u.s. politics: molotov cocktail through the overton window

[all swedes are racist]

9 hours ago, Triskan said:

My bolding.  But what they also help to highlight is that these challenges might be immense.  Not necessarily something that cannot be overcome, but it's a huge hurddle.  

Now gaming this out a bit I can see the strategy in the Dems putting out the so-called aspirational starting point at this early stage.  It will actually be a strong talking point, and it fills a critical need for the Dems in the "what does their party represent" realm.  And another thing I should have mentioned before is that the major resistance, both from the special interests and from the regular people afraid of losing the status quo, likely comes much more heavily at the implementation stage after a Dem has won the White House; not so much in the campaign.  That helps justify using it as part of the platform.

But I still think there are potential landmines once the implementation stage is underway.  Ryan Cooper makes many good points in this column but then makes a point that I find bizarre:

 

Cooper seems to offer the above as a way of saying "this is why you go for single-payer" when it points to the opposite conclusion to me.  The reason he gives for Clinton and Obama's hesitancy, that people were afraid of losing what they had, would be far greater in the push for single-payer.  Again, something like 150 million people have health insurance from their employer, so single-payer would represent a change to a number of people many times greater than Obamacare.  However good single-payer could be as a policy the United States might be, due to historic factors beyond simply the current special interests, uniquely situated to resist a move to it.

But to Coopers's other points, and RRL's point upthread, there are some very good substantive reasons for single-payer, so if they ever get the chance to go for this implementation they had better have worked out some really good ways to communicate these points:  you won't have your insurance stuck to your job anymore, whatever the overall sitcker price both the US and you personally will pay less, etc...

 

 

8 hours ago, Kalbear said:

No, medicare-for-all does not need to be. That is one implementation of one form of universal health care, and it is not remotely clear that it is the best solution for the US.

The problem I have with Sanders doing this is that he is using it as a litmus test for progressives, and that's hugely flawed for a number of reasons - the biggest one being that his plan fucking sucks ass. And supporting a shitty plan because you're behind the basic logic of its need is not a good idea on many levels, the biggest of which is that the smart people will not support you. Colorado's single payer program lost 80-20 because it did things like remove abortion coverage, they couldn't figure out how to pay for it and it came up with this bizarre version of voting that could cause some Colorado residents to not be able to vote for it. 

I support - and continue to support - universal health care coverage in the US. It remains one of the best predictors of social welfare in the world, it remains the single most important safety net that people have, it is a great balancer for mobility, and it is morally absolutely correct. Don't make it a litmus test to support Sanders and his poorly thought out, aspirational plan full of holes and bullshit. 

ok, so let me as you guys, and anyone else that feels similarly, (genuinely curious, not in a set up kind of way) what distinction do you make between simply UHC and a medicare-for-all type single payer? what does your ideal UHC without SP look like, and why do you prefer that? 

i will say for myself, one without the other is at best terrible stop gap compromise that is both doomed to fail and fails to adequately address the problems they are purported to solve. (i'll also that for many on the left, single payer is not even the ultimate goal, just one big step in the right direction)

[Manhole Eunuchsbane]

8 minutes ago, Nasty LongRider said:

What does 'MC' stand for?  

Dana Rohrabacher gots the skillz ta pay the billz, yo.

[all swedes are racist]

9 minutes ago, Nasty LongRider said:

What does 'MC' stand for?  

mercenarychef is the only answer i will accept

[Manhole Eunuchsbane]

9 minutes ago, r'hllor's red lobster said:

mercenarychef is the only answer i will accept

He chops and dices and gets much respect.

[DMC]

17 minutes ago, r'hllor's red lobster said:

i will say for myself, one without the other is at best terrible stop gap compromise that is both doomed to fail and fails to adequately address the problems they are purported to solve. (i'll also that for many on the left, single payer is not even the ultimate goal, just one big step in the right direction)

There are plenty of universal systems throughout the industrialized world that are not single payer.  As I said earlier, I'm not a policy expert and this is certainly open for debate.  But that's the point - how best to achieve universal coverage and minimize costs is open for debate, and many experts I've read and/or spoke to don't necessarily think single payer is the best means both on policy and political grounds.

20 minutes ago, Manhole Eunuchsbane said:

Dana Rohrabacher gots the skillz ta pay the billz, yo.

 

20 minutes ago, r'hllor's red lobster said:

mercenarychef is the only answer i will accept

Buncha smartasses...

[DMC]

Watching Fran Lebowitz on Maher right now.  Her on Sanders:  "I find him to be an unbelievably narcissistic old man."

[Shryke]

1 hour ago, dmc515 said:

Yeah if Rohrabacher was a MC during the McCarthy era he'd at least be in jail at this point.

To remind others who might not get the context, this was House Majority Leader Kevin McCarthy from last year:

Quote

There’s two people I think Putin pays: Rohrabacher and Trump

And there's like a dozen incidents that support this idea. Rohrabacher is like transparently a Russian controlled asset on some level or other.

[Kalbear]

1 hour ago, r'hllor's red lobster said:

ok, so let me as you guys, and anyone else that feels similarly, (genuinely curious, not in a set up kind of way) what distinction do you make between simply UHC and a medicare-for-all type single payer? what does your ideal UHC without SP look like, and why do you prefer that? 

i will say for myself, one without the other is at best terrible stop gap compromise that is both doomed to fail and fails to adequately address the problems they are purported to solve. (i'll also that for many on the left, single payer is not even the ultimate goal, just one big step in the right direction)

Medicare-for-all is not the only kind of single payer, and certainly isn't the only kind of UHC. I feel like this is some bizarre either-or  that you've concocted when my point is that there are a TON of different ways to do UHC, and only some are single-payer, and only some are single-payer like medicare for all. 

Here's a good breakdown of the three fundamental types of UHC which are in practice - Single Payer, mandate, and Two-tier. From there you get into some pretty big differences in how they work - the insurance mandate system of Switzerland is very different than the one in Germany, and the NHS is pretty different than Iceland's model, and none may hold a candle to Singapore at the end of the day. This also doesn't discuss how the public/private healthcare system is run, either, which is another issue. 

My suspicion is that it would be easiest to go to a model like Switzerland, where the private companies offer basic plans that are the same cost and provide the same value no matter what, but can also offer supplemental plans. My personal view is that something like Singapore would be the best system as far as price/performance, but I can't remotely imagine that the US would allow such heavy regulation in the industry. (it also happens to not be single-payer).

[DMC]

10 minutes ago, Kalbear said:

My suspicion is that it would be easiest to go to a model like Switzerland

In a lot of different ways, our political system is strikingly similar to a steroids version of the Swiss compared to other European countries.  It's weird.  I don't even like their cheese, and I love cheese.

37 minutes ago, Shryke said:

To remind others who might not get the context, this was House Majority Leader Kevin McCarthy from last year:

Ha!  I wish I could take credit for that type of contextual depth, but no, I was solely alluding to Joe in my comment.  That's an awesome addendum though.  Reminds me of an anecdote when he first became whip.  During a seminar one of my old advisors mentioned the new whip (for a reason I can't recall) and was like "I believe his name is McCarthy."  I, equally unsure who the new whip was, responded "I'm pretty sure Congress has outlawed McCarthys in leadership positions."  That was six years ago.  Fuck I'm old.

[The guy from the Vale]

2 hours ago, dmc515 said:

In a lot of different ways, our political system is strikingly similar to a steroids version of the Swiss compared to other European countries.  It's weird.  I don't even like their cheese, and I love cheese.

Ha!  I wish I could take credit for that type of contextual depth, but no, I was solely alluding to Joe in my comment.  That's an awesome addendum though.  Reminds me of an anecdote when he first became whip.  During a seminar one of my old advisors mentioned the new whip (for a reason I can't recall) and was like "I believe his name is McCarthy."  I, equally unsure who the new whip was, responded "I'm pretty sure Congress has outlawed McCarthys in leadership positions."  That was six years ago.  Fuck I'm old.

It's nothing like the Swiss system. There's no checks and balances in the Swiss system the way there are in the US (there's no Supreme Court with the same authority, and the office of the presidency has been split into a seven-member council); the constitution is ever-changing as four times a year, its clauses are amended by referenda, and through a reluctance to use First Past the Post, the Swiss have a multi party system with four large parties (15-30% each) that have been in an almost perpetual unity government coalition for the presidency and currently three smaller parties of considerable electoral support (the Greens, the Green Liberals (Liberal, in this case, referring to Classica Liberalism, so more like Green Libertarians - yes, they're a thing - and the center-right BDP)

[Rippounet]

7 hours ago, Lew Theobald said:

Personally, I don't think pure materialist atheism is philosophically consistent with meaningful belief in a non-subjective morality.

Which would imply that you believe morality can be objective in the first place.

I think our ways of thinking are so far apart that an honest discussion on this would require its own thread. And as it is, I just don't have the time for it these days. Maybe some other time if you're up for it. I'm somewhat genuinely curious as to how one would argue about the possibility of an absolute morality.

[maarsen]

2 hours ago, Rippounet said:

Which would imply that you believe morality can be objective in the first place.

I think our ways of thinking are so far apart that an honest discussion on this would require its own thread. And as it is, I just don't have the time for it these days. Maybe some other time if you're up for it. I'm somewhat genuinely curious as to how one would argue about the possibility of an absolute morality.

One argues it on a separate philosophy thread, preferably with a lack of double negatives and a lack of obfuscation. 

[LongRider]

1 hour ago, maarsen said:

One argues it on a separate philosophy thread, preferably with a lack of double negatives and a lack of obfuscation. 

Amen.

[DMC]

5 hours ago, theguyfromtheVale said:

It's nothing like the Swiss system. 

I was comparing to other European countries.  All of Europe has multiparty systems and I'm hard-pressed to think of any that have checks and balances resembling the US - although the Swiss are one of the few non-parliamentary systems.  What I had in mind were its strong federalism, a bicameral legislature directly modeled after the US', strong tradition of direct democracy at the subnational level, and the fact they are the two outliers with low participation rates for industrialized democracies (at least for national elections).

[James Arryn]

10 hours ago, dmc515 said:

Member of Congress.  Sorry, so used to using it as shorthand from composing powerpoint slides for teaching.

So what's the D for?

[all swedes are racist]

2 minutes ago, James Arryn said:

So what's the D for?

deez nutz, binch

[DMC]

12 minutes ago, James Arryn said:

So what's the D for?

Delirious.

9 minutes ago, r'hllor's red lobster said:

deez nutz, binch

That's a good one too.

[Altherion]

10 hours ago, dmc515 said:

In a lot of different ways, our political system is strikingly similar to a steroids version of the Swiss compared to other European countries.  It's weird.  I don't even like their cheese, and I love cheese.

Don't worry, the Swiss don't like what is called "Swiss cheese" in the US either. Most of the real Swiss cheeses are quite difficult to find in the US because they're made from unpasteurized milk.

As to your first statement... I worked there for a few years and from what I've seen, I have to disagree. There are some similarities, but, for example, France is probably more similar to the US than Switzerland is similar to the US. The Swiss do some really weird things (e.g. their nearly unbounded direct democracy or their implementation of jus sanguinis) and, unlike with most places that do weird things, these aren't just idle curiosities -- they're at the heart of the Swiss system and much more important than the structure of the legislature or whatever.

[Bonnot OG]

Anyone else notice how Trump went after Jemele Hill for calling him a white supremacist (which he is) but stays quiet when  David Duke or Richard Spencer calls him one? Weird eh? 

[Zorral]

One of the arguments made by people in the medical professions for the model being Medicare here, is that we already have it, and it works very well.  This includes a smaller payment for those who don't need medications on a permanent or long-time basis.  The infrastructure is in place, and anyone who uses Medicare knows how well it works.

What it would need is an expansion, of course, meaning that hospitals and doctors must accept medicare insurance and that Medicare and other health providers, like the Veterans Administration can negotiate with Big Pharma for bulk buying and thus lower prices.

There is still the problem in this nation of the ever expanding of pullback from the provision of services: lack of hospitals and medical centers in lower density and poorer regions, and so on and forth. 

Of course those for profits and Big Pharma and Big Medical "insurance"  will pour billions (not an exaggeration) into never changing a thing.

At the same time another essential difference between how things are done in the USA and health services in other developed / European nations, is the aid and assistance and paid leave for mothers and newborns.  Not to mention daycare for children, government paid for, which helps mothers and families enormously at home and to be productive in the work place.