Amendment 69, single payer and plausible option space

Amendment 69 was the Colorado Care amendment.  Ballotpedia has the language the results:

A “yes” vote supported creating ColoradoCare, a healthcare payment system designed to finance universal healthcare for Colorado residents partly through an additional 10 percent payroll tax—two thirds paid by employers and one third by employees—providing approximately $25 billion per year in revenue.
A “no” vote opposed this proposal, leaving the Colorado healthcare system unchanged.

No won by more than 3:1 over Yes.

It was not just Trump supporters who voted no.  Mechanically well over half of Hillary Clinton’s vote in the state voted against Amendment 69.  I probably would have been one of the Clinton-No votes as I could never figure out the financing of the proposal.

So what are the lessons that need to be learned?

First, single payer has a concentrated and motivated group of supporters but they are not a majority of the Democratic party.  We have revealed preferences on this in the 2007-2008 health policy proposals.  In that election cycle there were three viable candidates offering healthcare plans (Obama, Clinton, Edwards) and none of them offered single payer.  We also have Amendment 69 failing with at least majority Democratic opposition.  We saw major Democratic influencers not come out for Amendment 69.

Secondly, this is the second major single payer failure in the past three years.  Vermont stopped their exploration process because they could never make the money work well enough to get a viable proposal to send out for approval.  Colorado resoundingly rejected their proposal.

Single payer, behind a Rawlsian veil of ignorance and starting fresh, makes a massive amount of sense.  We do not operate in that world.  The world that we live in has a healthcare system that produces winners and losers.  Providers and healthy people with good insurance through either work or Medicare are either actual winners or apparent winners.  Most of the losers of the current system are either amazingly diffuse (lower cash wages for most workers), already somewhat covered (disabled on Medicare or Medicaid) or politically powerless.  The challenge is how to get a policy that is disruptive as all get out that mainly benefits people with low political salience and power while either hurting or causing fear in people with high political salience and power through?  I don’t know how to do that.  This needle threading exercise is one of the many reasons why the ACA was designed as it was as it sought to keep the status quo as visibly entrenched as possible while improving things for low political power and salience groups.

Third, single payer is hard.  It is not something that can just be hand waved into existence.  It is something that needs a lot of high quality nerds and experts working through odd scenarios, looking at interactions and then presenting their thoughts to the general public for a long and hard listening to the concerns, questions and suggestions of the people that will actually have to use the system.  One of the major reasons why I was not gung-ho for Colorado Care is that I had not seen them do the actual financial math.  They assumed they could get a 1115 Medicaid waiver and a 1332 ACA waiver even as the waiver granting authorities were indicating reluctance to grant the needed expansive waivers.  They just assumed the money would be there instead of lining up cash commitments ahead of time.  They also assumed Hyde and current Colorado state law would not apply to abortion and other female reproductive health care procedures.  There were a lot of assumptions on the mechanics of implementation.

Single payer is hard work to implement.  Lazy work turns off potential allies that may not be sufficient to form a minimally viable winning coalition but definitely necessary to that coalition.

Given today’s politics, single payer advocates will have a decade to get the hard work done of designing a plan, figuring out implementation and persuading the public including people who are current winners that this plan is better than the status quo and the uncertainty is low.  That works needs to be done and Colorado is a source of good information for that work.



Putin’s Puppet and NFLG Harry Reid

Senator Harry Reid has just released a letter to FBI Director Comey that is utterly (and IMHO appropriately) brutal.

It contains two key elements.  The first is a direct assertion that Comey has engaged in partisan political action, and may (by implication, has) broken the law by violating the Hatch Act.

The second is this:

In my communications with you and other top officials in the national security community, it has become clear that you possess explosive information about close ties and coordination between Donald Trump, his top advisors, and the Russian government – a foreign interest openly hostile to the United States, which Trump praises at every opportunity. The public has a right to know this information. I wrote to you months ago calling for this information to be released to the public. There is no danger to American interests from releasing it. And yet, you continue to resist calls to inform the public of this critical information.

neuville_alphonse_de_-_the_spy_-_1880

Hillary Clinton’s aide’s husband sent dick picks from a computer that may or may not contain emails that may or may not add to our nation’s stock of risotto recipes.

Donald Trump, apparantly, has consequential entanglement with the former KGB thug-led Russian government and its klepto-thug circle of supporters.

We know hair-raising innuendo about the former.

About the latter, from the same institution?  Crickets.

Sauce for the goose damn well ought to be sauce for the gander.  And Comey’s a hack who needs to go at the earliest politick opportunity. (And yeah, that’s not a typo.  I like that old spelling.)

No BS here: if the FBI has pertinent information on Trump’s potential for conflict of interest due to his Russian encounters, we need to know this now.

Here is Reid’s letter in full:

Dear Director Comey:

Your actions in recent months have demonstrated a disturbing double standard for the treatment of sensitive information, with what appears to be a clear intent to aid one political party over another. I am writing to inform you that my office has determined that these actions may violate the Hatch Act, which bars FBI officials from using their official authority to influence an election. Through your partisan actions, you may have broken the law.

The double standard established by your actions is clear.

In my communications with you and other top officials in the national security community, it has become clear that you possess explosive information about close ties and coordination between Donald Trump, his top advisors, and the Russian government – a foreign interest openly hostile to the United States, which Trump praises at every opportunity. The public has a right to know this information. I wrote to you months ago calling for this information to be released to the public. There is no danger to American interests from releasing it. And yet, you continue to resist calls to inform the public of this critical information.

By contrast, as soon as you came into possession of the slightest innuendo related to Secretary Clinton, you rushed to publicize it in the most negative light possible.

Moreover, in tarring Secretary Clinton with thin innuendo, you overruled longstanding tradition and the explicit guidance of your own Department. You rushed to take this step eleven days before a presidential election, despite the fact that for all you know, the information you possess could be entirely duplicative of the information you already examined which exonerated Secretary Clinton.

As you know, a memo authored by Deputy Attorney General Sally Yates on March 10, 2016, makes clear that all Justice Department employees, including you, are subject to the Hatch Act. The memo defines the political activity prohibited under the Hatch Act as “activity directed towards the success or failure of a political party, candidate for partisan political office, or partisan political group.”

The clear double-standard established by your actions strongly suggests that your highly selective approach to publicizing information, along with your timing, was intended for the success or failure of a partisan candidate or political group.

Please keep in mind that I have been a supporter of yours in the past. When Republicans filibustered your nomination and delayed your confirmation longer than any previous nominee to your position, I led the fight to get you confirmed because I believed you to be a principled public servant.

With the deepest regret, I now see that I was wrong.

Sincerely,

Senator Harry Reid

Image: Alphonse de Neuville, The Spy1880.



The Election Is Not Rigged & It Is Not Going To Be Rigged

A quick note from Speaker Ryan (R-Profile in Courage!):

Speaker Paul Ryan (R-Wis.) on Saturday dismissed Donald Trump’s repeated claims that the November elections will be rigged.

“Our democracy relies on confidence in election results, and the speaker is fully confident the states will carry out this election with integrity,” Ryan spokeswoman AshLee Strong toldBuzzFeed.

It is important to note and remember that 23 states are led by Republican governors that also have Republican legislatures – both chambers, referred to as the trifecta. Another 11 states have Republican governors and just 7 states are under Democratic control -the trifecta of a Democratic governor and legislature. There are 20 states total that share control – either GOP governor, Democratic legislature, or vice versa. Apparently the Trump campaign is suggesting that the Republican Party is rigging elections against the Republican nominee at the state level… Wait, what were we talking about again?

A somewhat more definitive explanation of the process of just how hard it would be to actually rig US elections has been provided by the Ashby Law firm, which focuses on electoral law and primarily works for Republican clients:


Read more



Early Morning Eye Roll Open Thread: Trump’s Not on Drugs, He’s Just Lost His Tiny Mind

Was just re-reading an old Agatha Christie mystery where a rich, dishonest businessman is murdered by one of his kids, before he can dissipate the family fortune as a result of suffering from “general paralysis of insanity“. That diagnosis has fallen out of general use, because it’s the result of third-stage syphilis, and (for the moment) we’ve got drugs to forestall its progression. But maybe Trump wasn’t kidding when he referred to his 70s-era sexual predations as “my personal Vietnam”



Preparing for the heat death of the universe open thread

Trump passed a fact check with flying colors:

Open Thread



Monday Evening Open Thread: GAME CHANGERS Y’ALL!!!

Mark Halperin needs his man-crush to get out there and compete!!!

“Wikileaks/Oct surprise”

“hidden Trump vote”…

“RNC ground game”… PBS Newshour:

As the presidential election marathon breaks into a final sprint, the Trump campaign faces a jaw-dropping gap in the ground game: Hillary Clinton currently has more than three times the number of campaign offices in critical states than does Donald Trump. Those figures include both Trump offices and Republican National Committee victory offices, as confirmed by the Trump campaign….

“win 2 debates”… hahahahahahahahahaha…

Apart from working to break Halperin’s tiny shriveled heart, what’s on the agenda for the evening?



Long Read: “The Sandy Hook Hoax”

If you stare too long into the abyss… Reeves Wiedeman, in NYMag: “Lenny Pozner used to believe in conspiracy theories. Until his son’s death became one“:

On December 14, 2012, Lenny Pozner dropped off his three children, Sophia, Arielle, and Noah, at Sandy Hook Elementary School in Newtown, Connecticut. Noah had recently turned 6, and on the drive over they listened to his favorite song, “Gangnam Style,” for what turned out to be the last time. Half an hour later, while Sophia and Arielle hid nearby, Adam Lanza walked into Noah’s first-grade class with an AR-15 rifle. Noah was the youngest of the 20 children and seven adults killed in one of the deadliest shootings in American history. When the medical examiner found Noah lying face up in a Batman sweatshirt, his jaw had been blown off. Lenny and his wife, Veronique, raced to the school as soon as they heard the news, but had to wait for hours alongside other parents to learn their son’s fate.

It didn’t take much longer for Pozner to find out that many people didn’t believe his son had died or even that he had lived at all. Days after the rampage, a man walked around Newtown filming a video in which he declared that the massacre had been staged by “some sort of New World Order global elitists” intent on taking away our guns and our liberty. A week later, James Tracy, a professor at Florida Atlantic University, wrote a blog post expressing doubts about the massacre. By January, a 30-minute YouTube video, titled “The Sandy Hook Shooting — Fully Exposed,” which asked questions like “Wouldn’t frantic kids be a difficult target to hit?,” had been viewed more than 10 million times…

“I prefer the term hoaxer to truther,” Lenny said, kicking a pair of jeans and Adidas flip-flops onto the footrest of a leather Barcalounger. “There’s nothing truthful about it.” There is no universal Sandy Hook hoax narrative, but the theories generally center on the idea that a powerful force (the Obama administration, gun-control groups, the Illuminati) staged the shooting, with the assistance of paid “crisis actors,” including the Pozners, the other Sandy Hook families, and countless Newtown residents, government officials, and media outlets. The children are said to have never existed or to be living in an elaborate witness-­protection program…
Read more