Making it easy for the clean up woman

I’m not much for “heightening the contradictions”. There’s an old saying, that when someone says “minor surgery” means someone else is getting operated on. Well, I think when someone says “heighten the contradictions”, it means someone else’s life is being destroyed by awful government policy.

So I think we should fight like hell to save ACA. That said, how on earth can the Republicans not think that their latest shitcare proposal is a one-way ticket to single payer within ten years? If 30 million people lose their health care by 2020 because of a shitty Republican bill, it’s not going to be that hard for President Gillibrand or President Harris (or maybe President Brown) to get a single payer bill through Congress in 2021.

Single payer and details

Margot Sanger Katz at the New York Times raises a critical point about Democratic goals for single payer plans:

Like “repeal and replace,” “single-payer” is a broadly popular slogan that papers over intraparty disagreements and wrenching policy choices. Republicans fumbled multiple attempts to replace the Affordable Care Act this year. If the Democrats eventually wrested back power, they could find themselves similarly factionalized and stymied over the details.

Rep. Conyers has released a set of single payer bills.  Senator Sanders is scheduled to release a single payer bill tomorrow.  These bills have no chance of becoming law in this session of Congress.  Yet they serve a good purpose in building consensus that originates from the intra-party consensus on universal coverage towards the mechanics of achieving that goal.

But the details matter. While it is true, as advocates often mention, that much of the world has some form of universal health care, there is wide variation in how those systems work. Nearly any single-payer plan would require substantial disruptions in the current health care system, upending the insurance arrangements of the 156 million Americans who get their coverage from work, changing the way doctors, hospitals and drug companies are paid, and shifting more health care spending onto the government ledger. Such a proposal would reshuffle the winners and losers in our current system.

If there is going to be a legitimate single payer push the next time there are working and functional universal coverage majorities in Congress, then the details matter.  And those details need to be fleshed out.  The first drafts (and that is what these bills are) need to be ruthlessly  edited.  They need experts to look at Section 1422-a-2-b and say that it does not align with Section 332-b nor does it play nicely with established case law and business practices.  These drafts need experts to ask if the implied trade-off is actually the trade-off that is intended to be made.  These drafts need to be ripped apart for internal weakness and stress tested against plausible events and corner cases.

If people are serious about wanting to move towards some type of single payer system anchored on Medicare as the means towards achieving universality, then the hard work of figuring out how to make things work is needed now.  If you want a slogan, than it is fine to be lazy.

I Have a Dream: 54 Years Later

Today is the 54th anniversary of the March on Washington and Dr. King’s I Have a Dream speech.

On this 54th anniversary the Anne Frank Center brings the heat:

Here’s the video of the speech:

ETA at 11:05 PM

Lest we forget, today is the 62nd anniversary of Emmet Till’s murder. The date for the March on Washington was specifically chosen to coincide with the anniversary of Till’s murder.



The President’s Campaign Rally In Phoenix, AZ Live Feed

You all know what to do!

Economic leverage

Josh Marshall makes a very good point this morning about Trump’s toxicity:

Every president has these industry councils like the ones we’ve been talking about in recent days. They range from meaningless to not terribly important. They’re mainly symbolic. With everything that’s happened in recent days, I don’t want to make it out like the decisions of a small number of CEOs is the biggest news. Still, we should recognize that it is entirely unprecedented to have a sitting president become so toxic that corporate America feels unable to publicly associate with him. That is totally, totally new territory.

Last November, the Brookings Institute looked at the election and they made a very key point. The areas of the country where there was both population density and wealth voted for Clinton.

Visibly enraging not-Trump voters is a money loser.

Vice News’ Interview with the Racists

Vice News has made their interviews with some of the leaders and participants from Saturday’s Unite the Right rally in Charlottesville online so everyone can see it, not just HBO subscribers. They describe their reporting as:

On Saturday hundreds of white nationalists, alt-righters, and neo-Nazis traveled to Charlottesville, Virginia, to participate in the “Unite the Right” rally. By Saturday evening three people were dead – one protester and two police officers – and many more injured.

“VICE News Tonight” correspondent Elle Reeve went behind the scenes with white nationalist leaders, including Christopher Cantwell, Robert Ray, David Duke, and Matthew Heimbach — as well as counterprotesters. VICE News Tonight also spoke with residents of Charlottesville, members of the Black Lives Matter movement, and the Charlottesville Police.

From the neo-Nazi protests at Emancipation Park to Cantwell’s hideaway outside Virginia, “VICE News Tonight” provides viewers with exclusive, up-close and personal access inside the unrest.

Here’s the video:

Single Payer 2020

Scott Lemieux published an interesting piece in The Week today about Kirsten Gillibrand’s support for a single payer solution as the ultimate goal for healthcare reform: “Kirsten Gillibrand is serious about Medicare for all.” An excerpt:

It would have been easy for Sen. Kirsten Gillibrand (D-N.Y.) to rest on her laurels at the town hall she held at Hudson Valley Community College in Troy, New York, on Wednesday. In the wake of the narrow defeat of the Republican “skinny repeal” of the Affordable Care Act, she received two standing ovations from a packed house before she even began to speak… But she had a more ambitious agenda in mind. Before taking questions, she celebrated the defeat of ACA repeal but quickly observed that it was not enough: Too many people still couldn’t afford insurance. And making a point she would return to repeatedly for the next hour, she identified her preferred solution: Medicare for all…

While the audience was generally supportive of her advocacy for Medicare for all — some scattered booing aside — one audience member asked a practical question: What should Congress do if the votes in Congress for Medicare for all aren’t there yet? Gillibrand had a ready answer: “You get to single-payer by letting people buy in [to Medicare] now…”

[W]hat’s politically possible at a given point is a question that can be answered the next time the Democrats take over the White House and Congress. In the meantime, the Democratic Party needs to establish Medicare for all or a comparable universal program as a goal — and whether it’s Gillibrand, Sanders, or another candidate, this is almost certainly the direction the next Democratic nominee will be pushing in.

I’m grateful to Gillibrand for stating outright that a market-driven system will never achieve affordable, universal coverage, so the public aspects of the ACA will have to be expanded to move in that direction. President Obama and the Democrats who worked on healthcare reform during his first term knew that, which is why they built in Medicaid expansion nationwide, a provision the SCOTUS sabotaged.

Anyhoo, the whole thing is worth a read. Love it or hate it, I think Lemieux is correct when he says single payer is becoming a core part of the Democratic Party platform, at least as an objective. The disagreements will arise around how to get there.