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PoliGAF 2017 |OT6| Made this thread during Harvey because the ratings would be higher

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Deleted member 231381

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I'm not necessarily convinced by that argument. One might argue that with the efficiencies from moving from insurance to single-payer, there's more money to employ more actual health care providers. It depends on what people would do with the gains from eliminating insurers' cuts.

I think you'd probably see a decline in certain types of specialists, true, but an increase in (for example) family doctors.
 

Barzul

Member
DJnv3QpXoAEbq_M.jpg:large


lol
 

pigeon

Banned
I'm pretty sure non-insurance healthcare employment would rise as uninsured and underinsured people would have access and increase demand.

This seems like a claim I might be comfortable making with the uninsured figure at 20%. At 8% it seems to want more of a defense.

The entire point of single-payer is to save us money. You seem to be envisioning a world in which that saved money comes entirely from the capital share. Since healthcare labor has no more bargaining power than other labor, why do you expect that to happen?
 
A few election related updates which I'm surprised have not gotten any mention/play here so this will be a bit long.:)

First if the nomination of Trey Trainor for a seat on the Federal Election Commission. Trainor is a well known Texas lawyer who loves him some deep religious causes. To the point where he's tweeted out anti-protestant propaganda and more. He's also a big of dark money in elections and just despises election regulators (so it makes sense that he would be one of them!). Read more about this peach here:

http://talkingpointsmemo.com/muckraker/trump-trainor-fec-nomination

There's a nice sampling of his tweets.

Besides that, Trumps commission on "election integrity" met yesterday in New Hampshire. A few things came out in the lead-up to that meeting including Kris Kobach penning an article for Breitbart claiming that over 5,000 out of state voters tipped the election for Clinton in the state as well as for Hassan. He based this on numbers released by the Republican speaker who basically made wild assumptions based on numbers from the Secretary of State's office (Bill Gardener who SITS ON THIS COMMISSION!). Here's the article (by the way, Kobach has admitted to being a paid Breitbart columnist).

http://www.breitbart.com/big-govern...rs-changed-outcome-new-hampshire-senate-race/

Both Gardener and Maine SoS Matthew Dunlap gave Kobach a swift and strongly worded rebuke for these claims. You can read more here:

https://www.bloomberg.com/news/arti...nel-s-kobach-rebuked-for-breitbart-commentary

Dunlap said drawing a connection between motor-vehicle law compliance and election law compliance was ”as absurd" as saying finding money in somebody's wallet might be proof they'd robbed a bank.

”I think that's a reckless statement to make," he said.

Gardener also took him to task for claiming the election was tainted: Gardner to Kobach: Problem w/your op-ed "is the question of whether our election as we recorded it is real and valid. And it is." Which got a loud applause from the audience.

Finally and more importantly, if there was ever any stronger proof as to how nakedly political this commission and how seriously it needs to be shut down - I give you a letter sent from the Heritage Foundation to AG Jeff Sessions all but forbidding that any members of the commission be Democrats or "mainstream Republicans". This was obtained via an FOIA request to the DoJ:

l445b6nfa9igrlsc92dr.png


Commission member Hans Von Spakovsky (who works for the Heritage Foundation was asked about the letter by reporters. He denied any knowledge about it and is on record (and has been recorded) as stating that he did not send it and wasn't aware of its existence.

https://twitter.com/JessicaHuseman/status/907965619819212800

Shortly after, the Heritage Foundation released this:

DJjg40UUMAEm-fg.jpg


Basically outing Hans as the author of the letter. Of course Hans today "didn't recall" the letter after a grueling 7 hour meeting of the commission and said he never sent it to Sessions and it was only personal correspondence that "somehow" ended up in the AG's email box.

Amazing.
 
This seems like a claim I might be comfortable making with the uninsured figure at 20%. At 8% it seems to want more of a defense.

The entire point of single-payer is to save us money. You seem to be envisioning a world in which that saved money comes entirely from the capital share. Since healthcare labor has no more bargaining power than other labor, why do you expect that to happen?
I'm not sure what you're asking, but if ~15-20% (including underinsured) of the population gains new access to healthcare they didn't have before wouldn't the number of healthcare workers outside of insurance increase to meet the expanded demand? This is purely intuition so if someone can explain why that's wrong I'm willing to listen.
 
Vox has a very good article about the compromises Bernie made in the bill to get widespread Democratic support.

https://www.vox.com/policy-and-politics/2017/9/13/16296390/bernie-sanders-democratic-single-payer

Sanders's new plan outlines how to move everyone onto the one government plan in a way that more Senate Democrats could support. Instead of a transition of just one year, Sanders's plan would take big but more gradual steps in its first year — eliminating all cost sharing in Medicare, lowering its eligibility age from 65 to 55, and enrolling everyone under age 18. Still, Sanders said, ”That's a pretty big deal."

In the second year of its implementation, Sanders's bill would again lower the Medicare eligibility age from 55 to 45. In the third year, the age would again fall from 45 to 35.

It's not until the fourth year of Sanders's plan that every American would get a "Universal Medicare" insurance card to use for the insurance they need. Activists are overjoyed by the basic framework of the plan, but the revamped time frame marks a real change that perhaps makes it easier to envision how single-payer gets implemented.

I like this idea a lot, and it's something I've thought was a good way to do Medicare for all, it's even the exact same 4 year time table I had in my head.

This I don't really like
Under the Sanders plan, private insurance would be outlawed in almost all cases. The 153 million Americans who receive insurance from their employers would lose that coverage — and in its place would receive government insurance that would force them to pay far less out of pocket, in almost all cases, than private plans do now. The private health insurance industry would all but evaporate, and government insurance would, largely, be the only game in town.
I don't believe even many European countries outlaw private insurance
 

NeoXChaos

Member
I like this idea a lot, and it's something I've thought was a good way to do Medicare for all, it's even the exact same 4 year time table I had in my head.

This I don't really like

I don't believe even many European countries outlaw private insurance

I take it Blue Cross Blue Shields and everyone that works there would be out of a job going by that last statement?
 

pigeon

Banned
I'm not sure what you're asking, but if ~15-20% (including underinsured) of the population gains new access to healthcare they didn't have before wouldn't the number of healthcare workers outside of insurance increase to meet the expanded demand? This is purely intuition so if someone can explain why that's wrong I'm willing to listen.

The reason people are arguing employment would contract is that single-payer is supposed to save money.

Currently all healthcare spending put together is $X and it pays for some number of workers to provide some number of services, plus a bunch of profit.

After single payer spending would presumably be $Y < X and it would pay for some number of workers to provide some number of services, plus profit.

In order for the number of workers to not go down or for workers in general to not get a pay cut, most of the difference in spending would need to come out of the profit.

But as we already know from the last three decades, workers have no leverage in this economic transaction. So why do you think this cut would fall on profit and not on workers?

Note that Bernie's bill does not eliminate for-profit hospitals as some other single-payer bills do.
 

kirblar

Member
I like this idea a lot, and it's something I've thought was a good way to do Medicare for all, it's even the exact same 4 year time table I had in my head.

This I don't really like

I don't believe even many European countries outlaw private insurance
I think banning cars would go over better.
 
This I don't really like

I don't believe even many European countries outlaw private insurance

Not to mention good luck telling the American people that you're taking away their existing health care coverage and then saying "Don't worry, the government will take care of it. Trust us!".

It's tone deaf to think that a vast majority of Americans are going to be ok with that (yes, its irrational but then so is the electorate) even if the end result is theoretically better. Obamacare is a pretty good litmus test of what happens when you give people something and then try to take it away.

I'll echo Plinko and I've made the same suggestion in the past - repair Obamacare, add a public option and that puts on a better road to universal healthcare and we can then deal with real cost control measures and possibly transitioning to a single payer style system.
 
Implementing a Public Option to build faith is the only reasonable answer. People don't trust the Government enough to not screw up this phasing in. Fox News and Conservative media is going to roll out footage of the exchanges being a mess and say it's round 2 of the "failed takeover of healthcare".
 
Implementing a Public Option to build faith is the only reasonable answer. People don't trust the Government enough to not screw up this phasing in. Fox News and Conservative media is going to roll out footage of the exchanges being a mess and say it's round 2 of the "failed takeover of healthcare".

They'd tell everyone it was a mess even if it was a huge success.
 
The reason people are arguing employment would contract is that single-payer is supposed to save money.

Currently all healthcare spending put together is $X and it pays for some number of workers to provide some number of services, plus a bunch of profit.

After single payer spending would presumably be $Y < X and it would pay for some number of workers to provide some number of services, plus profit.

In order for the number of workers to not go down or for workers in general to not get a pay cut, most of the difference in spending would need to come out of the profit.

But as we already know from the last three decades, workers have no leverage in this economic transaction. So why do you think this cut would fall on profit and not on workers?

Note that Bernie's bill does not eliminate for-profit hospitals as some other single-payer bills do.
I'm talking specifically about providers though. Insurance employment would collapse, which is where large parts of the savings come from?
 

Armaros

Member

pigeon

Banned
I actually...really like Bernie's bill. I think the changes he made to get Dem support are whip-smart politically. The four-year timeline provides bite-sized pieces that should make negotiation easier. Don't want to overhaul America in four years? Draw it out to the ten-year window instead! Easy changes.

The key aspect of the bill is not changing what happens in the first year. Once the bill is benefiting people it will have a natural constituency that will help move the process forward. The rest of the timeline is pretty malleable.

Personally, I would want to add in a buy-in for Medicare in the first year as well in the event that the timeline gets extended. It's also not really clear why private insurance needs to be outlawed.

Kicking off the pay-fors to a separate bill is actually...pretty smart. There is no particular reason our goals need to be tied one-to-one to our ability to fundraise.

Overall, pretty good!
 

The Technomancer

card-carrying scientician
The age staggering thing is absolutely the right way to roll something like that out. It means that with each wave you've got a huge cross-other-demographic swathe of people who now suddenly really don't want repeal
 
I think he derailed what would have been a very sellable bill with the whole "all other insurance is illegal" stuff.

Which means it's fairly easy to fix if there's just one glaring issue that isn't needed for the bill to function.

The age staggering thing is absolutely the right way to roll something like that out. It means that with each wave you've got a huge cross-other-demographic swathe of people who now suddenly really don't want repeal

You also start with the most likely to vote ;)
 

pigeon

Banned
Interesting that Bernie only talks about his senate colleagues in trying to get Dem support vs all the huhbub online about Pelosi.

Maybe as if he is currently working on just the senate and the House is another Beast.

I mean, if Bernie and Schumer can deliver 51 senators in 2021, there's no question that Pelosi will provide the House votes.
 

Armaros

Member
I mean, if Bernie and Schumer can deliver 51 senators in 2021, there's no question that Pelosi will provide the House votes.

The problem is that many people don't see it as a work in progress and that all Dems must sign on right now.

16 to 51 is a very long way to go.
 

Slacker

Member
It's a good read. I think a lot of the "Clinton should just go away" is subtle sexism and intellectually dishonest. She was a major presidential candidate who suffered a dramatic upset, and you think she should just vanish? Bernie Sanders lost the Democratic Primary, and he won't seem to shut the fuck up but nobody is asking him to sit down and shut up.
I agree, aside from the word "subtle.' It's ridiculous. I'm only about 20% through, but this strikes me as a critically important book because we (Democrats) do need to know What Happened.
 

FyreWulff

Member
Sanders' plan actually also included forgiveness for current loans. I'm not sure how he's going to wipe out billions in loans that private companies manage, but he said he was going to do it.

But even then, you'll get people (like me) slightly annoyed that they paid their loans well ahead of time to avoid interest, and people who didn't make an attempt to pay early, end up getting 20K+ just handed to them, while I had to live under my means for 5 years to rapidly pay off my loans.

It's going to be really difficult to convince people who have already paid off their loans that people should be cleared of tens of thousands of dollars of debt that the older people already paid off years ago. The majority of college educated voters are old enough that most will have already paid off their loans.

That's probably why making college more affordable, or making payoff schemes like "work 10 years for the government and your loans are gone" are likely going to be more effective than "everything is free and everyone's loans are gone." Americans really, really, really do not like it when they perceive others are getting a better deal from a law than they are.

But you already are paying for all those loans to be forgiven, because the government guarantees 100% of the student loan already. The money has been "spent" already. This is also a major reason why college has gotten so expensive, because colleges can literally just name a price and it will always be 100% paid out by the government even if you default. I almost struggle to call student loans.. loans, because they're a zero risk financial product that the middlemen can just sit back and do nothing and make free money.


Getting mad is fruitless when companies write off millions of dollars a day in legitimate debt as part of doing business. I don't even know how one could be morally capable of pointing a finger at someone trying to get out from a 20,000$ loan. And the only reason they can't file bankruptcy on it was literally due to fake news from the mid-century about how doctors were supposedly going to get their doctorate and then file bankruptcy to pay for none of it (spoiler: they weren't). There is no damn reason why any loan should not be bankruptable because the whole point of keeping the loan industry honest and sustainable is that there is risk to giving out one.
 
I respect the fact that Bernie is not going to be after Democrats who don't sign onto this bill, and that he is at least acknowledging that the phase in is best done gradually.

Still... removing all employer plans. Man, that's going to piss off people with good coverage through their employers. That's where the big fight is going to happen, and, I think that's a good fight to have. It could lead to stronger overall insurance coverage.
 
The banning all private insurance thing is weird but otherwise I like what I see so far. The initial rollout has to be perfect to change the image of gov't health care (which is currently the ACA for people who have it and the VA, which we want to avoid all comparison with).
 
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