Presidential Election: 11/3/20 ---Now the President Elect Joe Biden Thread

[No Excuses]

11 minutes ago, bearrock said:

I'm not talking about the how to pay or how to implement, but the question of why should it be done through the government.  The central philosophical question itself as to when is it preferable for a government to be the actor instead of private or some hybrid system?

 

I'm not trying to be a dick but this again is discussed time and time and time again. It's even captured in the god awful 10-people-on-a-stage format, and even moreso away from it. I am just not following you here. You seem to be asking for things that are already done.

[bearrock]

31 minutes ago, No Excuses said:

 

I'm not trying to be a dick but this again is discussed time and time and time again. It's even captured in the god awful 10-people-on-a-stage format, and even moreso away from it. I am just not following you here. You seem to be asking for things that are already done.

 

Not a problem, I wouldn't never think that of you.  Maybe it would be easier to approach it from this way.  Has Warren explained why MFA is better than a public option or a Buttigieg option?  If so, maybe I could read up on that and see if she addressed what I'm talking about.

[Renegade7]

1 hour ago, bearrock said:

 

But is that a problem with higher health care cost in the US in general or because private insurance is handling the reimbursements?  If government sets the rates and likely pays doctors and hospitals far lower than what they receive now, what effect will that have?  I still think a government run health insurance for basic and necessary care supplemented by private insurance option for optional expensive care makes more sense, but if progressives want a total takeover of healthcare reimbursement by the government, they need to justify why that's a better option and what fallout may happen. 

 

 

Theres a certain point where we have to accept that these issues are too complex to be soundbites.  The medicare for all bill is publically available for review, it's in the bill that this isnt about paying doctors less in regards to compensation but attacking administrative costs and demanding justifications for certain reimbursements to make sure they arent going to some beuracrates yearly bonus.  If hosptials choose to pay staff less to keep paying the higher ups more then they need, that's a different problem, and we see that in every other private business.

 

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Cause you can't get to 1/2 cost without having government make the call of what procedures and medication will be covered and what won't. 

 

 

The bill isnt going to say "you have this drug, so you dont need this one".  The goal is to cover the costs and let the doctors decide what's neccesary.  This is about eliminating the profit driven motives and treating it more like mass transit where we expect a loss but decide it's still worth it.

 

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Either we cover less procedures than we do now, pay less to doctors and hospitals than we do now, or some combination, all scenarios which will require trade offs.  So given that, explain to the public why a government run system is superior to private options and hybrid options without glossing over the negatives that comes with a solely government run system.

 

A lot of people agree that Bernie's bill is great, but wont be what passes congress.  I'd be shocked if the moderate dems vote for removal of private insurance, I expect a compromise, but understand the emphasis that the administrative costs are part of the big reason why health care is so high and why they are attacking that directly by getting rid of the need for it.  That comes up at every debate.

 

By time this gets to senate, discussion will be had about rural hospitals, but I believe why it hasnt is how many people in rural areas are already on government run insurance, like Medicaid and CHIP.  Medicare pays more then Medicaid, and there's nothing in the bill that says medicare rates cant be risen at all, jus have to be careful to raise them so high that hospitals dont rethink spending money where it doesnt need to be spent and balloons the entire program.

 

This is why if they do get rid of private insurance more hospitals  being taken over by the government will be inevitable, we already do that other countries do as well, and saying that's a bad thing is missing the point that private hospitals like any other business raise prices when economic situations change to maintain profit levels more so them making sure they turn a profit. The reimbursement system for medicare is something that many are saying needs to be reviewed or changed, I agree with you there

 

https://www.salon.com/2019/07/28/would-medicare-for-all-really-force-hospitals-to-shutter-the-devil-is-in-the-details/

 

That's why this whole for profit mentality is unsubstainable because if hospitals can keep overcharging insurance companies to maintain the insurance costs for dealing with the insurance companies in the first place who already decide when to say yes or no on stuff, it's a self-feedingn hurricane. This has come up in multiple debates now, our system is so far gone down this path that any correction will be disruptive,  but it was wrong to begin with that's the point.  You cant fix the system and maintain what was broken about it at the same time.

 

This post took a while and youd need a full on interview with the right questions to get this out any of the candidates.  This is a very complex situation that can only be so simplified.  Do candidates need to be better job addressing every concern?  Maybe.  Should media do better job of addressing every concern versus picking sides before they hear the details? Absolutely.  Do citizens need to do a better job of applying critical thinking to this whole situation and doing their own research? Easier said then done.

[twa]

 

[bearrock]

17 hours ago, Renegade7 said:

 

Theres a certain point where we have to accept that these issues are too complex to be soundbites.  The medicare for all bill is publically available for review, it's in the bill that this isnt about paying doctors less in regards to compensation but attacking administrative costs and demanding justifications for certain reimbursements to make sure they arent going to some beuracrates yearly bonus.  If hosptials choose to pay staff less to keep paying the higher ups more then they need, that's a different problem, and we see that in every other private business.

 

Administrative cost and bulk buying prescription drug aren't the only thing giving us savings in MFA.  Sander's bill has been estimated to cut cut reimbursement rates by about 40% of the average private insurance reimbursement rates, which has been estimated to put about half of all hospitals in a negative facility margin.  It's not a simple matter of shifting around profits from executives to medical staff.  We are going to be mandating a drastic and abrupt cut to revenue to all hospitals and medical providers.  

 

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The bill isnt going to say "you have this drug, so you dont need this one".  The goal is to cover the costs and let the doctors decide what's neccesary.  This is about eliminating the profit driven motives and treating it more like mass transit where we expect a loss but decide it's still worth it.

 

All insurance necessarily decides what is covered and what is not.  We are shifting the decision making from private insurance (driven by profits) to government (hopefully driven by good policy).  The argument of free marketeers has always been that if one insurance company exercises draconian policies in determining covered services, another competitor will simply scoop up those customers and those bad insurance companies will wither out.  We know from experience that this is not very true, because companies collude, copy each other's profit generating policies, insurance policies are vague and hard to decipher leaving consumers without sufficient information to meaningfully compare different companies and plans.  But it is also true that once government steps in as the only player in the game, there is no competition.  There is no remedy if a bad policy decision ends up screwing a group of people.  And where the real problem lies is that modern US Congress has proven especially inept at quickly addressing and attempting to fix problems.

 

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A lot of people agree that Bernie's bill is great, but wont be what passes congress.  I'd be shocked if the moderate dems vote for removal of private insurance, I expect a compromise, but understand the emphasis that the administrative costs are part of the big reason why health care is so high and why they are attacking that directly by getting rid of the need for it.  That comes up at every debate.

 

By time this gets to senate, discussion will be had about rural hospitals, but I believe why it hasnt is how many people in rural areas are already on government run insurance, like Medicaid and CHIP.  Medicare pays more then Medicaid, and there's nothing in the bill that says medicare rates cant be risen at all, jus have to be careful to raise them so high that hospitals dont rethink spending money where it doesnt need to be spent and balloons the entire program.

 

This is why if they do get rid of private insurance more hospitals  being taken over by the government will be inevitable, we already do that other countries do as well, and saying that's a bad thing is missing the point that private hospitals like any other business raise prices when economic situations change to maintain profit levels more so them making sure they turn a profit. The reimbursement system for medicare is something that many are saying needs to be reviewed or changed, I agree with you there

 

https://www.salon.com/2019/07/28/would-medicare-for-all-really-force-hospitals-to-shutter-the-devil-is-in-the-details/

 

That's why this whole for profit mentality is unsubstainable because if hospitals can keep overcharging insurance companies to maintain the insurance costs for dealing with the insurance companies in the first place who already decide when to say yes or no on stuff, it's a self-feedingn hurricane. This has come up in multiple debates now, our system is so far gone down this path that any correction will be disruptive,  but it was wrong to begin with that's the point.  You cant fix the system and maintain what was broken about it at the same time.

 

This post took a while and youd need a full on interview with the right questions to get this out any of the candidates.  This is a very complex situation that can only be so simplified.  Do candidates need to be better job addressing every concern?  Maybe.  Should media do better job of addressing every concern versus picking sides before they hear the details? Absolutely.  Do citizens need to do a better job of applying critical thinking to this whole situation and doing their own research? Easier said then done.

 

Now as the Salon article points out, final MFA, if it ever passes, may not (probably not) will not look like any of proposals out there on the table.  But it's simple arithmetic.  Admin savings, removal of profit, lower drug prices won't get us to half of current cost.  Lower reimbursements to hospital and medical providers will be inevitable.  The only question is how much.  

 

As you said, MFA is a fundamental rethinking of delivery of healthcare.  Profit should play no role in the process.  I agree with this on a philosophical level.  The reality also is that going from private system to MFA in 4 years will be a systemic shock to everyone, but most of all to hospitals and medical providers.  It's easy for me to sit at my keyboard and say those fat cats shouldn't make trillions of dollars delivering medical care, but it's also true that hospitals invested money, doctors took on gigantic student loans and spent years of their lives to pursue these livelihoods under one set of rules and assumptions and MFA advocates are talking about drastically changing them in 4 years.  

 

You can advocate for that kind of change.  Just tell me why that's better than a gradual change using a hybrid method and don't mince words on the inevitable negative effects.

 

[Renegade7]

@bearrock this is the wrong thread for this discussion and proves that I was right that I was wasting my time having it in the context of you needing more information or to be convinced this is a better idea.  If we agree this won't be the final bill and that health care should not be profit motivated, this sounds more like you don't want to give them the benefit of the doubt they won't destroy that part of the economy and thinking government can't do big things.  

 

We have done big things, and we've already had discussions about how this will be a phased approach, it won't just get clicked on.  You don't want to do this, I get it, but if you want to continue this discussion we shouldn't do it here, because your original point was that there wasn't enough information on this approach, now its clear that you just never agreed with it in the first place.  I'm on the fence on trying to convince you because I don't believe that's what you're asking for anymore.

[bearrock]

1 hour ago, Renegade7 said:

@bearrock this is the wrong thread for this discussion and proves that I was right that I was wasting my time having it in the context of you needing more information or to be convinced this is a better idea.  If we agree this won't be the final bill and that health care should not be profit motivated, this sounds more like you don't want to give them the benefit of the doubt they won't destroy that part of the economy and thinking government can't do big things.  

 

We have done big things, and we've already had discussions about how this will be a phased approach, it won't just get clicked on.  You don't want to do this, I get it, but if you want to continue this discussion we shouldn't do it here, because your original point was that there wasn't enough information on this approach, now its clear that you just never agreed with it in the first place.  I'm on the fence on trying to convince you because I don't believe that's what you're asking for anymore.

 

If your point is that this is not the thread to discuss the specific merits of the MFA bill, you're right, we have a thread for that.  But I responded to twa's post with the tweet expressing skepticism of more government programs and I pointed out that progressives do need to specifically defend the notion of bigger role for government.  This is not me disagreeing with the need for bigger government involvement.  This is me pointing out the political reality that many feel apprehensive at trusting the government to not screw it up in the process.  

 

As to MFA and Warren discussion, I never said MFA was lacking details.  Nor why MFA is a good plan.  But to my knowledge, there hasn't been a lot (any?) discussion from Warren as to why MFA is better than competing plans from her primary rivals or better than the ACA improvement bill she co-sponsored in April of this year.  MFA is by far the most drastic and sweeping of the healthcare reform plans out there.  It's not good enough for it to be just a good bill.  I think for voters to jump on board, proponents have to argue why it's better than the other options.  I was saying that I haven't heard this line of discussion from Warren (or others touting MFA), which is in the vein of saying that if progressives want to sell a bigger role for government (or government as the only player in the field), they have to address why such increased role if preferable to the alternatives.

 

[Renegade7]

2 hours ago, bearrock said:

 

If your point is that this is not the thread to discuss the specific merits of the MFA bill, you're right, we have a thread for that.  But I responded to twa's post with the tweet expressing skepticism of more government programs and I pointed out that progressives do need to specifically defend the notion of bigger role for government.  This is not me disagreeing with the need for bigger government involvement.  This is me pointing out the political reality that many feel apprehensive at trusting the government to not screw it up in the process.  

 

This is not a feeling, its a political ideology of big government vs small government that has been debated in this country since its beginning. 

 

It also doesnt take into account how the GOP has tried to sabotage government in order to turn around and say how much it doesnt work so they can contract it even more. EPA was a great idea, putting a coal lobbyist in charge of it was a stupid one that most people saw right through it, but some didnt, while many got it and didnt care because it served their interests.

 

You think everyone was on the same page when the Civil Rights Act was signed?  MLK was assassinated 4 years later, do you think were all on the same page about civil rights now?  Do we need to be in order to continue to make progress on it, or is it missing the point that the fact we all arent on the same page is why we need to make more progress on it?

 

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As to MFA and Warren discussion, I never said MFA was lacking details.  Nor why MFA is a good plan.  But to my knowledge, there hasn't been a lot (any?) discussion from Warren as to why MFA is better than competing plans from her primary rivals or better than the ACA improvement bill she co-sponsored in April of this year.  MFA is by far the most drastic and sweeping of the healthcare reform plans out there.  It's not good enough for it to be just a good bill.  I think for voters to jump on board, proponents have to argue why it's better than the other options.  I was saying that I haven't heard this line of discussion from Warren (or others touting MFA), which is in the vein of saying that if progressives want to sell a bigger role for government (or government as the only player in the field), they have to address why such increased role if preferable to the alternatives.

 

 

This is where you lose me on this, this is the internet, you wont finish every piece on the discussion of MFA since Bernie made it a serious topic 4 years ago, theres that many.  The UK system not only has universal health care, but its common for the hospitals to be state run with the doctors being government employees.  That system has its flaws and is not being proposed here.

 

What this conversation is about regards should the government take on the responsibility of the healthcare costs for its citizens since the private sector will only do if if they deem it profitable?  It's a bigger question then big government vs small government, it's that the only system that can afford to do that without requiring a profit is the government.  That's not debatable, so the debate we are really having is should we? 

 

UK is already doing block grants, that's the word I've been waiting for in these debates, because in order to really make health care a right the government has to get more involved then they are proposing because theres so many more people in the US then UK.  At the end if the day, UK was able to even get to that point because the system hadnt gotten so out of control costswise that doing it would've risked a retraction in the economy if they did it wrong. Key word, did it wrong.

 

Thats the biggest problem with this discussion in that it's being said over and over again that so many worries from fixing the system are born from the reality we were doing it wrong in the first place and people still not seem to process that.  The point that what we are doing already isnt working doesnt seem to be swaying people because for too many it's working for them and that's good enough.  

 

Majority of Republicans support MFA now, hell this article is from 2018 and Fox has been caught with their pants down in this as well

 

https://www.google.com/amp/s/thehill.com/hilltv/what-americas-thinking/412552-majority-of-republicans-say-the-support-medicare-for-all-poll%3famp

 

If your point is progressives haven't made a good enough case for why private insurance should be eliminated and the polls reflect that, you have to ask how much the GOP trying to convince its base it doesnt want MFA first is having an affect on that.  The case has been made ad nauseam, but as you admit, to your knowledge it hasnt.

[gbear]

What happens of Trump is convicted (crazy dream?)?

 

Does Pence automatically make it on the ballot and how much time has to be left to get his name on the ballot?

 

I have to admit, I would love Weld to be the Republican candidate. I would have to think twice about voting against him. He at least has put forth honest efforts on healthcare expenditures. Before Romney, it was Weld's work that made Romney care possible which eventually became the ACA.

[Momma There Goes That Man]

2 hours ago, gbear said:

What happens of Trump is convicted (crazy dream?)?

 

Does Pence automatically make it on the ballot and how much time has to be left to get his name on the ballot?

 

I have to admit, I would love Weld to be the Republican candidate. I would have to think twice about voting against him. He at least has put forth honest efforts on healthcare expenditures. Before Romney, it was Weld's work that made Romney care possible which eventually became the ACA.

 

Yep, we got the cancer out all is good. Time to go back to voting republican and not punish the party and policies that lead to Trump in the first place and reward the same people that protected him over our democracy and constitution for years. Great. 👍🏻

[bearrock]

3 hours ago, Renegade7 said:

 

This is not a feeling, its a political ideology of big government vs small government that has been debated in this country since its beginning. 

 

It also doesnt take into account how the GOP has tried to sabotage government in order to turn around and say how much it doesnt work so they can contract it even more. EPA was a great idea, putting a coal lobbyist in charge of it was a stupid one that most people saw right through it, but some didnt, while many got it and didnt care because it served their interests.

 

You think everyone was on the same page when the Civil Rights Act was signed?  MLK was assassinated 4 years later, do you think were all on the same page about civil rights now?  Do we need to be in order to continue to make progress on it, or is it missing the point that the fact we all arent on the same page is why we need to make more progress on it?

 

There are government programs that are struggling because of a particular admin's decisions or artificial constraints like USPS, but do you think that either party is out to sabotage things like the VA?  

 

Are we even in disagreement here?  Do you not think progressives need to be out there advocating for and defending the necessity of big government in many areas?  Call it feelings, ideological divide, whatever.  The reality is that in order to get people elected and pass big government programs, progressives need to convince more than just the choir that bigger government is necessary.  By in large, people like Warren are doing that.  Except when it comes to healthcare and specifically MFA.  I have not seen nor have I been able to find a single speech, interview, or statement on why MFA right now is preferable to the alternatives proposed by the moderate democratic candidates that takes a more gradual approach to a single payer system.  Maybe my google-fu is failing me and I've been living under a rock.

 

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This is where you lose me on this, this is the internet, you wont finish every piece on the discussion of MFA since Bernie made it a serious topic 4 years ago, theres that many.  The UK system not only has universal health care, but its common for the hospitals to be state run with the doctors being government employees.  That system has its flaws and is not being proposed here.

 

What this conversation is about regards should the government take on the responsibility of the healthcare costs for its citizens since the private sector will only do if if they deem it profitable?  It's a bigger question then big government vs small government, it's that the only system that can afford to do that without requiring a profit is the government.  That's not debatable, so the debate we are really having is should we? 

 

And this begs the question, why isn't a UK like system being proposed here?  Not a carbon copy of the NHS, but a system founded upon a principle that no one should be able to profit off of delivery of health care.  A system where such principle applies not only to insurance companies, but hospitals and doctors.  Why is it okay for the government to displace insurance companies, but not for profit hospitals and for profit doctors?  If it's not okay to totally displace profit motivation for hospitals and doctors, how much displacement is okay?  And how quickly?  Because MFA is going to be a steep decline overnight.  

 

Also, as much as Sanders likes to tout the Canadian system as being able to institute single payer at half the cost per patient of US, Canada has private insurance component to their healthcare.  So does every other nation in the world running single payer.  So MFA is going to totally displace private insurance?  Why?  And why stop there?

 

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UK is already doing block grants, that's the word I've been waiting for in these debates, because in order to really make health care a right the government has to get more involved then they are proposing because theres so many more people in the US then UK.  At the end if the day, UK was able to even get to that point because the system hadnt gotten so out of control costswise that doing it would've risked a retraction in the economy if they did it wrong. Key word, did it wrong.

 

 

We've heard plenty about block grants in US healthcare reform discussions, it's just from the GOP.  Herein lies the problem that anyone who calls healthcare a right has to answer.  At what cost?  We've rejected block grant proposals because of the obvious downside that grant may result in tough choices for states for whom the grant will not be enough to cover all needed services.  So healthcare is a right.  Great.  How much are we willing to spend to protect that right?  Because Bernie's MFA is a more generous plan than pretty much every other healthcare system in the world and in order to be funded, we're gonna have impose some hefty taxes.  Which is pretty much the point where MFA's popularity starts to nosedive.

 

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Thats the biggest problem with this discussion in that it's being said over and over again that so many worries from fixing the system are born from the reality we were doing it wrong in the first place and people still not seem to process that.  The point that what we are doing already isnt working doesnt seem to be swaying people because for too many it's working for them and that's good enough.  

 

Majority of Republicans support MFA now, hell this article is from 2018 and Fox has been caught with their pants down in this as well

 

https://www.google.com/amp/s/thehill.com/hilltv/what-americas-thinking/412552-majority-of-republicans-say-the-support-medicare-for-all-poll%3famp

 

If your point is progressives haven't made a good enough case for why private insurance should be eliminated and the polls reflect that, you have to ask how much the GOP trying to convince its base it doesnt want MFA first is having an affect on that.  The case has been made ad nauseam, but as you admit, to your knowledge it hasnt.

 

The case as to why single payer is preferable has been made over and over again.  And people agree on the broad principle.  But the moderate Dems have said we need to progress slowly towards a single payer.  Because for a single payer system such as one proposed by MFA to run, it will require seismic changes to multiple private industries and imposition of huge tax increase.  The attack is not that MFA should not happen, but that it shouldn't happen overnight.  And since Warren cosponsored a legislation that centered around improving the ACA this year, it can't be that she views anything short of a full MFA to be somehow unjust and inadequate.   So if Warren or Sanders discussed anywhere why these plans by Biden, Buttigieg, Klobuchar is somehow inadequate as an interim measure and it must be MFA and it must be within the next 4 years, please enlighten me.

[gbear]

Momma, Are you saying I would "go back to voting republican?" Lol

 

News flash, my parents were teachers. I live in MD. I have a chronic health condition the current Republican party wants to make it impossible to insure. I am an adoptive parent of 4 medically fragile children who would already have hit their life time caps under medical plans put forth by Republicans since the passage of the ACA or if the ACA had never been passed.  

 

That said I know the history of ideas that got us to the ACA, and ignoring Weld's part in it just shows partisan ignorance. Sure though, assume I would just "go back to voting Republican." 

[Renegade7]

1 hour ago, bearrock said:

 

There are government programs that are struggling because of a particular admin's decisions or artificial constraints like USPS, but do you think that either party is out to sabotage things like the VA?  

 

Are we even in disagreement here?  Do you not think progressives need to be out there advocating for and defending the necessity of big government in many areas?  Call it feelings, ideological divide, whatever.  The reality is that in order to get people elected and pass big government programs, progressives need to convince more than just the choir that bigger government is necessary.  By in large, people like Warren are doing that.  Except when it comes to healthcare and specifically MFA.  I have not seen nor have I been able to find a single speech, interview, or statement on why MFA right now is preferable to the alternatives proposed by the moderate democratic candidates that takes a more gradual approach to a single payer system.  Maybe my google-fu is failing me and I've been living under a rock.

 

 I'm fine with this staying here because you're debating more about the perception of how the presidential candidates have thrown support behind a bill that is not finalized

 

https://www.healthaffairs.org/do/10.1377/hblog20190302.150578/full/

 

That is an overview of the MFA bill majority of house Democrats now publicly support.  Note it is not identical to the Sanders bill Warren put her support behind (Sanders has since released a new bill to compensate for changes moderates approved in the house bill).

 

  If you want to say Warren is spending more time defending this from an ideological standpoint then dirty details technical point, I already agreed with you and said that's because the bill is a moving target, so it's hard to defend specifics on a bill thats not yours and being changed.  I'm giving Warren a pass on that, because I agree with the big picture of what they want and know this will work out in a way at least the democrats agree on.  Especially because of what they changed and that I believe Bernie when he says theres a constitutional way to get a MFA bill passed with simple majority, win the senate, wont need republicans to agree with it.

 

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And this begs the question, why isn't a UK like system being proposed here?  Not a carbon copy of the NHS, but a system founded upon a principle that no one should be able to profit off of delivery of health care.  A system where such principle applies not only to insurance companies, but hospitals and doctors.  Why is it okay for the government to displace insurance companies, but not for profit hospitals and for profit doctors?  If it's not okay to totally displace profit motivation for hospitals and doctors, how much displacement is okay?  And how quickly?  Because MFA is going to be a steep decline overnight.  

 

Also, as much as Sanders likes to tout the Canadian system as being able to institute single payer at half the cost per patient of US, Canada has private insurance component to their healthcare.  So does every other nation in the world running single payer.  So MFA is going to totally displace private insurance?  Why?  And why stop there?

 

Bernie doesnt help himself by demonizing the private insurance the way he does because anytime he clarifies that private insurance wont be allowed to offer the identical services to MFA, people get confused.  His bill and the house bill dont actually get rid of private insurance it shrinks their size considerably to only covering what MFA wont.  This is clearer in the house bill

 

 

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We've heard plenty about block grants in US healthcare reform discussions, it's just from the GOP.  Herein lies the problem that anyone who calls healthcare a right has to answer.  At what cost?  We've rejected block grant proposals because of the obvious downside that grant may result in tough choices for states for whom the grant will not be enough to cover all needed services.  So healthcare is a right.  Great.  How much are we willing to spend to protect that right?  Because Bernie's MFA is a more generous plan than pretty much every other healthcare system in the world and in order to be funded, we're gonna have impose some hefty taxes.  Which is pretty much the point where MFA's popularity starts to nosedive.

 

 

Under the House bill a fund will be created run by HHS.  The house bill also does block Grant's to the individual hospitals, so this is not just a Republican plan or suggestion. OMB has not got back with the final price tag for the house bill, but below is the doc Bernie wrote on how to pay for it, pulling money from standard section in the form of a middle class tax and then raising fractional tax rates on rich that add up to billions of dollars because that's how much money is at the top in this country, which both him and Warren mention repeatedly

 

https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.sanders.senate.gov/download/options-to-finance-medicare-for-all%3Finline%3Dfile&ved=2ahUKEwiJ2_fjw_LkAhVlTd8KHfduC6IQFjAAegQIBRAB&usg=AOvVaw2tqCxQugfNOPAoT_zhxHsW

 

 

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The case as to why single payer is preferable has been made over and over again.  And people agree on the broad principle.  But the moderate Dems have said we need to progress slowly towards a single payer.  Because for a single payer system such as one proposed by MFA to run, it will require seismic changes to multiple private industries and imposition of huge tax increase.  The attack is not that MFA should not happen, but that it shouldn't happen overnight.  And since Warren cosponsored a legislation that centered around improving the ACA this year, it can't be that she views anything short of a full MFA to be somehow unjust and inadequate.   So if Warren or Sanders discussed anywhere why these plans by Biden, Buttigieg, Klobuchar is somehow inadequate as an interim measure and it must be MFA and it must be within the next 4 years, please enlighten me.

 

That is a helluva leap for someone who so thoroughly defends MFA to say because she supported a compromise that she thinks her idea she really wants is garbage.  The House bill goes beyond the Sanders bill and makes the eligibility for Medicare lower for older Americans and everyone under 19 as part of phased approach. 

 

This includes adding a public medicare option in the ACA exchanges until its later rolled into the overall medicare program once everyone is eligible in 4-5 years.  Maybe it is fair to criticize Warren for not coming up with her own plan, but in context the house isnt negotiating with the Senate yet so Sanders is proposing his own bills. I can see why shes focusing on the philosophical approach, shes being asked to defend specifics that are actively changing and being negotiated, a moving target.

 

Heres something the house bill has that I asked for in regards to coal miners:

 

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Recognizing that M4A would be disruptive to the health insurance workforce, the bill allows up to one percent of the national health budget to be allocated to programs that assist health insurance-related workers who may experience displacement. This budget allowance is authorized for the first five years that M4A is in place. In differences with the Sanders bill, this assistance would also be available to those who perform related functions within health care institutions or organizations, and the assistance would have to include wage replacement, retirement benefits, job training, and education benefits.

 

 

Is it unfair to treat this as an issue with plenty of publicly available information on it in context that the final bill is under negotiations?  If you want to say Warren and Sanders need to give more specifics to defend this, I'm not sure what forum they could use to realistically address every issue in this complex matter like what I out in the first link if this post. 

 

The debates dont give them enough time to go into the nitty gritty if it, and risk getting caught on saying they support a specific that gets changed during negotiations.  What looks like is happening is Bernie is pushing the senate version that he will present to the house in respect to their own bill instead of letting them negotiate his baby for him. 

 

What I want them both to do is a better job of explaining the no-compete clause between private insurance and medicare.  They have done a terrible job of separating their rhetoric in private insurance from the actual policy change.  They created their own bumpsticker against themselves with that one.

 

Can stop about there not enough info from the candidates on the topic when they are writing and cosponsering each others bills?  Can we stop saying this wont be a phased approach and that's making people weary when really your jus uncomfortable with the 4-5 year time frame?  They absolutely have plans for addressing how quick this is going to move and who this is going to negatively impact, it's in the bills.

[bearrock]

35 minutes ago, Renegade7 said:

Especially because of what they changed and that I believe Bernie when he says theres a constitutional way to get a MFA bill passed with simple majority, win the senate, wont need republicans to agree with it.

 

Yes, his plan is to get rid of the legislative filibuster.  Which is one hell of a pandora's box. 

 

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That is a helluva leap for someone who so thoroughly defends MFA to say because she supported a compromise that she thinks her idea she really wants is garbage.  The House bill goes beyond the Sanders bill and makes the eligibility for Medicare lower for older Americans and everyone under 19 as part of phased approach. 

 

 

I honestly don't follow.  Are you saying that I said Warren thinks MFA is garbage?  I don't understand how you could get that from what I wrote.  I was referring to the Consumer Health Insurance Protection Act, which deals with strengthening ACA, which Warren co-sponsored.  https://www.warren.senate.gov/newsroom/press-releases/warren-colleagues-reintroduce-legislation-to-hold-insurance-companies-accountable-and-strengthen-consumer-protections

 

The point was that Warren appears willing to support a middle position.  Bernie, I get the sense that he views anything short of MFA as unacceptable.  

 

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Can stop about there not enough info from the candidates on the topic when they are writing and cosponsering each others bills?  Can we stop saying this wont be a phased approach and that's making people weary when really your jus uncomfortable with the 4-5 year time frame?  They absolutely have plans for addressing how quick this is going to move and who this is going to negatively impact, it's in the bills.

 

You are not getting the point I'm trying to make.  Maybe it's my fault for being too verbose, so I'll try to make it as simple as possible.  Yes, I think 4-5 time frame is too short.  So do many Dem primary candidates and voters.  So why is MFA superior to a public option or a medicare buy-in option first to see how a government run healthcare reimbursement system works within the US structure and then transition to MFA in the future once the kinks are ironed out?  And has Warren, Sanders, or other progressives addressed why they think MFA is superior to trying out the public option or medicare buy-in?

[TradeTheBeal!]

Saw a real, actual MAGA couple in the wild today.

 

After our grand opening we went to the brewery two dooors down to unwind.  Couple sitting next to us at the bar seemed chill, but a bit too bougie...Rolex, too much makeup, fake rack, etc.  

 

https://www.gardengrovebrewing.com/home

 

Next thing you know it comes out “Warren is the most dangerous person in America”.  No one would engage and stripper wife just nodded along.

 

It was amusing to see it up close.  They packed up and left about 10 minutes later.

[Renegade7]

@bearrock hes not getting rid of the filibuster, hes proposing to introduce the bill in the context of reconciliation so it dosnt need 60 Senate votes to pass to get around filibuster instead of getting rid of it.  Either way doesnt bother me because Republicans dont have an alternative to point if they decide to get in the way, them saying no no matter what with no alternative speaks volumes.  Talking about this getting OT.

 

I dont see how Warren being flexible is a problem.  I dont see how Bernie isnt being flexible when hes adopted solutions endorsed by moderate democrats in the house bill into his newer version.

 

And I dont need you to simplify your point that they haven't explained how their plan is superior.  I get it, I dont agree with you, and tired of trying to explain that they have versus they haven't done it enough.  I'm not sure how posting what they said in the debates will address your concerns whens you saw the same debates as I did.

[Commander -JB-]

 

[bearrock]

6 hours ago, Renegade7 said:

@bearrock hes not getting rid of the filibuster, hes proposing to introduce the bill in the context of reconciliation so it dosnt need 60 Senate votes to pass to get around filibuster instead of getting rid of it.  Either way doesnt bother me because Republicans dont have an alternative to point if they decide to get in the way, them saying no no matter what with no alternative speaks volumes.  Talking about this getting OT.

 

 

You can't pass anything resembling the current MFA proposals with reconciliation unless you load it up with gimmicks.

 

Quote

I dont see how Warren being flexible is a problem.  I dont see how Bernie isnt being flexible when hes adopted solutions endorsed by moderate democrats in the house bill into his newer version.

 

 

I never said it was a problem.  It's a good thing that they are flexible.  But then it begs the question, if there are acceptable alternatives, the argument is more nuanced than my plan is good, anything short of it sucks.  They got the my plan is good part.  I'm still waiting on the my plan is better part, especially compared to plans like Buttigieg's and Klobuchar's.

 

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And I dont need you to simplify your point that they haven't explained how their plan is superior. I get it, I dont agree with you, and tired of trying to explain that they have versus they haven't done it enough. I'm not sure how posting what they said in the debates will address your concerns whens you saw the same debates as I did.

 

I went back and read through each quote from the debates on healthcare by the two just to make sure I didn't miss something.  Lot of macro criticism of for for profit insurance companies, but nothing on why the change needs to be this sudden.  I haven't been able to find any other speech, quotes, statements, writings addressing that particular point either. 

 

But that's not to say that they don't exist.  I may have just missed it.  Much harder to prove a negative that something doesn't exist.  So when you say they have discussed it ad nauseam, I asked for some examples, because I would welcome the discussion on it and would love to know Warren and Sanders' reasoning on the need for the sudden change.  If the discussion is going to devolve into you claiming they have discussed it without providing examples and me being unable to find those examples, I guess that's it then.  

[88Comrade2000]

Maybe a thread for Healthcare for all?

 

The next Dem debate, with 12 candidates,  is one night only. Tom Steyer and Tulsi Gabbard join this one.

 

Those remaining candidates not making the debate, really need to drop out.

 

 

[Momma There Goes That Man]

11 hours ago, gbear said:

Momma, Are you saying I would "go back to voting republican?" Lol

 

News flash, my parents were teachers. I live in MD. I have a chronic health condition the current Republican party wants to make it impossible to insure. I am an adoptive parent of 4 medically fragile children who would already have hit their life time caps under medical plans put forth by Republicans since the passage of the ACA or if the ACA had never been passed.  

 

That said I know the history of ideas that got us to the ACA, and ignoring Weld's part in it just shows partisan ignorance. Sure though, assume I would just "go back to voting Republican." 

 

No I didn’t know that I was simply responding to your point about “having to think twice about voting for Weld” which imo is ludicrous and as you’ve now outlined your personal situation, makes it even more difficult to reconcile. 

 

On a more general note: 

There should be no thinking twice for a long long time. The current Republican Party is an absolute disease on our democracy. Every last one of them needs to be punished at the voting booth for decades until they return to realm of logic, reason, fact and legitimate policies that aren’t designed to create the exact scenario where someone like Trump can be elected and thrive. 

 

I dont care even if its a moderate republican or a never trumper. They didn’t speak up or legitimately try to exact change until It was far too late and never trumpers are still the republicans of GW and the Obama era which that resume alone makes them not worth considering.

 

honestly we aren’t even out of the woods yet. Who knows what happens with impeachment and if trump wins in 2020. That’s still very much on the table. So let’s not congratulate ourselves and return to thinking twice about voting republican when we haven’t done anything yet. We need another 20 years of total liberal leadership similar to what we had after the Great Depression that ushered in a revolution of liberal policies and ideals propelling the country forward for generations. 

 

And even then, we cannot backslide or give up ground or they’ll just so the same thing. Power and wealth is all they have sought for 45+ years. Their entire belief system is incompatible with American democracy. 

[Renegade7]

3 hours ago, bearrock said:

.  If the discussion is going to devolve into you claiming they have discussed it without providing examples and me being unable to find those examples, I guess that's it then.  

 

You've been moving the target this entire conversation.  You asked why their system was better at first now you are asking why it needs to be done in 4 years and insisting it's too fast without proof that it is. You said there was no phasing in our accounting for affecting on the industry which I proved wasnt true, especially with the latest version of the bills that are still being negotiated.  

 

No, in haven't seen them say in the debates specificly why it has to be 4 years, so if you going to insist that's too fast, bump the healthcare thread and prove why, that wasnt your original point otherwise I never would've responded to you here.  Asking why MFA is better overall system and solution is not the same as asking why it has to be done in 4 years, but if you are going to shrink this down to why they arent explaining why it has to be done in 4 years, that's a policy discussion, doesnt belong here.

 

You haven't proven anything expect you dont want to do this in 4 years.  I'll hear you out, but not here, its OT.  I wish it was more then 4 years as well, honestly, but that's not based in any hard evidence it cant be done.  I know the truth is likely wanting as much of it phased in as possible in case they lose reelection so a republican cant stop it.  As fruitless as their attempts to overturn ACA was overturning MFA will be borderline impossible once people get used to it.  I dont expect them to say that, I'm sure it's written somewhere else. 

 

I also understand not wanting to factor competiting insurance plans with MFA when deciding how much money to give hospitals to keep them open.  If you only have public option, but then want everything at medicare rates, you run into same problems, plus having to figure how to deal private insurance still trying to turn a profit, direct conflict, this is just as much about price control as it is coverage.  Whats more important, the hospitals getting help to deal with medicare rates or private insurance? I dont want to give block grants to blue cross.

 

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"We just need to be clear about what Medicare for all is all about. Instead of paying premiums into insurance companies and then having insurance companies build their profits by saying no to coverage, we’re going to do this by saying, everyone is covered by Medicare for all, every health care provider is covered,” Warren said. “And the only question here in terms of difference is where to send the bill.”

 

[The Sisko]

I haven’t read too much of this thread due to time constraints but, big ups to whomever it is updating the thread title. Funny stuffs!😂😂

[TheGreatBuzz]

1 hour ago, Rdskns2000 said:

Maybe a thread for Healthcare for all?

 

I think we have one.  Need to move the conversation there.

1 hour ago, Rdskns2000 said:

Those remaining candidates not making the debate, really need to drop out.

 

All but like 5 need to drop out.

[Renegade7]

12 minutes ago, TheGreatBuzz said:

I think we have one.  Need to move the conversation there.

 

I was wrong, i shouldve moved this a minute ago, my bad.  Im still going to disappointed if people are skipping these posts because they dont bekong here because he raised good points even if i disagree with him

 

@bearrock is this even the best thread for this, or should one be made specific to the democratic healthcare proposals?  This one looks offtrack lately, but closest i can find to recent healthcare thread

 

 

[bearrock]

1 hour ago, Renegade7 said:

 

You've been moving the target this entire conversation.  You asked why their system was better at first now you are asking why it needs to be done in 4 years and insisting it's too fast without proof that it is. You said there was no phasing in our accounting for affecting on the industry which I proved wasnt true, especially with the latest version of the bills that are still being negotiated.  

 

No, in haven't seen them say in the debates specificly why it has to be 4 years, so if you going to insist that's too fast, bump the healthcare thread and prove why, that wasnt your original point otherwise I never would've responded to you here.  Asking why MFA is better overall system and solution is not the same as asking why it has to be done in 4 years, but if you are going to shrink this down to why they arent explaining why it has to be done in 4 years, that's a policy discussion, doesnt belong here.

 

You haven't proven anything expect you dont want to do this in 4 years.  I'll hear you out, but not here, its OT.  I wish it was more then 4 years as well, honestly, but that's not based in any hard evidence it cant be done.  I know the truth is likely wanting as much of it phased in as possible in case they lose reelection so a republican cant stop it.  As fruitless as their attempts to overturn ACA was overturning MFA will be borderline impossible once people get used to it.  I dont expect them to say that, I'm sure it's written somewhere else. 

 

 

@Renegade7 I think the obamacare thread is as good a place as any to discuss the substantive merits of the competing proposals.

 

I just want to say this from the context of the 2020 election, which I think belongs here.  From the beginning, my point was that many voters don't trust the government to not screw up something this big.  A big part of that is the sudden and abrupt change MFA calls for.  Which is why Buttigieg and Klobuchar says they want MFA in the long term, but advocates for a more gradual approach. 

 

The question that I and a lot of voters are asking is not whether MFA is better than the current system.  It is whether it is better than the other competing proposals by people like Buttigieg and Klobuchar.  Warren and Sanders, to my knowledge, have not addressed it and the longer they go on without addressing it, more and more questions it will raise in the minds of the voters.  Warren is already getting some heat on the clarity of her positions regarding healthcare (not totally fair, but it's a perception issue).  It's only going to increase going forward.