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evilweasel posted:that is exactly an unfair criticism and "lovely incrementalism" is basically a way to whine that other people realize that reality sometimes places constraints on what you can do The democrats aren't in a position where they want single payer and are constrained by political necessity, their base supports it and the amount of Americans who want the government to be responsible for healthcare is growing. The party doesn't want it. The progressive wing does, sure, but if we've learned anything over the last election cycle, it's that the center would rather lose than listen to them.
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Mar 21, 2017 15:06
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Also "being constrained" or trying to "save up political capital" is a huge noob trap. The GOP never bothers to let reality get in the way of their drive to turn America into the Running Man, why the gently caress should we limit our imaginations?
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Mar 21, 2017 15:09
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daydrinking is fun posted:When Democrats retake the Senate and house (whenever that happens) I'm sure they'll try to enact reforms like this, resulting in healthcare costs only growing by a few percentage points for a few years, and then it'll all be torn away by the next Republican administration. Meanwhile, millions of Americans will still be without healthcare, American healthcare costs will still be the highest in the world, and people will continue to wear bracelets with poo poo like "i'm too poor, don't call an ambulance" written on them. Liberal incrementalism has failed, you might as well go for broke and push for single payer. I look forward to your proposal to convince ~100m Americans, across the ideological spectrum, to ditch the plans they and their families are quite happy with in favor of an unknown government plan that'll totally work and also not be subject to the whims of the next Republican administration. It'd be a tidy story if Single Payer in the US was a popular concept blocked only by the monied interest of the corrupt. Sadly, that's not the case, as demonstrated in the post you quoted. But it's not all bad news! Single Payer is not the only form of UHC. Other forms are very possible here, and will be very good. "Liberal incrementalism", such a dirty word, has failed by providing coverage to tens of millions who did not have it before and would have done substantially more were it not for an... idiosyncratic.... ruling by the Roberts court and the newfound Republican Congressional Majority blocking the mechanisms by which the bill worked. ACA, though imperfect, is still a solid foundation from which to build to UHC and to do so as soon as Democrats retake congress. It currently appears ready to survive the full force of a GOP onslaught. Why do you seek to scrap it and start over?
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Mar 21, 2017 15:12
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daydrinking is fun posted:Also "being constrained" or trying to "save up political capital" is a huge noob trap. The GOP never bothers to let reality get in the way of their drive to turn America into the Running Man, why the gently caress should we limit our imaginations? Because the Democrats are the party of Objectively Correct (they aren't) Technocrats and selling out your constituents is the only rational thing to do, as their stunning election results since Obamacare have shown.
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Mar 21, 2017 15:14
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Paracaidas posted:I look forward to your proposal to convince ~100m Americans, across the ideological spectrum, to ditch the plans they and their families are quite happy with in favor of an unknown government plan that'll totally work and also not be subject to the whims of the next Republican administration. Liberal incrementalism failed to stop the climbing healthcare prices. The AHCA provided people with health insurance (through an unpopular mandate), which isn't the same thing as actually providing them healthcare in a great deal of instances. Of course it's better than nothing, and better than anything the GOP can come up with, but that doesn't mean it's a success, and the main reason to scrap it is that it fails to confront the main reason healthcare is expensive, which is the parasitic middlemen in the form of the insurance providers.
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Mar 21, 2017 15:20
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daydrinking is fun posted:The democrats aren't in a position where they want single payer and are constrained by political necessity, their base supports it and the amount of Americans who want the government to be responsible for healthcare is growing. The party doesn't want it. The progressive wing does, sure, but if we've learned anything over the last election cycle, it's that the center would rather lose than listen to them. They are in a position where they can't pass poo poo. The last time they were in a position to pass stuff, they figured out the exact amount they could advance the ball without the bill being defeated, and advanced it that much. There were zero votes to spare. At the end of the day, your response to the reality that a problem is hard, is to whine and insist that people who recognize reality are traitors. There's really no good response but outright contempt: you have nothing of value to add because your response to any unpleasant reality is a trumpean rant about traitors and fake news. daydrinking is fun posted:America is a country of more than 300 million people so having a hundred million or so people happy with their plan is actually a huge failure, FYI. not the point, idiot when he says that he is not saying that it means that our health care is a success, it means that there is a very sizable bloc of people who will aggressively resist health care changes that they fear might give them a plan they like less
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Mar 21, 2017 15:23
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PT6A posted:See, I don't understand that. Sure, corn syrup is cheap as gently caress, but it's still more expensive than not putting corn syrup in at all. I mean that's kind of what corn subsidies encourage. Corn syrup makes things sweeter which will make a lot of things more appealing to people which will encourage them to buy it. By subsidizing it so that it's quite cheap to produce, if you can sell 5x what you'd normally sell by adding this cheap ingredient, you add the cheap ingredient.
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Mar 21, 2017 15:24
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evilweasel posted:They are in a position where they can't pass poo poo. The last time they were in a position to pass stuff, they figured out the exact amount they could advance the ball without the bill being defeated, and advanced it that much. There were zero votes to spare. Politics doesn't begin and end with voting or passing legislation! It's also about building coalitions and a base! And the Democratic party refuses to even address the popularity of single payer among its base! gently caress Evilweasel, is this really the lesson you've decided to take away from the failure of Clintonism?
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Mar 21, 2017 15:24
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daydrinking is fun posted:America is a country of more than 300 million people so having a hundred million or so people happy with their plan is actually a huge failure, FYI. First off: ACA Secondly, it absolutely is a failure that so few people are happy with it! Unfortunately, having 100m people who feel as if your plan is likely to lead to worse outcomes for them and/or their family is....not a great starting place. It'd be one thing if they were all GOP and thus against your plan to begin with, but they're not. It's the poisoned starting point from which all American Healthcare Reform conversations must begin. Don't get me wrong, I'd love Single Payer and I'm a big fan of decoupling insurance from employment. But I don't see a way to get over that barrier. Luckily, again, Single Payer is not the only form of UHC. There are a wealth of other options, many of which enjoy wide support among Dems and are only inferior to Single Payer if you'd rather rage against insurance providers than provide healthcare.
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Mar 21, 2017 15:27
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IIRC, the cost of Medicare/Medicaid/other public health expenditures per capita in the USA is the same as the most expensive anywhere else in the world. Even if covering literally everyone else was free we'd still be the most expensive and I'm not really sure why that is.
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Mar 21, 2017 15:28
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daydrinking is fun posted:Politics doesn't begin and end with voting or passing legislation! It's also about building coalitions and a base! And the Democratic party refuses to even address the popularity of single payer among its base! gently caress Evilweasel, is this really the lesson you've decided to take away from the failure of Clintonism? there's not actually a coherent thought in here, and you were, not five minutes ago, completely missing the point that went to coalition-building coalition building is precisely the problem: any democratic governing coalition requires people who are not ok with getting thrown off their health care plan. they support UHC in theory, but the practical details are a significant problem and where any health care plan goes from popular in theory to difficult in practice, and any health care advances must take those people's concerns into account that's what we've been discussing for some time, and your response is to stamp your feet like a petulant child and insist there are no such coalition-building problems
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Mar 21, 2017 15:31
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daydrinking is fun posted:The GOP never bothers to let reality get in the way of their drive to turn America into the Running Man Isn't reality getting in the way what's happening right now with members of the GOP worried about what will happen if they take healthcare away from their voters, hence Paul Ryan trying to thread a needle?
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Mar 21, 2017 15:32
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Paracaidas posted:Luckily, again, Single Payer is not the only form of UHC. There are a wealth of other options, many of which enjoy wide support among Dems and are only inferior to Single Payer if you'd rather rage against insurance providers than provide healthcare. There's also a variety of ways to get from here to single payer, they just don't involve declaring that we're all moving to single payer right now and will take a lot of time and effort.
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Mar 21, 2017 15:33
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daydrinking is fun posted:Politics doesn't begin and end with voting or passing legislation! It's also about building coalitions and a base! And the Democratic party refuses to even address the popularity of single payer among its base! gently caress Evilweasel, is this really the lesson you've decided to take away from the failure of Clintonism? Look man I know it's leftist dogma that the least popular presidential candidate ever losing by ~100,000 votes perfectly geographically distributed to gently caress her over means that all non-leftist democrats are doomed and Bernie is the Light, but those of us on planet earth see some problems with that conclusion.
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Mar 21, 2017 15:35
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Ogmius815 posted:Look man I know it's leftist dogma that the least popular presidential candidate ever losing by ~100,000 votes perfectly geographically distributed to gently caress her over means that all non-leftist democrats are doomed and Bernie is the Light, but those of us on planet earth see some problems with that conclusion. Have fun losing in 2018 and 2020.
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Mar 21, 2017 15:43
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*said against the steady background noise of people dying and going destitute* Slow and steady wins the race my friends.
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Mar 21, 2017 15:48
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Ogmius815 posted:Look man I know it's leftist dogma that the least popular presidential candidate ever losing by ~100,000 votes perfectly geographically distributed to gently caress her over means that all non-leftist democrats are doomed and Bernie is the Light, but those of us on planet earth see some problems with that conclusion. which is why Democrats currently control the Senate.
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Mar 21, 2017 15:49
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evilweasel posted:
True. Standing on the edge of a cliff makes you grip onto whatever you can to keep from going over. It's all part of the plan.
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Mar 21, 2017 15:53
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Glad we have another endless primary thread.
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Mar 21, 2017 15:55
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Ze Pollack posted:which is why Democrats currently control the Senate. The Senate is always going to be a problem for Democrats given that its setup favors rural areas over urban ones. But there's really not a solid argument that to take back the Senate what you need to do is move left because it requires capturing a number of seats in reddish states. Ironically, somewhat of a weaker national identity would probably be helpful as you need candidates in North Dakota able to run on a message that resonates in North Dakota rather than run as a generic national democrat. At the end of the day, any democrat you can get elected from those red states isn't going to be the senator you want, but they'll be far better than any republican you'll get from there - even if virtually the only thing they vote with you on is who the majority leader will be. There's a much bigger problem when you have less than ideal senators from states that are deep blue, of course: there's never a good reason to still have Liebermans around.
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Mar 21, 2017 15:56
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LeeMajors posted:True. America actually has tremendous healthcare if you're lucky enough to have one of the good plans. Many of the 100m or so do. They're not being tricked by the system. This does not excuse the abhorrent suffering that our current system causes (that ACA only partially mitigated), but contributes to the political reality of reform. tekz posted:*said against the steady background noise of people dying and going destitute* Slow and steady wins the race my friends.  nuD&D is the best.
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Mar 21, 2017 16:22
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daydrinking is fun posted:The democrats aren't in a position where they want single payer and are constrained by political necessity, their base supports it and the amount of Americans who want the government to be responsible for healthcare is growing. The party doesn't want it. The progressive wing does, sure, but if we've learned anything over the last election cycle, it's that the center would rather lose than listen to them. I think you might have missed it, but Colorado, a state that went Clinton and elected a Democratic Senator this past election also killed a universal health care measure 80-20. By those margins there's not even a simple majority Among Democrats that supports universal health care.
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Mar 21, 2017 16:24
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Hey guys I got this great idea. Let's just implement a system that works! Has anyone thought of that yet? I can add more snark and "Have fun losing the elections in [year]" if it'll help convince people.
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Mar 21, 2017 16:26
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Citing Colorado Care as evidence for people's taste for single payer is so goddamn stupid. I couldn't be a stauncher advocate for single payer, but making one state in the union UHC, especially one surrounded by crushing poverty, doesn't really fit with the idea of socialized insurance.
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Mar 21, 2017 16:27
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evilweasel posted:The Senate is always going to be a problem for Democrats given that its setup favors rural areas over urban ones. But there's really not a solid argument that to take back the Senate what you need to do is move left because it requires capturing a number of seats in reddish states. The solid argument is that if you propose something that will actually improve the material conditions of voters, they will vote for you. In a world where centrists were arguing Democrats should actually try to do something- indeed, anything- you'd be right, there's no solid argument to move left. In a world where "do something for your constituents that might piss off some lobbyists" constitutes a profound deviation from establishment orthodoxy, i.e. this one, the story is quite different. Paul Ryan's trying to hand the democrats the entire 64+ demographic going forward, neatly wrapped with a bow on top, and they're busy yelling about Russia instead.
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Mar 21, 2017 16:35
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call to action posted:Citing Colorado Care as evidence for people's taste for single payer is so goddamn stupid. I couldn't be a stauncher advocate for single payer, but making one state in the union UHC, especially one surrounded by crushing poverty, doesn't really fit with the idea of socialized insurance. So you're saying that if you were a Coloradoan, and even though you personally support universal health care, you would have voted against the amendment?
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Mar 21, 2017 16:35
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Ze Pollack posted:The solid argument is that if you propose something that will actually improve the material conditions of voters, they will vote for you. on the other hand, what happened after the stimulus and obamacare was passed, both things that actually improved the material conditions of voters in pretty dramatic ways
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Mar 21, 2017 16:37
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Some people have really good healthcare and they don't give a poo poo if everyone else doesn't. A repeal/replace system will never work in America. It should be more of Medicare for all imo. Something you don't have to take but corporations will sort it out the whole public adoption rate for us.
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Mar 21, 2017 16:38
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mastershakeman posted:IIRC, the cost of Medicare/Medicaid/other public health expenditures per capita in the USA is the same as the most expensive anywhere else in the world. Even if covering literally everyone else was free we'd still be the most expensive and I'm not really sure why that is. UMMM excuse me, Lurk More and read the ICD10 about the ID-10-T in subsection 14.88. How loving DARE you observe that everyone else pays less to get more. Simplex posted:So you're saying that if you were a Coloradoan, and even though you personally support universal health care, you would have voted against the amendment? No, I voted for it, primarily because I knew it wouldn't pass. It doesn't make sense to have UHC on a state level when people can freely come and go, much in the same way that everyone agrees non-mandate health insurance that covers prior conditions would incur a death spiral.
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Mar 21, 2017 16:42
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FWIW, UHG's strategy on their UHC side seems to be entirely focused on the Medicare/Medicaid enrollment side.mastershakeman posted:IIRC, the cost of Medicare/Medicaid/other public health expenditures per capita in the USA is the same as the most expensive anywhere else in the world. Even if covering literally everyone else was free we'd still be the most expensive and I'm not really sure why that is. A lot of reasons. We're a very advanced healthcare economy that drives a lot of R&D in both new, expensive devices and pharma. We're also an unhealthy country (behavior not outcome... but also outcome) with a focus on chronic (expensive) care and are aging to boot. Boon fucked around with this message at 16:46 on Mar 21, 2017 |
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Mar 21, 2017 16:43
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daydrinking is fun posted:Also "being constrained" or trying to "save up political capital" is a huge noob trap. The GOP never bothers to let reality get in the way of their drive to turn America into the Running Man, why the gently caress should we limit our imaginations? This isn't really true at all though. The Obamacare "repeal" is hated by the hard-right base, and they might not even be able to pass it. It's the epitome of a compromise bill, attempting to thread the needle and placate both the moderate and conservative GOP lawmakers. It is very much the product of the constraints and realties of trying to pass legislation.
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Mar 21, 2017 16:55
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evilweasel posted:on the other hand, what happened after the stimulus and obamacare was passed, both things that actually improved the material conditions of voters in pretty dramatic ways Obamacare didn't take effect (mostly) until 2014 (and by then Republicans managed to kill the Medicaid expansion in 40% of the country), and the stimulus was about 1/3 the size most economists said it needed to be to actually pull us out of recession. E: And then Democrats ran away from Obamacare. Kentucky just didn't tell everyone that their state exchange was Obamacare to get them to sign up, then whoops turns out no one knows they're on Obamacare so they vote for the guy promising to repeal it. That Obamacare never did anything for me, I'm on Kynect! VitalSigns fucked around with this message at 17:05 on Mar 21, 2017 |
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Mar 21, 2017 16:58
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evilweasel posted:on the other hand, what happened after the stimulus and obamacare was passed, both things that actually improved the material conditions of voters in pretty dramatic ways Fair line on the stimulus. After obamacare was passed, however, your average voter saw their premiums rise and their cheap doesn't-actually-cover-poo poo insurance get canceled. A strategic, pragmatic decision was made to screw over the average voter in favor of getting the health insurance industry onside, and it turns out the average voter faced with a change from "couldn't pay health costs in a million years" to "couldn't pay health costs in 30 years, also your premiums are higher now" bites back real fuckin' hard. "You and your children would be bankrupted trying to pay for your health care" is an improvement over "You and three more generations of your family would be bankrupted trying to pay for your health care" in only an abstract sense. To the voter on the ground? You are asking him for more money, and he still can't pay for the health care he needs. Obamacare 'helped' so many people that Democrats seeking reelection actively fled from any responsibility for helping pass it, and fled so successfully they managed to lose several state governments in the bargain.
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Mar 21, 2017 17:06
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call to action posted:UMMM excuse me, Lurk More and read the ICD10 about the ID-10-T in subsection 14.88. How loving DARE you observe that everyone else pays less to get more.
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Mar 21, 2017 17:07
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New Costa/Weigel piece in WaPo that has too much to quote. Lot of tea leaves (har har) to read. https://www.washingtonpost.com/powe...m=.b1cf30ac6f7e In short, it's looking like evilweasel was right, and the plan was to leave the Freedom Caucus loons out on their own, and both sides are still presenting themselves as having enough votes. Meanwhile Trump is trying to bluster and threaten while having just come back from a campaign rally in...Kentucky, presumably targeting Rand Paul and Rep. Tom Massie, two of the least likely people involved to feel any heat from that. It doesn't sound like Ryan is ready to offer much in the way of further concessions to the crazies, and is confident of his support among the moderates. The Hill's whip count, which appears to have been updated to reflect the comments in that story, still has 18 House members at a 'no' and 9 at a likely no vote. Gonna be hilarious if I was wrong and Ryan pushes this to a floor vote that manages to fail.
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Mar 21, 2017 17:17
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Simplex posted:I'm going to cut to the chase here because the point we are going to reach is that the people who support UHH voted yes, but the amendment failed because people were concerned dirty, poor (New) Mexicans were going to flood the state and steal our sweet, sweet healthcare. Again that doesn't suggest a whole lot of wide spread support for progressivism even among likely democratic voters. It's a valid concern. CO taxpayers effectively subsidize everyone living within X miles of the border where X = someone's willingness to travel for cheap/free healthcare. It's unsustainable both economically and politically and you'd be a fool not to realize it.
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Mar 21, 2017 17:17
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VitalSigns posted:E: And then Democrats ran away from Obamacare. Kentucky just didn't tell everyone that their state exchange was Obamacare to get them to sign up, then whoops turns out no one knows they're on Obamacare so they vote for the guy promising to repeal it. That Obamacare never did anything for me, I'm on Kynect! That's because Democrats are in love with invisible technocracy and are totally allergic to keeping it simple and taking credit for actual good policy.
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Mar 21, 2017 17:23
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Boon posted:It's a valid concern. CO taxpayers effectively subsidize everyone living within X miles of the border where X = someone's willingness to travel for cheap/free healthcare. Yeah I think any state-based UHC will need to be residents-only (at least at the beginning), which requires a private system to still stay in effect.
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Mar 21, 2017 17:26
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eviltastic posted:The Hill's whip count, which appears to have been updated to reflect the comments in that story, still has 18 House members at a 'no' and 9 at a likely no vote. Gonna be hilarious if I was wrong and Ryan pushes this to a floor vote that manages to fail. Hopefully some news org is working to get a better version of this - there's a lot of comments from moderates that the revisions were specifically targeting, and a lot of missing people. The Washington Post should just be ringing up every member of the Freedom Caucus to ask their position at this point, so should every other news org.
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Mar 21, 2017 17:32
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Ze Pollack posted:Fair line on the stimulus. After obamacare was passed, however, your average voter saw their premiums rise and their cheap doesn't-actually-cover-poo poo insurance get canceled. A strategic, pragmatic decision was made to screw over the average voter in favor of getting the health insurance industry onside, and it turns out the average voter faced with a change from "couldn't pay health costs in a million years" to "couldn't pay health costs in 30 years, also your premiums are higher now" bites back real fuckin' hard. I don't really believe there's any way to pass major health reform without either losers or (more likely) people who fear they will be losers, and it's very difficult to get the benefits to people before the next election. Its not like it was unexpected that the delay in the law's effectiveness until 2014 was going to be a problem - the bill was revised to push as many benefits (children on their parent's plan, for example) as early as possible. And even then we all remember the healthcare.gov issues. You just can't reform 20% of our economy on a dime: even if you can wave a magic wand and get your preferred bill through congress you can't implement it immediately without more magic. So there's always going to be a time between when the bill passes (creating, at a minimum, the people who fear they will be losers under the new system) but the benefits aren't really real. Hell, people are really only waking up to how important the benefits are to them now that they're at risk. And that was an "incremental" change rather than the sort of massive UHC change. Like, even if we just go to medicare for all, that is a lot of additional work. You have to build out all the systems to handle new people, transition people from their old insurance to medicare, get the doctors who previously weren't doing medicare doing it, wind down insurance companies, deal with the sure and certain republican sabotage and delay, etc. So at the end of the day if you want to do heath care you can't rely on "do good things for people and you will be rewarded". Maybe Obamacare could have been sold better - but I question if any messaging that needs to explain a new system to people can ever beat fearmongering based on fear of the unknown. It's always going to be simpler to attack any heath care plan than to support it. And at the end of the day, even if we go back to the pre-Obamacare disaster of 50 million uninsured, that's still a minority of the population. Even if you double that to assume 100 million people have health care that is nonexistent or is - in their own minds - effectively nonexistent so they will support any improved plan, you've still got the 200 million people who have a level of health care they are afraid to lose. So you've always, always, got the problem of the "middle class" who would be better off under UHC done right, but are afraid that their workable insurance will be replaced by UHC done wrong. The only real solutions I see to those problems are (a) incrementalism: create a parallel public alternative (expanded medicare/medicaid, public option) and let people transition to it slowly as they become comfortable with it or (b) wait for the reaganites to die out and younger generations who don't share the assumption that the government fucks things up take power and reverse the cultural assumption government fucks stuff up Republicans have managed to instill. Neither are quick options. And as we're seeing now, you have to keep power after you implement the changes long enough to make them stick: you can't just get power, ram them through, then lose power because then it's all for naught.
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Mar 21, 2017 17:47
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