Healthcare is complex. Being able to price and bill for medical procedures like the McDonalds down the street (something I've heard people say hospitals should be able to do) is about as workable as a '9-9-9' tax plan. At the moment, anyway. As far as I'm aware - and I work in the field - there's no ideal 'doctor to paper pusher' ratio that we should be trying to achieve.
Clearly more practicing doctors is good, as is widening what can be done by a PA, RN / LPN, MA, etc - there are lots of tasks that can be moved off to a lower / less trained level (with proper supervision / oversight). A program where doctors can spend X years working as assigned by the government in exchange for forgiving a portion of their education, as well as a way for someone struggling in medical school to 'bump' down to a lower tier without being crushed in debt would be a good thing (and extending the same courtesy to all professions / free college for all would be even better.
There isn't some magic number of 'single payer will reduce costs by X%', simply because there isn't enough data on the US Healthcare system and - most importantly - there is no single 'single payer' implementation. There are literally hundreds of different facets that can be implemented differently and can greatly change the savings.
Personally, I find Bernie's 'we can save 50% with single payer' to be a realistic 'back of the envelope' calculation. That doesn't mean his solution is the one that would be finally implemented, nor would we necessarily actually realize that savings, but it's not a ridiculous statement by any account.
I also find a pragmatic 'improve the ACA' to be a good approach to healthcare costs. I would definitely prefer Hillary stay left on this one.
As for all the poor poor insurance workers...it's not like the government is known to reduce bureaucracy. Government jobs are good jobs - more government employees is a good thing for everyone.
The nitty gritty is largely irrelevant in the face of the bigger picture. Implemented properly, national healthcare saves money. The only people getting bogged down in details are policy wonks (that's most of us here) and private insurance companies who have skin in the game. But until we are in a position to actually pass something, any discussion of details is premature.
But even if it cost us, we should still do it, because people deserve to be treated when they're sick and examined by a doctor to see if they are. That's the bottom line for me.
I would definitely prefer Hillary stay left on this one.
See, this is my deal.
I get pragmatism and that the current situation should be taken into account during actual governance and whatever. Great.
But I expect my party leadership, which Clinton would be as the nominee and eventual president, not to actively chop the legs out from under ideas that aren't sufficiently center-right. "Single payer isn't likely right now" is fine, "single payer is irresponsible and would raise taxes on Americans" is wrong. Stop doing that.
Marty: The future, it's where you're going? Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
The people who I know that use the VA don't have much bad to say except it takes forever to initially get scheduled. After you are seeing someone though, the care is fine and follow-ups aren't much different than other health systems.
That may vary depending on location - I guess the VA here in Ann Arbor is one of the nicer places.
I would definitely prefer Hillary stay left on this one.
See, this is my deal.
I get pragmatism and that the current situation should be taken into account during actual governance and whatever. Great.
But I expect my party leadership, which Clinton would be as the nominee and eventual president, not to actively chop the legs out from under ideas that aren't sufficiently center-right. "Single payer isn't likely right now" is fine, "single payer is irresponsible and would raise taxes on Americans" is wrong. Stop doing that.
Except that Sanders' proposal is irresponsible. It's at best a bunch of progressive wishes, with little consideration for how to actually achieve such a sea change. And we're seeing that with a lot of his proposals - a lot of good sound bites, but as was pointed out with his "too big to fail" bill, there's nothing under the hood.
Yup as much as I like a lot of what sanders is saying he is going to have to deal with at very least a republican house and probably a republican senate or a democratic senate with only a few votes above 50 that can't get past a fillibuster. Trying to anything as ambitious as he is trying to do facing that kind of obstacles is just a recipe for failure. I think clintons objectives likely wind up being more something that can actually be accomplished.
I would definitely prefer Hillary stay left on this one.
See, this is my deal.
I get pragmatism and that the current situation should be taken into account during actual governance and whatever. Great.
But I expect my party leadership, which Clinton would be as the nominee and eventual president, not to actively chop the legs out from under ideas that aren't sufficiently center-right. "Single payer isn't likely right now" is fine, "single payer is irresponsible and would raise taxes on Americans" is wrong. Stop doing that.
Except that Sanders' proposal is irresponsible. It's at best a bunch of progressive wishes, with little consideration for how to actually achieve such a sea change. And we're seeing that with a lot of his proposals - a lot of good sound bites, but as was pointed out with his "too big to fail" bill, there's nothing under the hood.
No, what's irresponsible is attacking long-held progressive ideals with Republican language. And painting a lack of progress as the only responsible option.
This is why the left is constantly losing ground in the national debate. To a party that wears a codpiece made of clownshoes.
Politicians outline goals all the time without giving you exact precognitive details of a final written policy. It happens literally every time someone runs for office. Hillary is doing it right now. She has several campaign planks that do not outline exactly how she will get them passed. I'm not really seeing the irresponsibility.
You know what I think is irresponsible? Hypocritically attacking someone from your own party with Republican talking points so that regressive Republicans can point at what you said years down the line as an example of your own party not even believing that government-run healthcare is going to be a good thing.
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JuliusCaptain of Serenityon my shipRegistered Userregular
I would definitely prefer Hillary stay left on this one.
See, this is my deal.
I get pragmatism and that the current situation should be taken into account during actual governance and whatever. Great.
But I expect my party leadership, which Clinton would be as the nominee and eventual president, not to actively chop the legs out from under ideas that aren't sufficiently center-right. "Single payer isn't likely right now" is fine, "single payer is irresponsible and would raise taxes on Americans" is wrong. Stop doing that.
Except that Sanders' proposal is irresponsible. It's at best a bunch of progressive wishes, with little consideration for how to actually achieve such a sea change. And we're seeing that with a lot of his proposals - a lot of good sound bites, but as was pointed out with his "too big to fail" bill, there's nothing under the hood.
I would definitely prefer Hillary stay left on this one.
See, this is my deal.
I get pragmatism and that the current situation should be taken into account during actual governance and whatever. Great.
But I expect my party leadership, which Clinton would be as the nominee and eventual president, not to actively chop the legs out from under ideas that aren't sufficiently center-right. "Single payer isn't likely right now" is fine, "single payer is irresponsible and would raise taxes on Americans" is wrong. Stop doing that.
Except that Sanders' proposal is irresponsible. It's at best a bunch of progressive wishes, with little consideration for how to actually achieve such a sea change. And we're seeing that with a lot of his proposals - a lot of good sound bites, but as was pointed out with his "too big to fail" bill, there's nothing under the hood.
No, what's irresponsible is attacking long-held progressive ideals with Republican language. And painting a lack of progress as the only responsible option.
This is why the left is constantly losing ground in the national debate. To a party that wears a codpiece made of clownshoes.
I won't say you're entirely wrong, I will say that isn't the whole story. The left is politically weak, with exceptions it may as well not be relevant to political discourse - that's why I'm disappointed in Sanders. If the left's best hope is Sanders this war is over before it began. However, I am glad he's pushing Hillary left and Hillary has embraced liberalism as politician to get votes. That's a big win for us.
imo the most likely path to a single payer system likely comes via the creation of a public option rather than a wholesale dismantling of the healthcare system.
Yup as much as I like a lot of what sanders is saying he is going to have to deal with at very least a republican house and probably a republican senate or a democratic senate with only a few votes above 50 that can't get past a fillibuster. Trying to anything as ambitious as he is trying to do facing that kind of obstacles is just a recipe for failure. I think clintons objectives likely wind up being more something that can actually be accomplished.
Please explain to me how the Republicans in Congress will help Hillary accomplish incremental objectives. I've mentioned this before and it's always crickets on the other end.
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
Less will happen with that tactic. This is about getting as much passed as possible, not making everything political untenable.
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
If nothing else it shows the people with little ambiguity that you're trying to give them what they want, but Republicans are what's stopping them from getting it.
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
Less will happen with that tactic. This is about getting as much passed as possible, not making everything political untenable.
I'm going to ask this until I actually get an answer: what makes you think Hillary will get even small things through a Republican Congress?
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daveNYCWhy universe hate Waspinator?Registered Userregular
I would definitely prefer Hillary stay left on this one.
See, this is my deal.
I get pragmatism and that the current situation should be taken into account during actual governance and whatever. Great.
But I expect my party leadership, which Clinton would be as the nominee and eventual president, not to actively chop the legs out from under ideas that aren't sufficiently center-right. "Single payer isn't likely right now" is fine, "single payer is irresponsible and would raise taxes on Americans" is wrong. Stop doing that.
Except that Sanders' proposal is irresponsible. It's at best a bunch of progressive wishes, with little consideration for how to actually achieve such a sea change. And we're seeing that with a lot of his proposals - a lot of good sound bites, but as was pointed out with his "too big to fail" bill, there's nothing under the hood.
Considering that the Republicans will be in control of at least the House until 2020, any Democratic candidate that campaigns on anything other than "I'll be the veto stamp holding back the crazy and that's about it." is being irresponsible.
Shut up, Mr. Burton! You were not brought upon this world to get it!
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
Less will happen with that tactic. This is about getting as much passed as possible, not making everything political untenable.
I'm not so sure. Either way compromises will have to be reached and non-ideal bills will have to be passed in order to keep the government functioning. Sanders may be idealistic but I don't think he'll refuse to sign any bill that doesn't meet his expectations; the man is not so irrational as to want to gridlock the government into catastrophe. I think the question is which candidate's presidency would result in better compromises, and I'm not convinced that the answer is "Clinton's."
To put it another way, starting with a strong left wing position and compromising for centrist solutions might not be worse than starting with a centrist/center-left position and ending up with the same compromises (or even compromising further to the right).
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
Less will happen with that tactic. This is about getting as much passed as possible, not making everything political untenable.
I'm going to ask this until I actually get an answer: what makes you think Hillary will get even small things through a Republican Congress?
Because she'll try to barter and compromise, which may not succeed but it has a higher chance at working then asking for something we know the GOP will never agree with under any circumstance. That's get us nothing, and the status quo remains in tact that much longer. At least we may get some kind of victory with Hillary.
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
Less will happen with that tactic. This is about getting as much passed as possible, not making everything political untenable.
I'm going to ask this until I actually get an answer: what makes you think Hillary will get even small things through a Republican Congress?
Because she'll try to barter and compromise, which may not succeed but it has a higher chance at working then asking for something we know the GOP will never agree with under any circumstance.
Yeah so I think the idea that Hillary will be successfully bartering and compromising with the Republicans to get things passed is about as wide-eyed idealistic as Sanders implementing his entire agenda unimpeded.
There are more reasons why the US is more expensive than just the insurance industry, which is why I'm skeptical of claiming massive savings no problem. US healthcare is expensive because of a huge number of smaller reasons, not simply the insurance industry.
There are lots of reasons, but the root cause of higher health care costs is almost always lack of preventative care resulting in much more expensive reactive care.
Improved access to low costs preventative care invariably results in lower overall costs. That's just how public health works.
Which is why I've said that cost reduction is likely, but that any specific number, especially Sanders 50%, is basically an eyeballed assumption.
Why is it inherently more expensive to provide care for Americans than for English people. They suffer from the same diseases, live a similarly 'advanced' lifestyle and so on. Why do economies of scale not work? If anything, it should be cheaper to build an equally good system in the US, since there are more people to spread the load.
The UK healthcare system works well, but perhaps pays its doctors and nurses not quite enough. So we should copy that, bump frontline medical pay and call it done. Savings between 25 and 50% over today no problem. Any money spent beyond that is wasted.
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
Less will happen with that tactic. This is about getting as much passed as possible, not making everything political untenable.
I'm going to ask this until I actually get an answer: what makes you think Hillary will get even small things through a Republican Congress?
Because she'll try to barter and compromise, which may not succeed but it has a higher chance at working then asking for something we know the GOP will never agree with under any circumstance. That's get us nothing, and the status quo remains in tact that much longer. At least we may get some kind of victory with Hillary.
Can you point to a single instance of negotiation and/or compromise resulting in anything useful coming out of the congress in the last 2 years?
Because from what I can tell, the next President is going to have the same situation and will be working primarily through executive orders.
I don't see why Clinton would be better at that. Due to that, I'm happy to support Sanders both for the effect within the party and messaging he brings to the table.
Good god of course single payer would be cheaper, Hillary changes her position on it and suddenly half of you are Republicans.
It would lower overhead, that's a given, medicare spends more of each dollar on healthcare than private insurance. Second of all, it creates a larger bargaining pool, if we have single payer, we can do what basically every other country does and pay what something should cost not what they tell us it costs, eg not paying a 900% markup or whatever. There's an easy 5-10% of all spending in savings to be gained from this lack of overhead. It'd take an enormous amount of research to find out how much savings there is to be had by having such massive bargaining power, but it's got to be substantial.
Now those alone wouldn't get the US anywhere close to other nations in terms of healthcare costs, to do that the single payer system would also need the authority to handle actual hospital and doctor appointments - taking scheduling away from doctors and giving it to hospital administration with a goal towards higher bed occupancy can lead to massive figure savings per year, in some cases over a hundred million dollars at a single hospital.
Also we need to get rid of the AMA's doctor shortage by lifting the cap on new doctors, and we need to substantially subsidize health care educations, which would allow us to gradually lower doctor salaries to something more normal for other countries. Now doctor salaries is only a tiny piece of the puzzle, but if we are to expand at such a level we need a fuckload more GPs and the best way to do that is to make becoming a GP cheap as fuck.
But economic arguments aside, it's the right thing to do good fucking god, regardless of the feasibility in passage, I'm deeply distressed by Hillary tilting the rudder of the left in America away from single payer. The only good argument against it is that the Republicans won't let us pass it, not that it wouldn't work.
Christ this kind of thing is over dramatic. Some of you guys need to not get so worked up about people disagreeing with your position on the issue.
No one is against the general idea, the objections mostly seem to be to the numbers Sanders' campaign is putting out. And it ain't just the people here making those points.
There are more reasons why the US is more expensive than just the insurance industry, which is why I'm skeptical of claiming massive savings no problem. US healthcare is expensive because of a huge number of smaller reasons, not simply the insurance industry.
There are lots of reasons, but the root cause of higher health care costs is almost always lack of preventative care resulting in much more expensive reactive care.
Improved access to low costs preventative care invariably results in lower overall costs. That's just how public health works.
Which is why I've said that cost reduction is likely, but that any specific number, especially Sanders 50%, is basically an eyeballed assumption.
Why is it inherently more expensive to provide care for Americans than for English people. They suffer from the same diseases, live a similarly 'advanced' lifestyle and so on. Why do economies of scale not work? If anything, it should be cheaper to build an equally good system in the US, since there are more people to spread the load.
The UK healthcare system works well, but perhaps pays its doctors and nurses not quite enough. So we should copy that, bump frontline medical pay and call it done. Savings between 25 and 50% over today no problem. Any money spent beyond that is wasted.
Well, for one, we're a larger, much less dense nation. And what you would see as a pay bump for doctors would be a pay decrease for many here - one big issue is that American and British doctors are in very different classes (British doctors tend to be firmly in the professional class, while doctors here can easily rate higher.)
The nitty gritty is largely irrelevant in the face of the bigger picture
No. Its not.
This isn't the shit that feels good rah rah party
Its the primary to decide who should represent the not crazy political party to gain the office that holds power of the life and death of humanity (nukes are still a thing), runs the most powerful singular entity in the history of mankind, acts as the single biggest individual in lawmaking (the veto), sets broad reaching and significant policy at home and abroad, and acts as leader of one of the two relevant political parties in the country.
If the only thing that mattered was a invoking "single payer" then Sanders should be able to come up with an honest plan based on real world numbers. The reason he hasn't is because the details do matter and a happy lie is more persuasive than an inconvenient truth.
This is like every Republican fiscal plan. You can't just cut taxes and claim it will spur growth enough to make up for revenue and you can't just shift healthcare to single payer and hope it will cut costs by 50+%. Its a lie that reinforces what you want to be true.
Single payer is cheaper somewhat because it removes a profit margin and administrative costs but more so because it pays less and pays for less.
Yeah so I think the idea that Hillary will be successfully bartering and compromising with the Republicans to get things passed is about as wide-eyed idealistic as Sanders implementing his entire agenda unimpeded.
That's why I didn't say it will work, I said it has higher chances of working. Which is better than asking for things we know won't ever happen.
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daveNYCWhy universe hate Waspinator?Registered Userregular
We've had to compromise and negotiate in order to squeeze out budget and appropriation bills. The 2008 ACA negotiations made it pretty clear that the Republicans in congress don't negotiate. They might show up for some meetings, but they're just there for the free food, and will leave you hanging if you actually need their votes.
It's a pretty easy position to have when the BATNA of 'the federal government shuts down' is considered a good thing.
Shut up, Mr. Burton! You were not brought upon this world to get it!
Also wasn't the pitch for Hillary that she would fight Republicans bitterly? Why is she all of a sudden compromising with them?
Because that's the convenient argument of the moment.
No, it's knowing when to fight her battles. Which is a wise decision. This is why pragmatism is excellent in politics, it allows politicians to be flexible rather than rigid. Rigid only works with leverage, and Bernie has no leverage.
Yeah so I think the idea that Hillary will be successfully bartering and compromising with the Republicans to get things passed is about as wide-eyed idealistic as Sanders implementing his entire agenda unimpeded.
That's why I didn't say it will work, I said it has higher chances of working. Which is better than asking for things we know won't ever happen.
I disagree!
Shifting the public narrative is a practical thing that a President can do!
So if I have a choice between a President that says a lot of things I agree with but only a 1% chance of getting those things accomplished and a President that says a few things I agree with and a 1.1% chance of getting those things accomplished, I'll take the former.
But I also disagree with your fundamental assumption, that there is any greater chance of Hillary successfully negotiating with Republicans. I think there's a 0% chance of either candidate pulling that off.
I don't really see voting for Hillary in the primary as "bunting".
No, voting is voting.
Her pitch, though, is that we're not going to get the things that we really want, so let's aim a lot lower and stop talking about the other stuff lest it get us into conversations we don't want. Which is crazy, because we want those conversations, even if we won't be able to do anything about them yet.
We want Republicans on the run defending regressive taxation, corporate oligarchy, discriminatory policies, unnecessary wars and the rest. That's how we win. Not bringing them up because Republicans will push back is effectively giving them a pass on it. If we want to sell our very attractive policies to the American people, we need them out there to stand as a contrast. She's not doing that, and instead choosing to use framing from the Republicans to challenge Sanders from the right.
This is hugely disappointing to me and I just can't see supporting her in the primary under those circumstances. My primary vote is about moving the party away from the stupid, fearful tapdancing we've done around our core issues for a generation now and toward the idea that what we want is actually the right thing for America and we're not ashamed of it. Clinton isn't giving that to me, so I won't be voting for her.
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
Less will happen with that tactic. This is about getting as much passed as possible, not making everything political untenable.
I'm not so sure. Either way compromises will have to be reached and non-ideal bills will have to be passed in order to keep the government functioning. Sanders may be idealistic but I don't think he'll refuse to sign any bill that doesn't meet his expectations; the man is not so irrational as to want to gridlock the government into catastrophe. I think the question is which candidate's presidency would result in better compromises, and I'm not convinced that the answer is "Clinton's."
To put it another way, starting with a strong left wing position and compromising for centrist solutions might not be worse than starting with a centrist/center-left position and ending up with the same compromises (or even compromising further to the right).
True, except Bernie is at greater risk for doing this. I agree she should start off with bigger stances before negotiating down until something gets past. If Bernie does this, he risks alienating his base who are idealists who don't want compromises, and if Hillary does this tactic in office why do we need Bernie?
If nothing is getting passed anyway, which seems to be the big pitch for Clinton, why are we bunting? Swing for the fences and make the case to the American people for why they'd rather have Democrats in charge of the whole shebang again. Universal health care, proper oversight of police forces, solid progressive taxation, dismantling the big banks, ending foreign troop deployment, equal pay for equal work, the whole shebang.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
Less will happen with that tactic. This is about getting as much passed as possible, not making everything political untenable.
I'm going to ask this until I actually get an answer: what makes you think Hillary will get even small things through a Republican Congress?
Because she'll try to barter and compromise, which may not succeed but it has a higher chance at working then asking for something we know the GOP will never agree with under any circumstance. That's get us nothing, and the status quo remains in tact that much longer. At least we may get some kind of victory with Hillary.
Can you point to a single instance of negotiation and/or compromise resulting in anything useful coming out of the congress in the last 2 years?
Because from what I can tell, the next President is going to have the same situation and will be working primarily through executive orders.
Sure, and again I'll repeat I don't know if it will work, but I find it a logical strategy that has some precedence behind it. This is how we got the ACA, rather than nothing.
I don't see why Clinton would be better at that. Due to that, I'm happy to support Sanders both for the effect within the party and messaging he brings to the table.
What effect? The time for messaging is over, he'd be president. Messaging for pulpits, not for passing laws and implementing policies.
Yeah so I think the idea that Hillary will be successfully bartering and compromising with the Republicans to get things passed is about as wide-eyed idealistic as Sanders implementing his entire agenda unimpeded.
That's why I didn't say it will work, I said it has higher chances of working. Which is better than asking for things we know won't ever happen.
I disagree!
Shifting the public narrative is a practical thing that a President can do!
So if I have a choice between a President that says a lot of things I agree with but only a 1% chance of getting those things accomplished and a President that says a few things I agree with and a 1.1% chance of getting those things accomplished, I'll take the former.
But I also disagree with your fundamental assumption, that there is any greater chance of Hillary successfully negotiating with Republicans. I think there's a 0% chance of either candidate pulling that off.
You're right, shifting the narrative is important, which is why some of the things Sanders pushes bothers me. Like making out the issue of health care in the US to be driven mainly by the insurance companies. Or the simplistic "too big to fail" rhetoric, which ignores real issues in finance like the shadow banking system.
The nitty gritty is largely irrelevant in the face of the bigger picture
No. Its not.
This isn't the shit that feels good rah rah party
Its the primary to decide who should represent the not crazy political party to gain the office that holds power of the life and death of humanity (nukes are still a thing), runs the most powerful singular entity in the history of mankind, acts as the single biggest individual in lawmaking (the veto), sets broad reaching and significant policy at home and abroad, and acts as leader of one of the two relevant political parties in the country.
If the only thing that mattered was a invoking "single payer" then Sanders should be able to come up with an honest plan based on real world numbers. The reason he hasn't is because the details do matter and a happy lie is more persuasive than an inconvenient truth.
This is like every Republican fiscal plan. You can't just cut taxes and claim it will spur growth enough to make up for revenue and you can't just shift healthcare to single payer and hope it will cut costs by 50+%. Its a lie that reinforces what you want to be true.
Single payer is cheaper somewhat because it removes a profit margin and administrative costs but more so because it pays less and pays for less.
I think you're completely missing my point. Nobody is making any progress on the healthcare front. And no, this isn't the bullshit feel good rah rah party but it also shouldn't be the "Welp guess we should never try to do what's best for the people because things are tough" party.
There's a lot of noise about how Hillary is the pragmatic one but watering down the narrative in the hopes of getting something done with Republican help isn't pragmatic, it's just as hopelessly optimistic as anything Bernie has proposed but with the added effect of watering down the narrative.
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Clearly more practicing doctors is good, as is widening what can be done by a PA, RN / LPN, MA, etc - there are lots of tasks that can be moved off to a lower / less trained level (with proper supervision / oversight). A program where doctors can spend X years working as assigned by the government in exchange for forgiving a portion of their education, as well as a way for someone struggling in medical school to 'bump' down to a lower tier without being crushed in debt would be a good thing (and extending the same courtesy to all professions / free college for all would be even better.
There isn't some magic number of 'single payer will reduce costs by X%', simply because there isn't enough data on the US Healthcare system and - most importantly - there is no single 'single payer' implementation. There are literally hundreds of different facets that can be implemented differently and can greatly change the savings.
Personally, I find Bernie's 'we can save 50% with single payer' to be a realistic 'back of the envelope' calculation. That doesn't mean his solution is the one that would be finally implemented, nor would we necessarily actually realize that savings, but it's not a ridiculous statement by any account.
I also find a pragmatic 'improve the ACA' to be a good approach to healthcare costs. I would definitely prefer Hillary stay left on this one.
As for all the poor poor insurance workers...it's not like the government is known to reduce bureaucracy. Government jobs are good jobs - more government employees is a good thing for everyone.
But even if it cost us, we should still do it, because people deserve to be treated when they're sick and examined by a doctor to see if they are. That's the bottom line for me.
I get pragmatism and that the current situation should be taken into account during actual governance and whatever. Great.
But I expect my party leadership, which Clinton would be as the nominee and eventual president, not to actively chop the legs out from under ideas that aren't sufficiently center-right. "Single payer isn't likely right now" is fine, "single payer is irresponsible and would raise taxes on Americans" is wrong. Stop doing that.
They tried to bury us. They didn't know that we were seeds. 2018 Midterms. Get your shit together.
Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
Underfunded and overworked. The vast majority of the problems with it is that they're simply overwhelmed, thanks to those two factors.
It would be fantastic if it was actually funded.
The people who I know that use the VA don't have much bad to say except it takes forever to initially get scheduled. After you are seeing someone though, the care is fine and follow-ups aren't much different than other health systems.
That may vary depending on location - I guess the VA here in Ann Arbor is one of the nicer places.
Except that Sanders' proposal is irresponsible. It's at best a bunch of progressive wishes, with little consideration for how to actually achieve such a sea change. And we're seeing that with a lot of his proposals - a lot of good sound bites, but as was pointed out with his "too big to fail" bill, there's nothing under the hood.
This is why the left is constantly losing ground in the national debate. To a party that wears a codpiece made of clownshoes.
They tried to bury us. They didn't know that we were seeds. 2018 Midterms. Get your shit together.
You know what I think is irresponsible? Hypocritically attacking someone from your own party with Republican talking points so that regressive Republicans can point at what you said years down the line as an example of your own party not even believing that government-run healthcare is going to be a good thing.
Wait...what is irresponsible about it?
I won't say you're entirely wrong, I will say that isn't the whole story. The left is politically weak, with exceptions it may as well not be relevant to political discourse - that's why I'm disappointed in Sanders. If the left's best hope is Sanders this war is over before it began. However, I am glad he's pushing Hillary left and Hillary has embraced liberalism as politician to get votes. That's a big win for us.
Please explain to me how the Republicans in Congress will help Hillary accomplish incremental objectives. I've mentioned this before and it's always crickets on the other end.
"They won't play along so we have to dream small" is a statement about governance, not messaging.
They tried to bury us. They didn't know that we were seeds. 2018 Midterms. Get your shit together.
Less will happen with that tactic. This is about getting as much passed as possible, not making everything political untenable.
If nothing else it shows the people with little ambiguity that you're trying to give them what they want, but Republicans are what's stopping them from getting it.
I'm going to ask this until I actually get an answer: what makes you think Hillary will get even small things through a Republican Congress?
Considering that the Republicans will be in control of at least the House until 2020, any Democratic candidate that campaigns on anything other than "I'll be the veto stamp holding back the crazy and that's about it." is being irresponsible.
To put it another way, starting with a strong left wing position and compromising for centrist solutions might not be worse than starting with a centrist/center-left position and ending up with the same compromises (or even compromising further to the right).
Because she'll try to barter and compromise, which may not succeed but it has a higher chance at working then asking for something we know the GOP will never agree with under any circumstance. That's get us nothing, and the status quo remains in tact that much longer. At least we may get some kind of victory with Hillary.
Yeah so I think the idea that Hillary will be successfully bartering and compromising with the Republicans to get things passed is about as wide-eyed idealistic as Sanders implementing his entire agenda unimpeded.
Why is it inherently more expensive to provide care for Americans than for English people. They suffer from the same diseases, live a similarly 'advanced' lifestyle and so on. Why do economies of scale not work? If anything, it should be cheaper to build an equally good system in the US, since there are more people to spread the load.
The UK healthcare system works well, but perhaps pays its doctors and nurses not quite enough. So we should copy that, bump frontline medical pay and call it done. Savings between 25 and 50% over today no problem. Any money spent beyond that is wasted.
Because from what I can tell, the next President is going to have the same situation and will be working primarily through executive orders.
I don't see why Clinton would be better at that. Due to that, I'm happy to support Sanders both for the effect within the party and messaging he brings to the table.
They tried to bury us. They didn't know that we were seeds. 2018 Midterms. Get your shit together.
They tried to bury us. They didn't know that we were seeds. 2018 Midterms. Get your shit together.
Christ this kind of thing is over dramatic. Some of you guys need to not get so worked up about people disagreeing with your position on the issue.
No one is against the general idea, the objections mostly seem to be to the numbers Sanders' campaign is putting out. And it ain't just the people here making those points.
Well, for one, we're a larger, much less dense nation. And what you would see as a pay bump for doctors would be a pay decrease for many here - one big issue is that American and British doctors are in very different classes (British doctors tend to be firmly in the professional class, while doctors here can easily rate higher.)
This isn't the shit that feels good rah rah party
Its the primary to decide who should represent the not crazy political party to gain the office that holds power of the life and death of humanity (nukes are still a thing), runs the most powerful singular entity in the history of mankind, acts as the single biggest individual in lawmaking (the veto), sets broad reaching and significant policy at home and abroad, and acts as leader of one of the two relevant political parties in the country.
If the only thing that mattered was a invoking "single payer" then Sanders should be able to come up with an honest plan based on real world numbers. The reason he hasn't is because the details do matter and a happy lie is more persuasive than an inconvenient truth.
This is like every Republican fiscal plan. You can't just cut taxes and claim it will spur growth enough to make up for revenue and you can't just shift healthcare to single payer and hope it will cut costs by 50+%. Its a lie that reinforces what you want to be true.
Single payer is cheaper somewhat because it removes a profit margin and administrative costs but more so because it pays less and pays for less.
QEDMF xbl: PantsB G+
That's why I didn't say it will work, I said it has higher chances of working. Which is better than asking for things we know won't ever happen.
It's a pretty easy position to have when the BATNA of 'the federal government shuts down' is considered a good thing.
No, it's knowing when to fight her battles. Which is a wise decision. This is why pragmatism is excellent in politics, it allows politicians to be flexible rather than rigid. Rigid only works with leverage, and Bernie has no leverage.
QEDMF xbl: PantsB G+
I disagree!
Shifting the public narrative is a practical thing that a President can do!
So if I have a choice between a President that says a lot of things I agree with but only a 1% chance of getting those things accomplished and a President that says a few things I agree with and a 1.1% chance of getting those things accomplished, I'll take the former.
But I also disagree with your fundamental assumption, that there is any greater chance of Hillary successfully negotiating with Republicans. I think there's a 0% chance of either candidate pulling that off.
Her pitch, though, is that we're not going to get the things that we really want, so let's aim a lot lower and stop talking about the other stuff lest it get us into conversations we don't want. Which is crazy, because we want those conversations, even if we won't be able to do anything about them yet.
We want Republicans on the run defending regressive taxation, corporate oligarchy, discriminatory policies, unnecessary wars and the rest. That's how we win. Not bringing them up because Republicans will push back is effectively giving them a pass on it. If we want to sell our very attractive policies to the American people, we need them out there to stand as a contrast. She's not doing that, and instead choosing to use framing from the Republicans to challenge Sanders from the right.
This is hugely disappointing to me and I just can't see supporting her in the primary under those circumstances. My primary vote is about moving the party away from the stupid, fearful tapdancing we've done around our core issues for a generation now and toward the idea that what we want is actually the right thing for America and we're not ashamed of it. Clinton isn't giving that to me, so I won't be voting for her.
They tried to bury us. They didn't know that we were seeds. 2018 Midterms. Get your shit together.
True, except Bernie is at greater risk for doing this. I agree she should start off with bigger stances before negotiating down until something gets past. If Bernie does this, he risks alienating his base who are idealists who don't want compromises, and if Hillary does this tactic in office why do we need Bernie?
Sure, and again I'll repeat I don't know if it will work, but I find it a logical strategy that has some precedence behind it. This is how we got the ACA, rather than nothing.
What effect? The time for messaging is over, he'd be president. Messaging for pulpits, not for passing laws and implementing policies.
Both of those things are worth more to me than a smooth coronation for Clinton.
They tried to bury us. They didn't know that we were seeds. 2018 Midterms. Get your shit together.
You're right, shifting the narrative is important, which is why some of the things Sanders pushes bothers me. Like making out the issue of health care in the US to be driven mainly by the insurance companies. Or the simplistic "too big to fail" rhetoric, which ignores real issues in finance like the shadow banking system.
I think you're completely missing my point. Nobody is making any progress on the healthcare front. And no, this isn't the bullshit feel good rah rah party but it also shouldn't be the "Welp guess we should never try to do what's best for the people because things are tough" party.
There's a lot of noise about how Hillary is the pragmatic one but watering down the narrative in the hopes of getting something done with Republican help isn't pragmatic, it's just as hopelessly optimistic as anything Bernie has proposed but with the added effect of watering down the narrative.