If you support the Republican Party, you presumably could not give the slightest fuck about this:
“The draft [health care reform] bill does not expand coverage; it does not do enough to protect people in need of care; nor does it provide enough assistance to those who need help in paying for health care and coverage,” said Bernard J. Tyson, the chief executive of Kaiser Permanente, a California insurer that offers plans on the exchanges in eight states and in Washington.
But it’s likely that you actually would care about this, if you could take off your right-wing blinders long enough to understand it.
If the Senate version becomes law, insurers could increase premiums for individual coverage by at least 20 percent more than the double-digit increases already under consideration. By 2020, other changes are likely to result in plans with much higher deductibles. People now getting tax credits that allow them to purchase a policy with a deductible of $3,500 would get subsidies for a plan where the deductible would nearly double, without any funding to pay their out-of-pocket costs.
Maybe I’m silly, but I think you should listen to the people who actually understand health care policy and the insurance industry. If they tell you that the Republican Party is going to make your deductibles much higher and cause your out-of-pocket costs to soar, you should probably listen to them.
You don’t even need to know what empathy is to understand that you’re about to get screwed six ways to Sunday.
As long as Those People are getting screwed worse, or merely perceived to be, it’s all good for the GOP base.
I think that works better in the hypothetical than in the “Oh my god! My health care freedumb is costing me an extra 20 grand a year!”
I dunno, man; you’d think by now a significant fraction of the freedumbers would have figured that out by now, and yet they keep voting for the people punching them in the gut.
By now I should have learned by now to copy-edit one more time by now before posting.
I do that to!
👹
.
For forgot the ‘Thanks, Obama!’
These people are cultists. Deluded, racially motivated, misogynists who happily volunteered for Jay Gould’s Army
Conservatism can never fail, it can only be failed.
The GOP base is getting 800 Billion a year. They will then turn around and pour that money into campaigns. The campaigns in turn will cut ads making any Democrat look like Attila the Hun.
That is all any of them care about.
This is feature, not a bug.
And besides a few Sanders events this weekend, there are very few demonstrations about HCR in opposition.
McConnell was smart. He outfoxed the Democrats, who are distracted.
On every level this is a failure by those opposed to Trump.
So who is it, exactly, who is shooting themselves in the face?
The shear amount of denial is incredible.
That would be you.
.
You really are a vicious person.
That is all you ever have to contribute.
How’s your search through Podesta’s emails going? Find anything?
No? Well, at least your efforts accomplished exactly what Putin was after. At least you will always have that.
.
The republicans are having an orgasm over the taxes they will save on repeal of Obamacare. Oh praise ye the free competitive market and your personal responsibility. Or fuck you Jack, I got mine.
Therein lies the problem. Obamacare relied on taxes for the wealthy to support the system. And the Kochs and those smarty pants figured it out. So let’s just stop that shit, ok? No more special taxes.
Why in heavens name can’t or won’t the democrats get behind universal single payer health care? Let’s have something to fight for.
When the wealthy don’t pay taxes (and they regularly don’t), who makes up the difference? If you don’t see a spiral in self-reinforcing austerity in that plan, you don’t understand GOP thinking.
I’m waiting for them to drown the national security state in the bathtub. I wonder what millennium that will happen.
Absolutely! The owners of the country, the Kochs and those who aspire to that level, are damned not going to pay for your health insurance, it is your responsibility to buy it in the free market. And the democrats can’t get together a coherent message to stop the lying bullshit. Hell they even like the idea of drowning the government in a bath tub. It sounds good you know. We all know government can’t do anything right.
Ha ha, I’ve always hated that “shrinking the government so much that it could be drowned in a bathtub” bit. Little did the Republicans realize that when they elected Trump and Co that they wouldn’t waste time shrinking government, but would blow it to bits with grenades.
It’s all Obamas fault anyway. Trump is working to erase him.
Trump is successfully erasing him.
They still love their personal and corporate tax loopholes, subsidies, infrastructure, schooling and training, fire protection, etc. supported by taxpayers. They aren’t in support of a free market. The thumb is on the scale on the owner side. That they love.
Especially because even California cannot pass its long-announced single-payer bill that was going to the The Resistance (TM) if Trump repealed Obamacare.
That is the real shooting yourself in the face.
And stabbing your national allies in the back as well.
The plan to kill the best reform plan for health care by incorporating it into the infrastructure, an idea since Theodore Roosevelt, has now failed. BTW, Roosevelt’s proposal was for a public health service much like the UK’s National Health Service that the Tories are trying to dismantle before they get thrown out of office.
The GOP plan is denial of governance and then what essentially amounts to a police/military state to maintain power. Democratic politicians are still playing business as usual. Who exactly is shooting themselves in the face? Under the GOP strategy, elections don’t matter because voters don’t matter and their votes don’t count. They were doing that well without Russian help for over a decade. And they have the NRA as their de facto armed partisan militias to defend them. That looks like shooting yourself in the face only if you intend to face an honest election again.
I agree with that except for California. They already pay significant taxes and single payer on the state level would make it worse. I’d love to see them do it, but this is something that should be done on a national level in my view.
It is an open question now who works for the average family?
How much are they paying for health care insurance and health care out-of-pocket costs?
There is no “too much in taxes” except as it balances against the benefits of the state-subsidized infrastructure. Looking only at government expenditures is an old conservative trick; too bad Democrats have absorbed that bad habit. What do you get for those expenditures and taxes; in California at one time you got free college education (or close to it) and the best public education system in the world. But the elders wanted their tax freedom after their kids were gone; that tax freedom now will eat their health care and possibly cost them their lives. Inter-generational compacts really are a good idea.
The problem with implementing single payer:
1. The tax break for employer health care:
“The ESI exclusion cost the federal government an estimated $260 billion in income and payroll taxes in 2017 making it the single largest tax expenditure”
One reason Single Payer looks so expensive is this tax expenditure. The beneficiaries mostly don’t know they benefit.
When Vermont ran the numbers they concluded this was why Single Payer will look more expensive.
That is a federal rule. At the Federal level you transfer the 260 Billion into subsidy. But the states can’t do that.
2. You are implementing Single Payer with the high costs of the current system.
This is the real problem. The private market has created prices that 40% higher than in single payer countries. But you won’t get lower prices overnight, particularly when there are federal limitations.
Not so say it can’t be done: it should be done.
But there are two obstacles that are very real.
It’s no more a tax expenditure than excluding wages. I do favor a gross income tax like individuals pay. If wage earners paid on their net like businesses, hardly anyone would pay more than a pittance.
Yes, divorcing price from payment is obviously not a good idea. The market still works except what health care providers get is the market price paid by the patient plus a huge bonus from the insurance company. No one decides that they will not have a procedure because the insurance company will pay too much. People only care about their own pocket. Insurance is the wrong paradigm for something you know will happen (as opposed to might happen) anyway. And a price mechanism divorced from the purchaser is insane. I don’t know the right way to determine health care costs but there must be a better way than the free market.
Nice analysis of the tax implications and the current market for insurance.
The sooner employers are taken out of the picture, the better. Employers have been wanting to have it both ways: have the golden handcuffs of fringe benefits without the cost of fringe benefits. Keeping employers in the picture means cheap high-deductible insurance and health savings accounts. The employer does little at all for those handcuffs.
Don’t finance with tax cuts; have the state government pay all health care costs outright on the basis of Medicare/Medicaid cost caps to start out with and then creating state standards if the Congress kills Medicare and Medicaid. (This was supposed to be an alternative to whatever Trump had in mind, after all.) States (and municipalities) need to look at this with the contingency that federal health care could go away completely during the Trump interregnum.
Yes, you will get to lower prices overnight if you have efficient billing and payment procedures so that providers can shed most of their billing staff and all of their collection staff. The systems that pay for Medicare/Medicaid are all contracted within states and can be leveraged to begin with. That actually made the rollout of Obamacare go smoothly. There is no marketing app like healthcare.org; everyone is enrolled on the same basis. Also, you have an immediate 15% savings for the indirect costs currently being billed in insurance premiums under Obamacare (the flip side of an 85% medical cost ratio.) No more paying those million-dollar CEOs; no more paying marketing and legal departments aiming to extract profits; no more paying nurses to deny coverage. No more special reporting for self-funded employers. All of that overhead is gone from the git-go.
And ending deductibles, co-pays, exclusions, and recissiions (which are coming back) does make it attractive to individuals.
The other big items to fix are funding fuctional/integrated medicine fees as semi-preventative and not as fee for service (i.e. capitation fees); that can offer dramatic reductions in fee-for-service usage for expensive and serious treatments. Legislatively, that should be easy to implement.
Also full dental and vision coverage for medical treatment and a reasonable change cycle for glasses (an item that affects education that might not be currently being covered well.)
Ignore the federal limitations; this is complementary to the federal (like an “Advantage” coverage until the Federal coverage goes away). If the federal government pays anything at all, it should lower costs further.
What is real is the research and careful drafting that needs to be done to make the proposal as simple, effective, saleable as possible and still interface with whatever federal plan is out there.
If the federal government uses heavy tax cuts, the state and municipal plans should claw back those tax cuts from the eligible taxpayers in their jurisdictions. After all the state or municipality is funding a Medicare for All plan that covers everybody for everything reasonable. It is infrastructure.
Legislators who don’t want to do something make it more complicated than it already is. Legislators who want to insert hooks for potential future graft make it more complicated than it is. Legislatures who want to make it easy for lawyers to find something to sue the state about make it more complicated than it is.
Taking insurance totally out of the system and just subsidizing health care payments themselves makes it very simple.
And all those currently in the health care insurance field who will lose their current jobs– they will at least have guaranteed health care coverage of payments for their entire family with no co-pays, deductibles, or other exclusions.
This was thoroughly hashed out in blogs when Obamacare was going through Congress. It is not that difficult to legislate and no more difficult to administer than current government health care claims payments. All known processes. And by now, the states should have the usage data they need to estimate administrative budgets fairly accurately.
You stop paying insurance companies; you start paying state taxes, and you pay less. That’s the value proposition.
I don’t see how a state can afford single payer. Estimates for NYand Ca indicate up to a doubling of already high taxes in those states depending on (Trump approved) waivers for Medicaid and other federal funding. There is a reason why no state has made it across the finish line, and many have tried. Maybe the cost and complexity are just too much. At least at the federal level there is progressive taxation.
I was against Single Payer for 25 years.
But there really is no other realistic solution in the longer term that is going to work.
So I agree with most of what you have written.
What is need is a strategy you can implement at the state level. One place to start is the creation of a Medicaid buy-in option.
The first thing to do is eliminate state balanced budget amendments and replace them with something more reasonable. States at one time had “rainy day” funds that allowed them to run surpluses; the first act of Republican controlled legislatures was to spend them down on tax cuts.
The second is to put state fiscal policy on a taxation basis that is progressive and reduce sales taxes. That means ignoring the threats of relocation from companies that tax shopping.
The third thing to do is figure out what the total health care costs and cost per capita actually are. The cost per capita should be close to the average tax bill for health care after passage and set the benchmark to show when the single payer plan actually outperforms what was there before. As the plan outperforms, the taxes allocated to health care go down.
The fourth thing is to make sure that the appropriation is from the general fund and not a special fund that can become a slush fund. (Unless it is a general infrastructure fund.) Don’t paint a target on the money while it is proving itself.
The fifth is to make provisions for transition of workers from the insurance industry to other employment.
That’s some heavy lifting in some states, less in others.
What we really need is a grassroots model legislation drafting bunch to come up with common progressive state legislation that seamlessly integrated progressive economic policies into a world with New Deal policies. And move power to the states and localities (such as Seattle).
I agree with the gist of your policy proposals here. However, the political and policy difficulties of accomplishing what you are demanding here are infinitely more difficult than you want to believe they are.
Each of the policy points you mention are very complicated, and good policy analysts who are ideologically allied with us often differ in their answers to the questions within the policy points. And your cavalier claim that just the states should rid themselves of their balanced budged amendments so they can engage in the deficit spending necessary to finance single payer seems akin, in the current campaign finance and media climate, to saying the Legislatures and Governors should jump to the moon.
As an example, sending revenue meant for a single payer health program into the general fund has its good points, but California is famous for its wildly fluctuating year-to-year revenue levels. In low revenue years, health programs would have to be cut substantially to balance the budget, and single payer would fail to achieve its needed health care outcomes.
As progressive as the majority of Californians are, polled voters here remain reluctant to alter the very regressive budgetary restrictions imposed by the Proposition 13 referendum in 1978, and wiping away the balanced budget requirement here would be an even more radical change.
That this is really hard doesn’t mean we shouldn’t try. It does mean we should refrain from calling liberal/progressive politicians who have passed ground-breaking legislation cowardly and corrupt when those politicians call a mountain a mountain.
I font yhink you get lower prices at all. Nurses are overpaid (paycut ~5%) Doctors are overpaid (paycut ~10%). Specialists are CRIMINALLY overpaid (paycut ~66%). There is essentially almost no way except drug prices to reduce costs of the current sysytem with single payer. What it will do is restrain costs.
Given that the system at the moment is a micromanaged fee-for-service with often guaranteed patient coverage of at least 20% of the costs, I don’t get where you are getting the salary figures from. Medical system CEOs increasingly set the salary and working conditions of medical personnel. And those CEOs in this area make better than $1 million a year. Those outside the medical systems are primarily specialist professional association practices who depend on balance-billing employer-insured and private patients. And who still think that their degree grants them a license to print money.
California as the largest state economy will have an impact on pharmaceutical prices; if pharmaceutical companies think they can make it up from other states by increasing those prices, there will be a political issue. Are Democrats willing to talk about concentration of corporations in the pharamaceutical, hospital supply, and medical technology industries?
Paycut numbers come from what equivalents earn in western states that have socialized medicine. Granted I last took a hard look at the data in 2010.
Here are some benchmarks based on California’s $2.6 trillion economy.
Total cost at current US 17.1% of GDP rate – $446 billion
Total cost at current best of class 9% rate – $235 billion
Capitation (per capita) cost at 17.1% for everyone – $944 a month
Capitation (per capita) cost at 9% for everyone – $500 a month
Part of lowering the costs comes from catching serious issues earlier reducing the number of extreme stays in hospitals, using preventive and functional/integrative medicine to prevent the development of serious conditions to begin with, and covering everyone so there is no cost-shifting of unpaid bills.
As for the insurance amount from indirect costs, that should show $67 billion in savings the first year. Savings on billing and collection by providers should show up the second year. That is hard to estimate, not knowing what percentage of provider budgets that constitutes. But it could be substantial if the single payer system simply and reliably pays its claims.
What is needed in medicine is the hiring of more patient-facing personnel and ending the number of people leaving those professions. That will require higher salaries of frontline personnel and and a larger head count in frontline positions. Shrinking management layers and salaries of large medical systems would be a first start, especially amount pure MBA types. For lots of practices, consolidation and concentration has be to extract rents not to provide efficiencies and better service.
Also full inclusion of EMS services as infrastructure will unburden many strapped local governments of current unpaid bills.
201 of 240 House Republicans had margins over 15 in 2016. They face a more friendly electorate in 2018 if history is a guide.
In the Senate here are the Republicans who are up:
Flake (Clinton lost AZ 3. This is a winnable seat for the Democrats)
Wicker, Mississippi (Trump won by 17)
Fischer, NE (Trump won by 25)
Corker, TN (Trump won by 26)
Cruz, TX (Trump won by 9)
Hatch, (GOP won by 18)
Barraso (GOP won by 46)
Clinton won only 1 state that the GOP holds, NV. Heller, may vote no. They can afford two defections, but the Kochs is already on the air in Nevada threatening a primary.
There 8 seats up, of which 6 are maybe winnable.
They don’t fucking care about the upcoming elections that much, because they are insulated.
If the Kochs are already on the air, this is anything but historical precedent. Or a friendly electorate. The Kochs don’t create friendly electorates, they create hostile electorates.
All of those Senators who are up can be defeated if the lemmings do indeed jump and the voters get their Obamacare repeal and experience it before 2018 (bet Trumpcare doesn’t take place immediately).
If they are insulated, that means that Democrats will just be going through the motions in 2018, which means it will really be worse than expected.
In fact, we do not have a vigorous opposition party in the US in the midst of plutocratic kakocracy and rampant militarism.
>>All of those Senators who are up can be defeated if the lemmings do indeed jump and the voters get their Obamacare repeal and experience it before 2018
even the turtle is smart enough to see that. Taking effect in ’19 is part of the plan.
Then they get defeated in 2020.
Democrats thought they would be smart by kicking the can down to 2014. That was when they got slaughtered for delivering less than promised.
Friendly in the sense that key Democratic groups (POC, the Young) do not turn out in as big numbers in mid-terms.
Even if I didn’t agree (and I do), I would have recced that for kakocracy.
Wikipedia doesn’t give a derivation but I can guess. The Italian word “caca”?
From Gk. κακος, bad. The underlying IE great root kakka means ‘to defecate’.
Same derivation in Italian and I think Spanish too.
Jeff Flake only won 49.2% to 46,2% back in 2012, AZ was a lot redder back then, demographics etc.
I said that.
But we are unlikely to get the same turnout in key groups in 2018 as we did in a Presidential year.
In many ways Flake may be the vote to watch.
Your focus on the California single payer bill is misguided. The bill was a joke! It had no funding mechanism! There’s no reason to even believe the Feds would allow the repurposing of existing funds, let alone any proposal for new taxes to make up the remainder. It was completely symbolic, not a serious piece of legislation. You can’t just say “Yay, single payer!” and not actually construct the nut-and-bolts specifics that would make things work.
If the bill had gone to a vote it would have gone down in flames. If, against all reason, the bill had passed, Californian Democrats would never recover from the clusterfuck that would result. Implementing a statewide single-payer system is extremely serious business and half-assing it is a recipe for catastrophic failure.
If there’s any betrayal here it’s the advocates demanding a show of loyalty from Democratic legislators over a bill that simply isn’t capable of achieving it’s goals.
If the bill was a joke, the California Democratic establishment designed it to fail to cut off the pressure for single payer forever.
That, in fact, is not a joke, it is a monstrous betrayal of the interests that the Democratic base has been voting for for decades. They had the power; they decided not to use it for a real alternative in the face of the imminent passage of Trumpcare.
Their arrogance is similar to that of the North Carolina Democratic Party before 2010. Their positions as a majority are not guaranteed; they must earn them. If I were a California Democrat, I would be worried as hell now about 2018. But I’m not, and I suspect that those who are are complacent and thinking their blue island is protected by the Coastal Range (it certainly isn’t the Sierra Nevadas that are protecting it judging from the 2016 election map.)
No one asked them to half-ass it; taking that tack is like the NC Democratic member of the Assembly who “accidentally” voted for the fracking bill in a close vote; the chair ruled she could not reverse her vote. That was what allowed a hideous mineral rights bill to pass. Everyone was clear that it was too cute by half under the circumstances.
Advocates deserve a bill that actually does single-payer well to be argued and voted on. The big fanfare over California’s resistance by passing single payer just blew up in the establishment’s faces. Their only way of recovering now is by putting forward and passing (Democrats do control all three power centers as I remember) a solid, quickly implementable single-payer bill that delivers benefits to people before November 2018. Legislators 50 years ago knew how to rise to that occasion. They either do or they are gone. It’s that simple; progressives are tired of waiting. Loyalty is a two-way street. When you have total power, that means doing good things, not just stopping bad things.
What we are seeing increasingly is that divisions within the Democratic caucus are sacrificing the electability of the Democratic Party, and those divisions are coming from Democratic politicians who are not committed to what they ran on.
Tarheel, it really seems today that you have some vision of California that doesn’t accurately match the place I have lived my whole life. You also seem to have more emotional attachment to that single payer bill than any of the California activists talking about it.
>>Advocates deserve a bill that actually does single-payer well to be argued and voted on.
Sure. that isn’t the bill that we’re talking about.
>>The big fanfare over California’s resistance by passing single payer just blew up in the establishment’s faces.
The big fanfare was about vague generalities. The specific bill sucked.
As others here have mentioned, though there should be enough money to do single payer, actually redirecting that cash flow is easier said than done, and not at all easy at the state level.
If you have a plan to come up with $400BN to pay for the costs without federal cooperation go ahead and tell us. It seems to me that you don’t have the slightest idea what would be involved in implementing single payer and are simply choosing to deflect attention from the actual harm Republicans are about to do with this silly “stabbed in the back” narrative.
You know why the advocates who authored the bill didn’t include a funding mechanism? Because the sticker shock would guarantee the bill’s failure and they wanted to get the largest possible number of senators on board. It wasn’t the “Democratic Establishment” that chose to produce an irresponsible bill. It was the bill’s supporters.
You know what would cut off the pressure for single payer forever? Passing a single payer plan in California with a $400BN funding shortfall and watching the state implode.
You know what would make elected Democrats in California take the single payer bill seriously? A plan to fund it.
In the real world that means at a bare minimum a Democrat in the White House. That might get you halfway there. Then you could include the taxes required to make up the rest, and you’ve have a bill people could take seriously.
Unfortunately a bill that can be taken seriously is a bill that raises taxes dramatically which is political poison even though a lot of the new taxes are replacing previous premium spending. That’s the real hurdle that single payer advocates need to leap. If we can make clear that the tax increases are in part offset by spending reduction and the remaining increase is due to guaranteed access to reliable, high quality care that’s when single payer has a chance. Hiding the costs behind a magic asterix and then whining about the Democrats selling us out is childish twaddle.
You can’t do it on a state basis. Taxes would have to double at least in the state. a Bloomberg piece has this to say about California and New York:
That means at least a doubling of their taxes.
No. Not true:
http://www.latimes.com/opinion/op-ed/la-oe-pollin-single-payer-healthcare-healthy-california-2017062
1-story.html
Speaker Rndon called the bill ‘ woefully incomplete’ partly due to financing. I personally would like it as would my family that lives there, but the increase in taxes and coordination with federal funding for Medicaid and the like needs to be resolved.
Firstly I don’t mean to slag on the UMass Amherst analysis- I think they put the most favorable possible gloss on the numbers but that’s fine- it isn’t completely unreasonable. They magic up about 20% savings more or less out of thin air but 20% should’t be a deal breaker if everything else holds together and there is reason to expect at least some savings. And it’s great that they proposed some possible funding mechanisms, which the actual bill notably does not. But that being said…
The study makes a completely unwarranted assumption to cover the majority of of the funding, to whit:
Setting aside that the California legislature estimated the existing financing and the remainder to each be $200bn under their analysis, the problem is that there is no chance in a million years that a unified Republican Federal government under Trump is going to grant California waivers to enact a single payer system. Zero chance. Zip, nada, zilch. So we’re looking at an analysis that can only be implemented with Democratic control of at least the White House.
So back-of-the-envelope to meet the necessary funding level using the favorable numbers they provide you’d be looking at a sales tax rate increase of approximately 7% alongside either a payroll tax increase* or a tax on gross business receipts (this sounds crazy to me) also of approximately 7%.
I mean, with federal cooperation the numbers are certainly less prohibitive, though the UMass more favorable estimates would need to be vetted, but without fed cooperation I don’t see any way to pull this off.
*to both employee and employer so wow
7 percent to both employer and employee? That would be 14 percent to the self-employed!!!
Speaking as a self-employed person, that’s intolerable. No way, no effing way — you’d have every self-employed person in the state crawling over broken glass to vote against it.
I don’t have the time to go back through it but I think their proposal exempts businesses with under 10 employees. Though that might have been just for the gross revenue proposal. You’d have to verify.
The 7% I used is a rough ballpark number that’s almost certainly off one way or the other. I doubt that roughly tripling the dollars that need to be raised is really equal to tripling the rate. The number they used assuming federal cooperation is 2.3%
Hmph. We self-employed folks are already paying both sides of certain employment taxes to the Feds; we know how that works and what a big bite it takes. We’d be damned skeptical of any plan that threatened to do the same for a state’s single-payer plan, and distrustful of vague promises it wouldn’t happen — if not immediately, then in the future.
TarheelDem, you’re getting comprehensive responses from multiple community members who live in California. We’re giving you solidly reasoned responses to your claim that Not Passing Single Payer In California Means The End Of The National Democratic Party.
Your response shows you unwilling to respond to the specifics of our views, and you rush to take a maximal assumption of bad faith here.
“…the California Democratic establishment designed it to fail to cut off the pressure for single payer forever”? What is this horse hockey? You reveal in subsequent paragraphs that you’re quite openly projecting your problems with your Party in North Carolina onto the CDP. And, without evidence, you disparage a State Democratic establishment that has passed by far the broadest, deepest set of progressive policies in the United States.
I agree with marduk’s view that it is extraordinarily unlikely that Trump’s HHS would grant a waiver to California to implement single payer here. That should be a substantial warning that you’re on the wrong tack here. But the mountain to traverse on this issue in this State becomes even more insurmountable in the face of clearer evidence.
Here’s what would happen if a solid single payer program were passed by the California Legislature in the current session. Money men would finance a successful signature-gathering effort to place it on the November 2018 ballot, and the voters would reject single payer. How can I be so certain?
First, because California voters considered a single payer proposal via State referendum in the past, and not only did they vote it down, they utterly smashed the proposal:
Proposition 186 (1994)
No 6,110,899 73.4%
Yes 2,212,691 26.6%
Second, and even more relevantly, because current polling of Californians shows that only 43% of likely voters would support a single payer program in the State if it required tax increases. That’s the real number; the decision by ballot measure proponents to marquee the higher number in the poll is happy talk which misinforms us in ways which are harmful to our movement.
We have experienced many progressive ballot measure campaigns in California which have started out with overwhelming support, but have been smashed by obscene levels of funding by mega-wealthy interests for an armada of deceptive ads. Two that come to mind are our multiple failed attempts to establish an oil extraction tax and a more recent proposal to establish regulatory labeling of genetically modified foods. Each of these followed the pattern: massive early support, massive funding differences between the Yes and No campaigns, massive defeats on election day.
I have great doubts that single payer could maintain its current 43% real support with California voters in the face of a monolithic Bullshit Mountain campaign waged against it.
But, much worse from someone with the policy acumen you sometimes display, you recklessly demand that California Legislature and Governor must now be “…putting forward and passing…a solid, quickly implementable single-payer bill that delivers benefits to people before November 2018.“
This is delusional talk. Upending the health care system in the largest State in the Nation, a trememdously diverse State with a particularly complicated economy and budget process, would have to be done with great care to be done right on a policy basis, even before we consider the difficult politics. What you’re demanding here guarantees that California’s single payer program would be done poorly. That would set our movement back and would bring even more certainty that the single payer law would be repealed by State referendum.
Two things your “DO IT NOW!” demand fails to consider
– The State budget cannot run a deficit. State law demands that it must be balanced each and every year. The budget for July ’17- June ’18 has already been passed. Setting up a single payer program in California could not be done with the revenues from a few months of taxes which would not begin until the summer of 2018.
– Vermont, a State which should have had a much easier time passing single payer, with Bernie’s long leadership on the issue and a relatively homogeneous population, could not accomplish the legislation after a couple of years of trying. And Vermont voters responded to Governor Shumlin’s attempts to lead on this effort by cratering his support and voting a Republican opposed to a Vermont single payer program into the Governor’s seat in 2016.
marduk, you’re missing the point.
The point is to get people to stop discussing republican issues, and to focus on the failures of Democrats. ‘Both sides are the same’ IS the whole point.
No Democrat is ever good enough, no Democratic policies ever go quite far enough, no Democratic run state is ever doing it right. Constantly discussing Russia, or the removal of healthcare by the Republicans ruins this meme. It has to be pulled back.
Don’t feed the trolls.
.
For a lot of the people that do this I don’t think that is the point. There’s just a lot of terribly muddled thinking about politics and ego-driven purity signaling that produces this kind of behavior.
I’ll never forget the back-and-forth I had with a poster here in November where they absolutely refused to believe I had backed Bernie in the primary because they hadn’t ever seen me slag Hillary during the general. The fact that I refused to campaign for Trump once my initial choice was denied was literally inconceivable to them. Being of the left was to attack the Democratic party, by definition. How this attitude could ever produce left policy remains a puzzle to me.
Then Trump was elected and while the rank-and-file democratic voters were marching and knitting pink hats and organizing letter campaigns and pointing out the incredible interventions of Comey and Russia you had a crew attacking all of those efforts and making sure we maintained focus on the real enemy: Hillary Clinton. Or if necessary Nancy Pelosi. At least Victoria Nuland was temporarily off their radar…
And now the Republican Senate is pushing to kill off thousands a year and bankrupt who knows how many more and the liberal blogosphere is flooded with the usual suspects attacking Democrats and Obamacare. Campaigning again for the Republicans.
And I do think it’s mostly unwitting- there’s some psychological quirk where the only people in the universe with agency are elected Democrats and the actions of everyone else in the world are just an unfortunate circumstance, like a hurricane or an earthquake that “the authorities” didn’t sufficiently prepare for. Here comes another Republican plan to fuck us all over: stupid Democrats! But unwitting or not it’s quite consistent. Too many who claim to be on the policy left act to the advantage of the political right.
Yes on everything you wrote.
But now they want to rewrite their history, and put back on their ‘let me help you’ hat.
But two years from now they will be right back where they were a year ago. Gillibrand won’t be pure enough. Harris will have sold us out. Booker will be in the pocket of Wall Street.
Plus, they too often parrot republican memes…right at the right time. Right now it’s trash Pelosi time for republicans, so they make sure…VERY sure…to join in. And right now CA is attempting to become a bulwark against Trump, and Trump is threatening CA. So right at that time…..they trash CA and its leadership, trying to convince democrats of CA perfidy, and CA leadership is not to be trusted. Right…On….Que.
They were dupes to Wikileaks and Putin. They spent months mouthing Putin inspired propaganda. And they still are doing it! After all, what is ‘Russia talk is a distraction’ but EXACTLY what Trump said. And ‘Russia talk is an attempt to displace blame from Democrat failures’ is very nearly EXACTLY what Putin has said.
So while everything you wrote is very true, there should still be consequences for being a dupe. And a fool. Inadvertent or not.
There are very few coincidences.
No post is an island unto itself.
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Amen! Preach!
Correct. Distracted in 2 ways:
> Russia <> money-laundering. I think there is some “there” there, it’s not an empty or irrelevant issue. Perhaps we disagree on this. But in any event whether it’s real or not the DP is doing no organizing here to isolate Ron Johnson, no organizing against Trumpcare, no organizing around this issue period.their candidates are already in campaign mode and that’s all they are thinking about
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The alternative to your view here is that Senator Baldwin seeks to have sufficient campaign funds to defeat the upcoming effort by extraordinarily wealthy people who have created the Walker-led revolution in your State to take her out in the next election.
The Koch Brothers, the Mackinac Center and others plan to install a Senator who would come to CNN to talk about the glories of ripping away health insurance from tens of millions of Americans and undermines the health insurance of tens of millions more. Tammy can’t beat them with chicken feed, and the campaign reporting deadline is a real thing.
McConnell is going to pass this with 50 votes, at most. Democrats aren’t distracted. They are powerless.
Bernie is putting in a few events so he can say he tried. He was largely absent for the last month. He has no interest in preserving the ACA and will use this as an opportunity to advance Medicare for All. No issue with that.
Instead, when ACHA passes you will see elements of the left attacking the Democratic party for allowing Republicans to repeal a bill that they have always considered terrible.
This is nonsense:
“He was largely absent for the last month”
Really just a comment at odds with reality.
It’s just dumb
There was a 4,000 person 3 day activist event he hosted in Chicago 3 weeks ago.
Oh… he hosted an event 3 weeks ago? That changes everything. You seem to think the left has some leverage here and its due to Democrats not being sufficiently engaged. Elsewhere in this same thread you refer to the fact that too many Republicans are practically invulnerable.
So you’ve both identified the actual reason why Republicans will be able to ignore pressure and pass this bill and then ignored it to make your usual talking points.
“Democrats aren’t distracted. They are powerless.”
Talk about a self-fulfilling prophecy
Maybe the fact his wife is under FBI investigation has something to do with it.
Good to see you prompting a Trumpian smear. You, like a lot of other people, obviously didn’t read the CBS article.
The Republicans will always go for the bottom line and making sure the rich get their tax breaks, period, full stop. While we’re seeing a scant number of Republicans speaking out against the damaging new bill, most will clam up because they are stubbornly loyal to their party and afraid of blowback, not from their constituents, but McConnell and Trump.
I also think the diehards (such an appropriate term) are hoping that since the majority of changes will take place gradually and not kick their base until 2020 or so, they can hold their noses and pass this abomination.
On the other hand, they are probably just cruel, heartless assholes who give nary a shit about the lives of anyone else.
Two things : first most people get their health insurance thought their employer. So it’s fuck you I got mine. And two, repeal results in a nice tax savings for the upper income. So why in heavens name did we ever do that to begin with? That tax is a nice shiny object and pays for vacations nicely. So fuck you again, its your personal responsibility, not mine.
“first most people get their health insurance thought their employer. So it’s fuck you I got mine”
Precisely. Most people don’t get insurance in the markets or are effected by the Medicaid Expansion.
But the whole health care reform movement that swept Obama into power (and Bill Clinton before him) was driven by sticker shock of those with increasing employer-based health insurance premiums, declining subsidies from employers, and increased out-of-pocket costs. Those things will be reinstated if the 85% medical cost ratio and employer tax cuts go away.
These were the political voters who were turned with the 2009 TEA Party propaganda that the Obama administration never answered until it was too late.
Job lock is another issue that would come back, many people have family members with preexisting conditions.
They only avoid it for pre-existing conditions in the future. Being through the era of Obamacare brought many pre=existing conditions onto the record in hopes that Obamacare was permanent. These are the most likely swing voters in 2018 because pre-existing conditions are not distributed by political party.
Conditions like Type 1 Diabetes, rheumatoid arthritis, congestive heart failure are not exactly “secrets” to “bring onto the record.” Everyone knows, there are massive amounts of care and medications involved, can not be kept secret.
But other pre-existing conditions that people were just suffering through were brought on the record when there was the hope of having expensive procedures or pharmaceuticals paid for. These people likely are now worse off than they were when they were not getting medical help.
How do you know these were people who became Tea party voters? This is a self-serving argument that blames Democrats for the choices others make.
I don’t know about TEA Party voters, but the TEA Party propaganda of 2009 and 2010 caused massive changes in a number of legislatures – Wisconsin, Michigan, North Carolina, those are two of the significant ones. And that flip has lodged Republicans in hard with gerrymandered districts.
Who effectively answered the “death panel” arguments during August 2009 when they were uncorked? No Democrat; Democrats were on their annual “August vacation”. Mostly they were stunned by the outright lying and could not formulate a response that made it through the media.
How did so many people make different choices than they made two years before? That does not make them TEA Party voters, just not motivated to vote Democratic after the heavily TEA Party influenced media environment of 2009 and 2010.
It is not self-serving. In no way did that outcome serve my interests. Quite the contrary.
I’m saying it’s self-serving because you implied that people were swayed by tea party propaganda because Obama’s health solutions were insufficient. So, had Obama proposed and somehow passed single-payer then the Tea Party would never have come about? This is self-serving in that you think these negative trends would have been avoided had the Democrats pursued your policy preferences.
I think it would probably be more accurate to say inadequate healthcare, economic, housing solutions caused former Democrats to vote for Trump but not that it led people to become part of the Tea Party movement.
I was saying that in August and the fall of 2009, no national Democrats vigorous opposed the attacks unleashed with the “death panel” charge, none took the media to task for peddling the “death panel” charge. And neither did President Obama. It seemed to be stunned silence that the GOP was lying so boldly.
Obamacare could have survived had it had a vigorous defense against outright lies and had the lies been called out over and over again. But this was the era of “good feelings” bipartisanship in which there was the illusion that one or two Republicans might vote for the Affordable Care Act. Had Democrats accurately read the outcome, they would have shoved it through the first moment they had the votes. Oh, that’s right Joe Lieberman prevented that. Democratic betrayal. Yes, Connecticut is an insurance company state, but betrayal of a campaign promise is still betrayal. Oh, that’s right. In spite of Obama’s ditching Lamont, Lieberman still supported John McCain. Lieberman and Zell Miller, the first of the “business-oriented Democrats”.
Not much to disagree with here except that I think you are underestimating the level of hostility against Obamacare that could have been overcome. They won multiple election cycle running against ACA. The truth didn’t matter.
As seen in the 2016 election, some lies take hold and prove almost impossible to defeat.
Until Trump, I thought that the intention of the Democrats going forward was to overcome the GOP-generated hostility through the actual successful operation of the program, fixing issues along the way. Unfortunately, the health insurance industry got greedy and started manipulating prices for political purposes. And providers never understood what of their interest was at stake.
Ever higher out-of-pocket costs after insurance pays for services (even if they are capped at 20%) from financially strapped people makes them just a little bit angry.
Yes, defeating the outright and bold lies is our major political issue right now. That’s why Democrats better be scrupulous about the narratives that they put forth. The narrative about the California single-payer bill failed that scrupulous part. Yes, Democrats are being held to higher standards just because the media tolerates GOP lying. That is just a given that we are going to have to deal with.
Don’t forget that the Tea Party wasn’t launched in response to Obamacare. It was an effort to ensure no
profligate minorityunderwater homeowner could escape foreclosure.There were actually multiple beginnings until a few large conservative PACs started flooding a few of them with money. It was launched in response to Obama winning in 2008. Its first outing on Obamacare was opportunistic. From the beginning, it was about taking down the first black President. The Confederate battle flags in the early rallies made that point. The Gadsden flag and the 18th century clothing was trying to obscure those origins.
I mean, yeah, eventually the Tea Party swept up all the dregs of the right wing but it definitely originated in “popular” opposition to mortgage relief.
I remember the Santellli story but did not realize it occurred right after the inauguration.
Mortgage relief is a pretty strange issue for a “populist” movement, and CNBC is a strange venue for the “white working class”.
Thanks for rescuing this from the “memory hole”. I was thinking it was a construct of (which Texas asshole?) Dick Armey and his PAC.
This is fascinating. Who was Santelli the voice for? Blankfein?
Well it was all part and parcel of the effort to deflect attention from Wall Street’s responsibility for the financial crisis and blame it all on
minoritiesbad people who got loans and didn’t deserve them. NoDocs, Liar Loans, CDOs, CDSes, Ratings Fraud, Risk Hiding, the Sin Eater AIG (and later MERS abuse and Robosigning)- all of it down the memory hole. Blame it on the blahs and the CRA and you’ll have the so-called “white working class” (in actuality the racist Republican base) eating out of the palm of your hand. Wildly effective and you can draw a straight line from there to Trumpism.An enormous amount of weight hangs on the phrase “…a response that made it through the media…” here.
We’ve got a real media problem; it amplifies and multiplies our campaign finance and voter suppression and gerrymandered Districts problems. The Democratic Party didn’t create these problems; much the opposite. These problems won’t be solved by better messaging and more progressive economic policy proposals alone.
I think it requires, chiefly, well-trained organizers for face-to-face conversations, both professional and volunteers. It’s expensive and difficult to execute persuasive canvassing operations. And it’ll take a while to pay off completely.
And thanks to the AHCA, consumers of these employer-based health insurance plans will experience a significant increase in premiums. In addition, insurers backing these plans will be freed from having to provide coverage for maternity care and other basics that consumers of employer based health plans take advantage of. The AHCA will make these consumers pay more for a lot less.
Will they still be saying, “fuck you I got mine,” or will they see finally realize they are the victims of the greed they’ve been supporting all these years as long as it didn’t affect them? Most importantly, can a craven democratic party take political advantage of it? I certainly have my doubts.
Given the heavy emphasis on “personal responsibility”, most likely they will turn their anger inward or rationalize what happened as independent of the political decisions.
A craven Democratic party loses faster than a craven Republican party.
House Democrats provided zero votes for the ACHA and discussed the horribleness of the specifics of the Bill frequently, on national, local and social media.
Senate Democrats stayed on the floor the entire night on the day McConnell’s Bill was introduced, will provide zero votes for it, and are discussing the horribleness of the specifics of the Bill frequently, on national, local and social media.
I’ve been contacted my my State and County Party leaders, urging me to make personal calls and join local phone bank efforts to pressure persuadable Senators and Congressmembers.
Some craven Party.
So the establishment in your area is beginning to wake up to my observation that what is sauce for the elephant is not sauce for the donkey. Good for them. I hope it’s contagious.
Meanwhile, after closing 50 schools in the City of Chicago, Rahm Emanuel is now selling those school buildings for conversions to condos.
CBO says 15M people lose health insurance next year alone. That poison might be too bitter for quite a few senators to swallow.
Be interesting to see Susan Collins try to weasel her way to “Yes” after that. I think if one or two more GOP senators (besides the five already there) decide to say “No” she might feel safe enough to join them.
I wish. I hope. I don’t have any faith in the integrity of republican “moderates”.
Me neither, alas.