! Thanks guys!
oralloy
 
  -3  
Reply Fri 22 Mar, 2019 07:59 am
@blatham,
blatham wrote:
Smart lady, this one.
Just another leftist who thinks violating people's civil liberties is fun.
0 Replies
 
oralloy
 
  -3  
Reply Fri 22 Mar, 2019 08:01 am
@hightor,
hightor wrote:
Yeah -- I've only lately come around to the demand to include all semi-automatics.
Unconstitutional. No justification for doing so.

hightor wrote:
The gunbunnies love to play this game where they take an assault style rifle and compare it to a more traditional semi-auto and defy you to explain why one should be banned and the other is okay.
Pointing out facts that contradict your position isn't a game. That's called a rational discussion.

hightor wrote:
Well they succeeded in convincing me that if they're both equally dangerous they're both getting banned! Thanks guys!
They aren't getting banned. We have the NRA, the Supreme Court, and Donald Trump to protect us from you.

But thanks for making it clear to hunters that leftists want to ban their hunting weapons.
snood
 
  4  
Reply Fri 22 Mar, 2019 08:29 am
@blatham,
blatham wrote:

Quote:
By trying to force Dems from conservative districts to run as Democratic Socialists they could very easily allow the GOP to recapture the House. They might want to think this through some more.
Purists don't leave themselves much latitude in their ideas and choices.

And they try to proselytize their limited scope.
revelette1
 
  3  
Reply Fri 22 Mar, 2019 09:54 am
@Lash,

Quote:
People don’t like Hillary Clinton


Which is why she won the popular vote by a huge number.
 

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