but maybe that isn't the narrative you wish to push.

..just a thought.

I fully support it.

people have a right to receive healthcare.

Most other countries with universal health care get there with multi-payer systems.

And therefore accuse anyone who points out that there are other ways than Single Payer to get to Universal health care as "being opposed to universal health care."

.

here were with the O man, oh never mind

It has been interesting to watch.

time here lately.

It's a flawed plan.

It's too expensive.

It's too ambitious.

It's this, it's that.


I will tell you what it is--it is NOT GOING TO PASS, like it hasn't passed the last dozen or so times a guy named John Conyers has proposed it.

We have a GOP House, a GOP Senate and this bill hasn't a hope in hell. No matter for whom you're flecking your spittle. Not one GOP legislator is likely to cross the aisle and plenty of fiscally careful Dems will hold back as well.

We have a tough row to hoe hanging on to ACA at this stage of the game.

....for decades, and before that John's father introduced it for decades, going back to 1943. It's not something that gets passed just because someone introduces a vague, unfunded bill. Better to shore up the ACA and strengthen it rather than try to come up with something new.

from certain death--and they're trying, ever still, to kill that. https://finance.yahoo.com/news/group-republicans-just-launched-desperate-171036554.html

Why it's an either or is beyond me. I don't think the repugs will allow either to happen.

i.e., spare ACA from certain death?

Any more than "repeal and replace!!!!!!!!!!!!!" got us any closer to universal health care.

The ACA is based on a Multi-payer plan, like most of the rest of the developed world uses to get to UHC.

Remember when Obama said that "you can keep your plan" when there was no guarantee that you could (because no one EVER has the guarantee of keeping your plan if your employer is the one choosing your plan) and the GOP used that as ammunition that the ACA was a LIE?

Yeah, that's what's going to happen with the promises of Single Payer.

Ask the residents of Vermont about that.

Vastly different/smaller scale. Economics 101.

Fighting for single payer now is the only way we'll get an acceptable solution (notice I didn't say single payer). It's also the position we need to take to actually grow the party and take the House in 2018. Being for the best we could get because of the Republicans will result in more of the same. No victory or accomplishment in that.

Do we want to win? Then let's act like it.

People in Vermont were told it would work. It didn't. And when Sanders brushes off any discussions of lessons learned from the failure of Green Mountain Care, that doesn't bode well for his national plan.


Do you want to win? Then don't forget what happened when Obama said "You can keep your doctor" and how much ammunition that gave enemies of the ACA?

And no, it's not the only way to get an acceptable solution.

https://www.vox.com/the-big-idea/2017/9/8/16271888/health-care-single-payer-aca-democratic-agenda

Saying it isn't is disingenuous or uninformed imo. Vermont has less than 630,000 people living in it for crying out loud. Among all the States, only Wyoming has a smaller population but not by much. Geesh!

What I'm hearing here is denial. And that strikes me as pretty darned arrogant especially in the face of our party's recent decline and failures.

What I'm hearing is "we woulda, coulda, shoulda won if it weren't for every possible reason other than we didn't appeal to voters adequately to actually win. No need to change what we're doing. No reason to take a different tack.

Look, I'm not saying that single payer is the only solution, but running around saying we're for incrementalism is not an inspiring or confidence building proposition for most people. It doesn't garner votes from those who are currently dissatisfied and either didn't vote or didn't vote for Hillary in 2016.

My view? The Democratic Party needs to stop giving the impression that it is satisfied playing and operating along the margins rather than standing up for what is right for working class Americans. It needs to stand up and take on the socially destructive aspects of unbridled capitalism head on. It needs to stand up for the working class in a way that the working class actually feels like it is. Wonkish incrementalism doesn't do that. Instead it breeds distrust. Just look at the results.

nor the next, nor the one after that) we see what the GOP has done--slapped down Graham-Cassidy like a stinky fish on our national table. And they're gonna vote on it soon, and if we can't find three Republicans to say "Fuck No" we can watch not only the ACA die a strangled death, but we can also watch the slow, steady dismantling of all assistive public health care over the next decade or two, or it will be held hostage like the debt ceiling.

You need an operation? Pricey drugs? Go Fund Me! And if you're not cute enough, endearing enough, or have a compelling personal backstory that touches the hearts of strangers (throw in some religion on your begging page, now) you'll die--because if you don't have the cash, your only hope is charity.

I'm quite disgusted at this "Let it all blow up....that will make the unicorn appear" attitude of these naive nitwits. People are going to DIE if the "revolutionaries" don't get off their asses and join the fight to preserve ACA. They're not doing it though--and a lot of the "Let it burn" attitude is coming from creatures that look pretty damn botty to me.

because Bernie says anyone who disagrees with his bill, or points out obstacles that he's not addressing is wrong.

And that would mean.... maybe anyone who disagreed with this wasn't actually corrupt.... or just trying to take away everybody's HOPE.

INCONCEIVABLE!

Maybe we should junk it up with Republican amendments until he withdraws support. Would that be good?

I am for any plan that covers everybody and can get passed by Congress and signed by the president. This means there will be a Democratic Congress and president. The passage of such a bill is contingent on the support of a super majority of American people who will express their preference at the ballot box. Without that there is no way to pass such a bill.

But don't try to mention that, or you are deemed a corporate shill...

Some however may question whether Single Payer in an effort worth investing time and effort TODAY, givens the likelihood of success. For example, will Single Payer deliver the wins we need in 2018, or are other issues more salient?

I believe the ACA was the down payment on universal coverage. That's where we should be headed, in my opinion. If single-payer is proposed to do that all the better. It is important how the issue is framed. Many among Trump supporters do not look at Medicare as "government controlled health care." It's like an 80 year-old carrying a sign that says "Keep government out of my healthcare!" Thus, we need to do a really good job of making sure that everyone who likes their Medicare understands that it is a government-controlled healthcare benefit.

is where I stand.

Many countries have universal healthcare with private insurance. Those insurance companies are highly regulated.

for this now when there is no way it will go anywhere in a Republican controlled government. That's a legitimate objection that some are mistaking for objection to the policy.

There is some advantage to putting forth a "Wouldn't it be nice ..." kind of idea that might fall on sympathetic ears in the aftermath of the GOP Health Care debacle.

However, there is some substantial hazard in pushing for a specific policy proposal. The amount of blowback is going to shock some people around here. The entire tea party was generated around the resistance to a re-engineering of just the individual market-place for insurance. And we needed all branches of government to make it happen. What do you think is going to happen when the entire insurance system (including employer based) is proposed to be scrapped?

Meanwhile, we have zero branches of Government so we have absolutely no power to actually implement such a policy.

There seems to be this attitude that the public will cheer Democrats for offering this. I think they have short memories as to how brutally we were beaten down by the opposition after pushing through the ACA. It has nothing to do with the reality of whether the ACA was a policy improvement. The GOP simply won the war of public opinion through propaganda and manufactured outrage. That will all look like childs-play when it comes to fighting back against a Single Payer.

That is just my opinion. Offering single payer now is an unforced error that will rally the right against us with absolutely no chance of success.

I support Single Payer. I just don't think we can get there right now and the backlash from the effort will do more harm than good.

What I see as more viable is to pitch Medicare as an optional buy-in for the ACA to provide competition or support in underserved areas.

This would stabilize the ACA while giving Medicare a chance to expand its offerings to all ages. If it performs well, it will attract more and more patients and swell in popularity.

The next step beyond that would be to offer Medicare in policy groups so that businesses can offer it.

If it succeeds, there would be gradual transition to the desired outcome.

This gradual approach is the only way I see it working. The most obvious reason is that the transition would be largely voluntary as Medicare proved superior. The less obvious reason is that this becomes a way to utilize the current funding mechanism of employer based premiums to support the cost. If we try to do it all with taxes, people are going to freak. All of those premiums paid by companies and employers need to be transitioned into the system to keep the cost workable.

They just out maneuvered the left in the public perception front every way possible. The ACA was undersold and under explained. We need to start convincing people that affordable healthcare will work out for everyone, not just a particular class.

services to patients, I've seen several of the holes in Medicare up close and I know that Medicare for all is not the panacea some want to believe it is. I've been backed up by several here who are on Medicare who have ended up with very large out of pocket expenses and that is after purchasing private supplemental insurance to layer on top of Medicare.

I suspect that Medicare for all is not the way to do this if we are going the single payer route. Medicare was passed in 1965 under assumptions that seemed right at the time (and yes I know it has been modified several times) If we are going single payer I think we should take a fresh look at this from scratch.

This is the size of a pamphlet. Where is the comprehensive transition plan addressing the fallout for unemployment (retraining opportunities, assistance with relocation for employment within CMS for displaced workers who are willing to accept the move) and disparity in reimbursement rates so that healthcare providers can continue to provide the same level of service offerings while maintaining their organizations and staffing. These are just two items and should have been included. Funding is a serious issue indeed but the practical matter of continuing to provide healthcare is serious. Also the matter of huge layoffs is rather a big deal but I have observed some just do not seem to care (here.).

I could have gone with paperback but they're longer than the proposal too. Physicians are also currently under no obligation to accept Medicare patients and some practices have a cap on how many active Medicare patients they will see. A mandate to see and accept all Medicare patients should be tied to their license. Lastly, under the current Medicare reimbursement rate some hospitals and hcos will close their doors. I work in the industry, I am intimately familiar with medicare and the costs associated.

Look, I believe that universal healthcare will eventually happen and it SHOULD. It has to be done carefully with every aspect fully defined and explained to allow for ultimate success. I do not see that with this bill

I'm not against anything. Just so what's proposed is done with care. Yes, every aspect fully defined and explained.

I think universal would be the way to go.

It's true that docs are under no obligation (and haven't been since I 've been seeing docs) to accept Medicare patients. They can and will cap the number on new patients.

The reason is obvious and has been stated in this thread already.

They show up like clock work... not to add their own ideas, but to torpedo this one.

It won't work
Costs too much
We don't want Socialism
Nobody wants it
It's a left wing plot
Why should I support anything Bernie wants?
There are more important issues
Vermont couldn't even pass it

...however, slap Hillary Clinton's name on it...

....doesn't have anything in it discussing how it will be funded. So your second bullet is moot.

that view health care as a right.

People conveniently forget that even at the time, we on the left were told the ACA was a starting point, one that we would need to work to improve with time. Even the strongest supporters never claimed it was the ideal end goal. It was a good start. Start being the operative word.

I think here on DU it is only the idea that a Republican congress will not pass it.

If people want it they have to vote D in 2018 and get out and VOTE in 2018.

It can be convenient for a lazy mind to equate tactics with goal, despite two wholly separate meanings.

Posting something twice makes it true.

Is there an echo in here?

Government-funded universal comprehensive coverage is a goal. Single payer is a tactic for delivering that coverage, i.e. achieving that goal.

There have been Medicare for All bills introduced in the past that called for the individual states to administer the program through state insurance plans. There are other Medicare for All bills that call for the federal government to administer it through one national plan.

I think it's clear to a majority. Some view a simple discussion of the best path to be something that gets in the way of the end goal. Most understand that it is what's important in achieving the end goal.

This upgraded version of Medicare would also be a lot more generous in terms of access. There would be no cost-sharing, except for prescription drugs. It is, as Paul Waldman argues, probably best understood as an opening bid — a symbolic maximal demand rather than the usual pre-compromised Democratic fare.

The United States, by contrast, is very rich, and already dedicates way more than enough resources to set up the world's most generous health-care system, and a lot more besides. We spend $3.2 trillion per year — literally twice as much as the OECD average as a share of the economy. We pay enough in health-care taxes alone — that is, the government revenue that goes to Medicare, Medicaid, the VA, and a few other things — to cover a Canada-style Medicare-for-all system for the whole U.S., and then that much again in private money

"The way to get over people's fears of losing their (increasingly lousy) coverage is to promise them something so good that people can be certain they'll end up better off."

There is a long history in this country of people being scared off the moment they hear the words "taxes," "government," or "liberal."

I am not saying that this cannot change. And I do think it is slowly changing. Americans born in 1979 and later (people who were under 30 during the Obama/McCain election) are much more liberal. And, of course, there could be a backlash to Trump. But that doesn't mean that the post-Reagan dynamics have suddenly gone away.

Single payer may have to be implemented in several steps over many years.

define arguments. I remember how Joe Biden was ridiculed for saying paying taxes was patriotic. I wish Democrats would discuss taxes as what we pay to live in the commons and not give in to the fear of "higher taxes". But unfortunately messaging isn't a strong point in the Democratic Party.

However this discussion needs to be had and Dems should to start defining their aspirations for this country in ways that give people hope and inspiration. Obama won on Hope and Change. It was refreshing. We need big bold ideas and the words to inspire people to realize their taxes could go for things that make their lives better. Right now taxes are subsidizing corporate insurance companies that turn huge profits and pay exhorbitant executive salaries. Personally I'd rather have my taxes go for health CARE and not tv commercials. Seems like Dems could find the way to frame the argument better.

important stuff

and it was "refreshing" in the face of Obama winning and having the nerve to get us farther down the road to UHC than we have ever been in our history.

They used voting for it dozens of times as a requrirement for staying in office. They didn't care if it wasn't really possible.

Do Democrats need the same sort of thing?

Americans -- that It’s time for Americans to stand up and make it clear that health care is an undeniable human right.

make it clear that all pregnancies should be wanted pregnancies? Which is what the Right thinks.

Or "Build that Wall" is a mantra that will make it clear that we want to send a message to terrorists to stay out? Which is what the Right thinks.

Mantras aren't always right, and they can sometimes destroy their own goals.

Did the mantra "repeal and replace" give the GOP an alternative to the ACA?

I look at mantras, and I like to know what they mean before joining in. Sometimes they accomplish a political goal instead of a goal that furthers justice...

I know that there is envy of the right, with their slogans and mantras like "MAGA" that give them a sense of power that comes with joining millions walking in lockstep, but I had no idea how prevalent it was, and how much of need people on the left are expressing it.

I'm not talking about "universal health care for all!" which is an actual goal, but "Medicare for All" which seems to be more a cult of personality, and says more about a specific, exclusionary path to getting to Universal Health Coverage, at the possible expense of getting there at all.

Dems messaging and framing of issues hasn't been as focused or as liar sighted as Rs and that it has helped Rs win. Perhaps you want to argue with yourself but I'm out of this silliness. Thanks for playing.

Just that it unites dems?

is no reason to keep saying the same thing to your ridiculous comments. For further clarification, just read my tag line.

and we had no health insurance. They are in their 50s now.

We understand precisely what the current proposed bill is and hte fact that it has absolutely no chance of ever making it to the floor.

Getting universal health care, Medicare for all, or whatever you want to call it is a process. So maybe this bill goes nowhere in an republican-dominated government. It forces representatives to take sides and it documents who stands for what.

So if this bill fails, another one will take its place. And so on until it is passed.

Because of the republican control, it will likely be a long time before we see universal health care. But it has to be put out there in the marketplace of ideas so that people can become familiar with it. (Although truly, I doubt that few are familiar with it, given that we are talking about something that touches each and every one of us).

While this process winds its way, what Americans and those who care about health should be doing is improving the American diet. Obesity causes most health problems, and to make universal healthcare affordable, we need to attack that problem.

Here is an article at Truthout that describes a type of program that would help:

http://www.truth-out.org/news/item/41932-no-elitist-farmers-market-here-free-healthy-food-and-profits-for-farmers#15056563435741&action=collapse_widget&id=0&data=


Cher

Why is promoting those off the table?

(IE - letting people buy into Medicare at 55, letting the system absorb and adjust to that for a few years, expanding SCHIP coverage to all children under 18, letting the system absorb and adjust that for a few years, etc..)

they are good ideas.


Cher

Last edited Mon Sep 18, 2017, 08:57 AM - Edit history (1)

All those things, plus a public option to be expanded were HRC's plan, which was demonized by those who said Sanders' plan was the only way to go.

Think about the dismissive pushback that so many have to "the public option" as being a sellout and too much of a compromise.

At least when HRC proposes it.

Those are the choices.

he still has a hard time paying for medical care. Which is something that wouldn't be as much of an issue for many if the republicans didn't work so hard to water down the ACA, or refuse to work with dems to fix the various shortcomings that are inevitable with anything new.

thanks for sharing

So personally it really makes no difference if we have ACA or not. I don't have healthcare either way.

Medicare...which I just signed up for is 3 times more that ACA was.

The GOP will be able to turn this against us ...with a CBO score and even that old Bernie video...we have not shot at passing this and regardless of how one feels about single payer, the timing if awful; we should save the ACA first and then go for a public option when we are back in power. I am for universal coverage (leaving workplace insurance to die a natural death) not some big single payer bill which people will hate in general when they see the taxes etc...and punish us for as they did with Hillarycare.

Repeal and replace is not going to happen and that an ACA fix might be the only solution. Sanders throwing the 'Medicare for all" issue right in the middle of the ACA campfire will send the Republicans running back to their bunkers. That issue is political dynamite to them. Accusing those the disagree with Sanders timing by painting those that understand the political reality is an extreme act IMO. I can't really respond the way I would like to such a broad brush of disingenuousness.

With this Congress.

It will not happen until we have a Democratic President, Senate and House - we need to be realistic about this. It also has to be 'sold' as truly all inclusive and assurances to the 'others' that they will be included - no ifs, ands, or buts, about it.

Coates got a lot of folks 'woke'. Us is woke - and it might seem silly - but I think in certain circles there will be a fear that we will once again be asked to pay into something that Fed Gov 'red lines' from.

I know - it's silly - but you have to be realistic about a very large and consistent voting block within the Democratic Party. Us is 'woke' - and we won't be falling asleep again any time soon.

To get that block? Start now. Really - start now. Talk to black women about breast cancer death rates and make the play - you will FINALLY get equal treatment. Start now!

The politicians do not run things, we do

Only at the polls.

I also believe there will need to be concessions to implement this.

No one group gets 'everything just the way they want'. If I have to throw away college for all - to get this - I'm okay with that. Everyone is going to have pick one or two things they are willing to give up to have this.

It's call compromise - and it's what makes our imperfect union work. Remember - before the Civil Rights and Voting Rights Act - there was Brown V. B I and II. And, prior to that Plessy v Ferguson.

It sometimes takes awhile to get things 'perfect' - but that's the reality America.

. . . I never thought I'd see the day where a Democratic board would have even a small percentage of it's participants semi-supportive of a universally declared human right.

Again, a case where Repubs benefit from us being all over the map.

that strive to foment division and discord.

That's the reaction to anything said. Universal healthcare has been a Democratic goal for decades, and there are myriad ways to get there, but they insist that it's some sort of team sport or popularity contest, and that there is only one dogmatic way to get there and if you're not blindly supporting that then you're evil.

That's not what anyone who has any idea of what Democrats have been fighting for would say or any understanding of how American government works would be posting.

Either we've got a lot of very angry people can't read, failed civics, don't understand what the CBO is and who legitimately think this is some brand new idea, or we've got some divisive actors who delight in cheering on division and toxicity every chance they get.

It could be both, but the latter group leads along the former group to sow their toxicity.

I just today read an article on the efforts to get healthcare passed in 1993 and 1994. Universal coverage has always been the goal and single payer has always been on the table.

There are strong forces arrayed to stop this but I think the wall is cracking. Heck, even Obama thinks Obamacare is just a first step. In retrospect, it seems brilliant, because now instead of offering people something that they might not think they want, something is being taken away. This is opening the door to an even better system, IMO.

It's not going to change overnight. It just isn't.

People who are deliberately and willfully ignorant about how politics and government work are being led astray by those who are exploiting that ignorance.

There is a process, and it works incrementally. That is how progress is made, whoever started this whole disinformation campaign that everything needs to happen overnight really needs to be held accountable.

Not anymore.

but a lot of people seem to think it's some recent development.

of getting there.

I think there is room for reasonable people of goodwill to oppose single payer while still supporting the goal of universal coverage.

Personally, I like the notion of single payer. But I'm a middle-aged self-employed individual who makes just enough not to qualify for ACA subsidies. All my options through the private sector are pretty shitty ones. I might be singing a different tune if I had high quality employer-provided coverage. (And lots of voters still do.)

Don't confuse discussion about strategy with "wishing for failure".

We have lurched about as right as we can get without becoming Repug ourselves!

For the selfishness part, some people will see an increase in taxes or paycheck deductions because M4A will be more than what they are paying now, if they pay anything.

For the ignorance part, some people probably believe they will have paycheck deductions both for M4A and private insurance. Any private insurance would be optional insurance or for supplemental insurance beyond M4A.