Obamacare not enough, so some in labor want single-payer system

[OhioChick]

September 12, 2014 at 12:29 PM

CLEVELAND, Ohio - When many in the labor movement speak about health care reform they are not talking about Obamacare, but a single-payer system.

"It has been a historic goal of the labor movement to establish a Medicare for all, single-payer system in the U.S., just like almost every industrialized country in the world," said Mark Dudzic, national coordinator for the Labor Campaign for Single Payer. "The labor movement, we believe, has to be in the forefront of the fight, if we are going to win that."

Dudzic is one of the speakers in a forum tomorrow (Sept. 13) being sponsored by his Washington, D.C.-based group and the Single Payer Action Network of Ohio, or SPAN, which is lobbying for instituting such a health care system in Ohio. The event is scheduled for 2 to 4 p.m. at the North Shore AFL-CIO Federation of Labor, 3250 Euclid Ave., in Cleveland.

Those supporting single payer emphasize that they are not seeking a publicly funded system run by the government, in which health care workers would be public employees. Instead, they want one more like Medicare, in which users would go to private doctors, using public money to pay the bills. Supporters say one of the reasons such a system would cost less to operate is that administrative costs associated with a private insurance system would be gone.

More: http://www.cleveland.com/business/index.ssf/2014/09/obamacare_not_enough_so_some_i.html#incart_more_business

[riqster]

1. It's the next step.

[JoePhilly]

10. +1

[rhett o rick]

49. Love the sound of that, but when? nm

[joshcryer]

54. Vermont gets it in 2017.

And the ACA enabled it otherwise they would've had to have raised payroll taxes 11%.

[merrily]

80. Vermont was working on it anyway, some for 20 years.

http://www.usatoday.com/story/news/nation/2014/08/07/stateline-vermont-insurance-aca-obamacare/13721355/

[joshcryer]

89. And? The ACA enabled it.

Without the ACA they had to raise payroll taxes 11%. You know who gets hit hardest by that? The working poor.

[merrily]

91. That you say that does not make it so.

The working poor were also hardest hit by the cost of private health insurance. The working poor were also hardest hit by the consequences of not having any health insurance or having only the minimum.

[joshcryer]

92. If not the ACA, then how does Vermont get it?

Is it possible for Vermont to 1) raise payroll taxes 11% and 2) not get federal subsidies and 3) not have Medicaid expanded and 4) not reduce the uninsured to near 0% without the ACA?

I don't think that is possible. Give credit where it is due.

Do you not know that Green Mountain Care is an ACA insurance exchange, which will be the single payer insurer in the end?

[merrily]

95. Again, because people had been working on it for 20 years.

I did give credit where it was due. I linked to an article that said people had been working on it for 20 years.

[joshcryer]

98. Working on it, but not achieving it.

Until the ACA.

I wonder why that is? Perhaps it's because they didn't want to raise payroll taxes 11% or that it wasn't feasible, perhaps it's because they now get federal subsidies? Perhaps it's because the ACA reduces the uninsured to near 0% or perhaps it's because Medicaid was expanded in the state?

Or perhaps you're just being dismissive and don't have a response.

[JDPriestly]

134. Credit to Bernie Sanders for helping to make it possible.

[riqster]

149. Absolutely.

[grahamhgreen]

57. +1

[still_one]

151. It is the next step but won't happen until more progressives are put into congress

[riqster]

155. Just so. That is why GOTV is job 1 right now.

Then we all must push progressives to run in the 2016 primaries.

[TheNutcracker]

2. Obamacare is not access to healthcare, it's access to health insurance. YES FOR SINGLE PAYER

[JoePhilly]

11. ACA was a necessary first step.

[nomorenomore08]

64. Reluctantly, I have to agree with you.

One could argue the Dems should have pushed harder for a real public option, but getting full single-payer in one fell swoop would've been impossible in the current political climate.

[joshcryer]

67. They even had to dump the public option.

If people believe we could've got single payer in that political climate I have a bridge to sell them.

[nomorenomore08]

68. It sucks. I hate it. But I don't condemn Obama for not doing the impossible. n/t

[joshcryer]

73. I will always condemn the cowardly filibuster rules.

But, without getting into details, I understand why they exist.

I think a big "care package" was possible if they changed the filibuster rules.

[merrily]

81. The bill never had a public option, so we can blame fiibuster or anything we want.

And Reid has since proven beyond doubt that he could have eliminated filibuster selectively. anyway.

The filibuster rules exist as much to block legislation and obliterate accountability as they do to give the minority a voice. By definition, gridlock serves conservatives. And the meme in Congress is that you never lose your seat for bills that don't pass, but you might lose you seat for bills that you helped pass.

And, filibuster presents great opportunity for D.C. kabuki by both sides. Depending on which bill it is, it takes all only a few to vote against their own caucus to stop a bill.

If you are even confronted on a cloture vote--unlikely in itself--you can always claim you really all for more affordable college loans, but there was this one part of the bill you just could not live with because it did not help enough or some such bs. As you know, it's done all the time.

[joshcryer]

87. Baucus fought for the public option.

The public option was always on the table there simply weren't the votes for it for the super majority that passed it (it would not have passed with the filibuster rules in place). Lieberman was really the one who did it, and it was probably to spite Democrats.

Reid is actually responsible for the filibuster rules. The idea was that if you had a virtual filibuster you could fast track legislation and have conconcurrent legislation going through at the same time. It was intended to be more efficient and more powerful. He probably could've seen that it'd never work that way. But as a good friend of mine once said, the best thing about democracy is inefficiency, so gridlock is actually a feature, and it is good.

The biggest problem is that the Democrats aren't as unified as the Republicans, so they're afraid of changing the filibuster rules away from that more "efficient" model (they can actually do other legislation while the magical virtual filibuster is going on; this is against the Senate model where Senators are supposed to be "great debaters" and do legislation one at a time sequentially).

[merrily]

97. Well, that's one view of it. An excessively charitable view, but one view.

I'm sticking with the one I outlined in my prior post.

[joshcryer]

99. Fair enough.

I think the real world is charitable.

[merrily]

103. The real world in DC is almost as charitable as House of Cards.

Lobbyists haven't been spending milllions there to make sure legislation is charitable.

Big difference between "charitable" and "gullible."

[joshcryer]

105. Lobbyists can't stop progress.

They can only delay it. Which is why we got the ACA but states will be implementing single payer due to it.

[merrily]

107. Lobbyists can't? That may be the funniest thing you've ever posted.

[joshcryer]

108. Laugh it up.

[merrily]

79. At what stage of the process were "they" forced to dump the public option?

[joshcryer]

88. When Baucus couldn't get Lieberman's vote for it.

[merrily]

90. I call bs.

[joshcryer]

93. Oh yeah, Lieberman was all for the public option.

Talk about BS.

Baucus put the public option in the committee: http://www.huffingtonpost.com/2009/08/24/baucus-declares-that-he-w_n_267307.html

He simply didn't have the votes for it: http://abcnews.go.com/Politics/HealthCare/senate-finance-committee-vote-public-option-health-care/story?id=8701097

Votes matter.

[merrily]

94. See? BS. You KNOW that I never said Lieberman was for the public option.

The issue was the stage of the process at which the public option was dropped.

Do you remember why White House visitor logs were being sought so early in Obama's administration?

http://politicalticker.blogs.cnn.com/2009/09/04/white-house-to-release-logs-after-settlement-interest-group/comment-page-2/

[joshcryer]

96. Relevant to the Senate votes?

They didn't have the votes in the Senate. Rather than being vague, explain your conspiracy.

I already damn said it was because of the filibuster rules that they required 60 votes instead of 51. I don't see what the disagreement is about except 9 damn votes. You seem to think they had those 60 votes with the public option. I don't even know what we're disagreeing about.

[merrily]

101. Geez I wasn't vague at all and I have no "conspiracy."

Surely, you remember the FOIA request for the White House visitor logs? It was from the ACLU, not from me.

[joshcryer]

102. What to WH logs have to do with Senate votes?

Please. I am struggling here, I really am, I really am completely out of it at this point.

[merrily]

106. Please stop diverting, Josh. The point in the ACA process

where the public option got dropped was the point at which Rahm asked the industry lobbyists who were streaming in the WH what they wanted in the bill.

After the ACLU request, they moved the meetings outside the White House.

Surely, you recall all this.

[joshcryer]

110. And? They didn't have the votes.

But Wyden made sure that there was a waiver in there. So the lobbyists didn't get what they wanted. And you'll see, give it 10 years, we'll have a dozen or more states with single payer. Vermont will have it (and only due to the ACA), Oregon will likely have it, and Colorado is poised to have it (Colorado already has free clinics paid for by the state).

[BlindTiresias]

113. A few marginal cases

Is not a compelling argument that the ACA wasn't a gift to the insurance industry. It is extremely doubtful we will see widespread adoption of single payer systems on a per state basis despite what the pollyannas say.

[joshcryer]

114. Is the insurance industry sustainable?

Because I don't think so. And I think that the ACA is their demise.

[BlindTiresias]

115. I think it is

I think they received a massive gift via the ACA and can continue on indefinitely now that they have a captive market outside of the aforementioned marginal instances of states enacting single payer.

[joshcryer]

117. The ACA sets minimum standards.

If it is, then OK, I'm fine with that, because it will successfully prove that it can compete with non-profit sectors.

I think it is unlikely.

[BlindTiresias]

119. Eh

The standards set are questionable as it has been slowly revealed and mostly leaves the insurance companies untouched now that their market has been greatly expanded. You would have a point if it wasn't for the captive market but that is a huge bonus for the insurance companies and in many ways permanently cements their position, I think.

[joshcryer]

129. I'm speaking of waivers.

No waiver can be worse than the current insurers, so if there's a waiver, it'd almost certainly be a public option or single payer system. I don't rule out the possibility that a state could have a highly cost effective for profit insurer, but that is so unlikely as to be laughable.

[quakerboy]

120. Chicken or egg

Did they have to do it because of the political climate, or did they create/allow the political climate that required it?

I saw R's get out in front of the cameras constantly, lying, for a year, with no real messaging opposition. D's that I saw were fairly quiet and by all reports trying to work out a backroom deal to get it done. This meant the public basicly got one side of the story, repeatedly, loudly, and vehemently. And they were left to stew in their juices. That never turns out well, in my experience. It should have been a public fight, no holds barred, between the forces trying to get health care and the forces trying to prevent it. Let the public decide which was the more compelling need.

[joshcryer]

128. If Franken was seated or Kennedy didn't die, we'd have it.

It was purely on the Republicans. The timing was shit. We were basically boxed in. The public did decide, but the timing and the tragedy of Ted Kennedy dying was to the Republicans favor. They took advantage of it. In a more gentle world, they would've saw Kennedy's vision, and some of them would've voted for him, in his honor. But sadly, evil people prosper, and they didn't do that.

[quakerboy]

153. Fillibuster

as many of us said at the time, its time was over. It makes an undemocratic organization even less undemocratic. Even with the looming possibility of a Republican takeover of the senate: the Filibuster should be gone. It should have been gone then.

As to timing.. there was a year of lies that preceded that timing. A year in which Democrats, and our president in particular, spent their time trying to reach out to republicans, offering them ever greater compromise to break ranks and vote for the ACA. Its my contention that they should have basically ignored the republicans, and instead been out rallying the nation. Instead of the tea party disrupting town halls across the nation and on the TV lying every day while our elected leaders quietly tried to cut a deal, the strategy should have been to raise our base, get them angry at the obstruction, and have them out, flooding the town halls of Republicans and wavering Dems. Approaching it as a compromise rather than as a war for the hearts of voters was a mistake that lead to a lesser law being passed.

[JoePhilly]

157. Yup, and I think state level POs will

be the next shoe to drop.

Blue states will add them.

Then probably the federal exchange adds a PO.

State single payer after that.

I'd like to see it move faster, and it might, but the red states are so nuts, they'll work hard to delay anything at all here.

[IronLionZion]

135. SINGLE PAYER is not access to healthcare, it's access to health insurance.

YES to understanding what single payer is. Think of it as medicare for all, its the payment system not the providers.

[still_one]

152. It is both. the extension of medicaid, and the subsidies based on income are

giving those who could not get Healthcare access because of means the ability to

[jwirr]

3. Many of us want single payer because it will lower the cost even more.

[Doctor_J]

4. Hillary and Obama's hhs Secretary have vowed to not let it happen

Get used to mandatory for profit insurance, cause that is all we're going to have in this century

[sendero]

9. Good reason..

.... to not vote for her.

Single payer IS coming, be it in 5 years or 50. The providers-name-their-price system we have not is not sustainable, and the only real way to reign in costs is with single payer.

[Adam051188]

17. Americans have a remarkable propensity for conniving duplicity and shameless profiteering.

people in civilized countries know that it is morally wrong to seek to profit off of the pain and misery of others.

my prediction is that some sort of "medicare for all" nonsense that will still be far more expensive than anywhere else in the world will be implemented after the complaints over the holes in the ACA become more apparent. nothing will be done about the poor healthcare infrastructure or doctors workloads because no one really cares about that here. fawkem.


...i don't like your little footnote thingy....who decides what is "good"?....

beyond that have a nice day

[sendero]

26. Any single payer system..

..... has to have someone determine how much should be paid. Medicare does a very good job of this and I am in a position to know.

[Adam051188]

158. no it doesn't.

they invented this thing called math a few thousand years ago for stuff like that.

if you want a person to just toss a dart at a board, you're dumb. if you want a person to just make up a number, guess high, and keep whatever is left, you're dumb and you're an american.

[sendero]

159. You haven't ..

... the slightest idea what you are talking about, but you probably think you do.

[Adam051188]

160. uh huh

things cost money. we measure that money with these things called numbers. those numbers add up, or sometimes subtract down, or even other things sometimes.

people like you are the reason private companies make huge profits off of american societies decision to socialize risk. you must think the post office just arbitrarily decides how much stamps cost based on how much profit someone wants to make.

americans don't understand things. very universally true statement.

[Doctor_J]

20. But it's the law

The providers-name-their-price system we have not is not sustainable,

It is now the law of the land - guaranteed minimum of 20% overhead. The ACA has made SP impossible.

[sendero]

27. The ACA......

.... is an incremental step towards single payer. Before the ACA there wasn't even a 20% cap. It will eventually be 15% for most carriers.

[Doctor_J]

31. And how is that a move toward SP???

It will eventually be 15% for most carriers.

You admit that the best we'll ever do is 15% for the death merchants, and yet claim this is a step toward actual healthcare. I ask this respectfully, what the fuck is going through your head?

[Scootaloo]

51. because Obama's a democrat

Don't ask for the math, it'll all work out becuase magic.

[sendero]

126. Yawn...

..... think whatever you want. The ACA is not great but it is a helluva lot better than what we had.

It is a step forward in that it is going to wake up a lot of people who have been propagandized for decades. For starters by effectively eliminating the ridiculous connection between a job and health insurance.

[BlindTiresias]

50. Uh

How is that an incremental step towards something if it is moving in the opposite direction?

[sendero]

127. It is a step in...

.. the opposite direction only if you are logically challenged.

[BlindTiresias]

140. haha. Nope

Mandating private insurance is in the opposite policy direction from singlepayers systems or anything even remotely resembling UHC, because it richly empowers insurance companies to resist those policies.

[JoePhilly]

13. Got a link to their "vows"??

[Doctor_J]

19. Here you go

Burwell seeks to allay Republican fears about Obamacare

Hillary Clinton Likes Obamacare, And Opposes Single-Payer Health Insurance

I know the BOG is impervious to facts, but I'll just put them out there anyway - someone might make some use of them

[SunSeeker]

52. I don't see any "vows" in there from Hillary.

The Burwell link talks about Burwell.

The Huffpo link is a blog with the following smoking gun quote:

 

"We don't have one size fits all; our country is quite diverse. What works in New York City won't work in Albuquerque." 

That reads like an observation, not a vow.

What did I miss?

[Quackers]

55. I think this shows she doesn't support single payer.

From the article:
Hillary Clinton has confirmed, to a paying audience of 20,000 sellers of electronic health records systems, that she supports Obamacare, and opposes single-payer health insurance.

[SunSeeker]

59. That's the blogger's opinion, not a Hillary quote. nt

[Quackers]

109. These are her own words

Q: Let’s talk for a minute about the formulation of your plan. I’m interested in how seriously you considered proposing a single payer system and at what point in that discussion did you decide to propose an individual mandate?

MRS. CLINTON: You know, I have thought about this, as you might guess, for 15 years and I never seriously considered a single payer system. Obviously, I listened to arguments about its advantages and disadvantages, and many people who I have a great deal of respect for certainly think that it is the only way to go. But I said, as you quoted me, that we had to do what would appeal to and actually coincide with what the body politic will and political coalition building was. So I think if you look at most public opinion surveys, even from groups of people who you would think would be pretty positive towards single payer, Americans have a very skeptical attitude. They don’t really know that Medicare is a single payer system. They don’t really think about that. They think about these foreign countries that they hear all these stories about, whether they’re true or not, which they’re often not. And so talking about single payer really is a conversation ender for most Americans, because then they become very nervous about socialized medicine and all the rest of this. So I never really seriously considered it.

http://www.pnhp.org/news/2008/march/hillary_clinton_on_s.php

[SunSeeker]

143. Again, not a "vow" against single payer. She's just talking about others' opposition to it.

She explains why she didn't consider single payer. She, very correctly, knew even the incremental changes of the ACA-like Hillarycare would meet tremendous opposition. She notes that Americans don't think of Medicare as single payer. She is correct. I remember those teabaggers in 2010 walking around with "Keep your government hands off my Medicare" signs.

Hillary is not against single payer on principle. She even defends single payer in the quote you cite, noting the stories pushed about the problems with other countries' single payer systems are often not true.

She just opposes the political strategy of attempting to go straight to single payer rather that doing it in steps.

I think the next step to single payer should be to dramatically expand Medicare. It is much more politically palatable and physically doable--the structure is already there. The quote you cite is actually encouraging to me since it sounds like she would agree with that strategy.

[NorthCarolina]

146. Right, I'm sure she's 'secretly' all for it

[nomorenomore08]

65. Oh well. We'll still get it without her support, even if it takes decades.

[Quackers]

104. I hope it doesn't take that long.

I would at least like to see the legislation within my life time.

[BlindTiresias]

112. Unlikely

The union will likely dissolve before we seen a UHC style plan.

[joshcryer]

58. Which is why the ACA has waivers and Vermont passed single payer?

Is this crazy land?

The insurance exchange idea was to keep insurance alive and let it compete with non-profit or fully socialized medicine. It's a typically American approach. "Let competition decide."

[BlindTiresias]

62. "Let competition decide"

Said the wild eyed John Galt, raising his gold plated S&W Model 586 and shooting single-payer in the kneecap.

"Let the competition decide..."

[joshcryer]

66. Unfortunately.

I wish we had candidates who would actually stand on an issue and fight for it but if there's a place they can let the markets work it out, they will find it. Al Gore comes to mind with his advocacy for offsets and cap and trade.

[BlindTiresias]

69. Spoiler:

Single payer will remain a marginal measure on a per-state basis and this localization will allow insurance companies to shift operations towards the least regulated states in order to evade regulations in a way not unlike what has been plaguing local economies for a few decades now in terms of gaining favor with businesses. Their success will be highly politicized and obfuscated and failures due to the localization magnified to prevent national measures.

[joshcryer]

72. They can't hurt the single payer states, though.

And other states will follow suit. It's like with gay marriage and marijuana legalization efforts. Once one state does it, others follow suit.

It's really the only way to go about it in America unless we had a strong party with a strong party leader and complete control of Congress. People forget FDR achieved so much because he really did have a lot of power, I mean a lot of power.

[BlindTiresias]

111. No, that is not guaranteed

Gay marriage doesn't threaten the wealthy, marijuana legalization is VERY mixed and the debate is still open regarding how likely legalization on a national level is and it only partially threatens some industries.

A national health care program threatens the rich very much and so widespread adoption is extremely questionable on a per state basis.

[joshcryer]

116. It's all about cost.

Marijuana legalization so far has not hurt Colorado, and in fact, it looks to be profiting Colorado. It's slightly too early to tell, but so far, the cost-benefit analysis is positive. As Obama said, it's no worse than alcohol, and I think Colorado is the bellweather.

Gay marriage doesn't threaten the wealthy, true, but the statement isn't simply about the 1%, it's about doing good as opposed to doing nothing. In that vein, actually, the largest insurer in the united states, is Keiser, which is a non-profit. It pays its CEO millions, but it's still a "non-profit." National health care reduces the overhead from 10% to 2% which absolutely threatens not only the for-profit but the non-profit health industries. Vermont will pave the way, because that extra 8% is untenable. It just isn't worth it.

[BlindTiresias]

118. And the insurance companies will fight it

If there was a serious monetary advantage as you say it would have happened by now, that it hasn't means the resistance is ideological and therefore resistant to cost-benefit analysis.

[joshcryer]

130. The fight is over.

If they were to sabotage the ACA it would've been to prevent a waiver. They failed to do that. Progress is one way and the lobbyists hands are tied.

[BlindTiresias]

142. Progress is one way? I don't understand

Societies can change in either direction over time.

Nothing in the ACA has to be sabotaged, it already places insurance companies in a comfortable position for the forseeable future.

[VanillaRhapsody]

77. WHAAAAATTTTT?????

Hillary Clinton.....the person that rallied for Healthcare reform during her husbands administration while she was First Lady? That Hillary Clinton?

amazing the stretch people will go to smear her.....if you are going to bash her....at least use a credible attack!

[merrily]

82. If enough Americans look as though they may rise up, that could change.

It's really too bad that so many, especially on the left, stayed home during Occupy.

[IronLionZion]

136. So when are you moving out of the country?

Giving up so easily?

[BlindTiresias]

141. Nothing wrong with leaving.

Most of us are descended from or are immigrants anyway.

[leftstreet]

5. DURec

[1StrongBlackMan]

6. Read the comments following the article ...

It'll give you a big reason why the decision to leave Cleveland was not that difficult.

[OhioChick]

7. Repubs dominate the comment section

However; Cleveland (Cuyahoga County) is a Democratic stronghold. The largest, bluest county in Ohio.

[1StrongBlackMan]

8. Yep ...

the Bluest county in Ohio; with some of the most racist working class folks in the country.

[Adam051188]

18. south bend shocked me that way just in passing through.

[merrily]

83. They usually do. It's orchestrated.

[Gormy Cuss]

12. The best possible outcome of ACA is that Obamacare becomes the gateway to single payer.

I don't hold out hope that it will happen soon but once people recognize the leap forward we made with ACA they'll be less likely to buy the bull about how horrid single payer systems are.

[Doctor_J]

21. How can a step AWAY from single payer be a "gateway to single payer"?

Unless you mean that's it is so godawful that people insist it be done away with. Try to think this through:

1. Single payer = no for-profit insurance companies
2. Obamacare = mandatory for-profit insurance companies for everyone

No possible gateway there, period.

[Gormy Cuss]

44. Because it seems to be changing some people's expectations on health care access and payments

The new protections under ACA have changed expectations on access to health care and has already started to change expectations. And knowing that you can not be declared uninsurable, for example, is huge.

[Marr]

100. That is just magical thinking.

The public was already extremely fed up with healthcare in this country and demanding change. That's why it was issue. Obamacare rescued the insurance industry; welding it into place with legislation, and attaching a nozel from it to the Treasury in the form of subsidies.

[Doctor_J]

133. people were fed up with big insurance, so the president made us all customers

Will be remembered as the biggest corporate coup ever

[RufusTFirefly]

145. Yup!

The President takes an idea that originated with Republicans and was first implemented by Mitt Romney and yet Democrats now become its biggest defenders. Makes perfect sense.

[Gormy Cuss]

137. No, magical thinking is believing that single payer would have happened when the ACA was passed.

As much as I dislike the mandated purchasing from private insurers, the ACA is[/] significantly better than doing nothing. Most people were unhappy with what we had before but far too many people were also afraid of single payer because of the socialized medicine propaganda and fear of 'big gubmint.'

What we have now is better access for many who were marginalized by the older model.

[Andy823]

14. And the best way too get a single payer system is

Get rid of the republicans in congress! Until we can reduce the number of republicans who will fight tooth and nail against a single payer system, things won't change. It's the reason we could not get it this time, republicans were against it, and even a enough dems were, so we would never have gotten it passed in congress. What we have now is the building block for such a system, and putting more democrats in congress while taking republicans out is the only way that is going to happen.

Sure some democrats who get elected might not vote for it, but we have a far better chance of getting it than if we allow republicans to gain seats, and if we don't get everyone out to vote there is a good chance that could happen.

I say vote in democrats, and if they don't do their job, vote them out in the next primary, and put in those who will do the job, but sitting out the elections in November will only hurt, not help. The only ones who get helped if we don't vote are the republicans, and we sure as hell don't need to help them.

[calimary]

16. Hey, that's the best way to get a LOT of good accomplished for the vast majority of Americans.

GET RID OF THE republi-CONS - not just in Congress, though. But EVERYWHERE. ESPECIALLY at the state level!!!!

[Andy823]

42. I agree

From the state level on up we need to change the players. Less republicans mean better chances to change things, on all levels. We have to unite and do it, and ignore the doom and gloomers who keep trying to convince us that democrats and republicans are all the same, because that's just plain BS!

[calimary]

139. Won't work, though, unless OUR SIDE GETS OUT AND VOTES!!!!!!!!

For Pete's Sake, WE have the numbers! The NUMBERS! They're on OUR side! All we have to do is GET UP OFF OUR APATHETIC ASSES AND START CARING, and GET OUT THERE AND VOTE!!!!!

Otherwise, we give it away to the enemy without even putting up a fight.

And for anyone who has morans to deal with "Oh, Both Parties Alike!" "They're All the SAAAAAAME...."

Just ask:

Who's trying to take away the right to vote? Since when do we have to make it harder to vote? Voting is a RIGHT! NOT a privilege!

Who's trying to take away women's rights?

Who claims they want small government but can't wait to shove the government into your doctors office examining room and up your vagina?

Who wants to get rid of all environmental regulations - screw the environment! Money's far more important.

Who doesn't believe in income equality and doesn't see the need to do anything about it?

Who wants to take your affordable health care away? Hell, who wants to take ALL your prospects for affordable health care away, or make sure they never happen if you live in a red state where they see no need to help you?

Who refuses to believe the FACT of climate change? Who's digging in their heels and denying it and refusing to deal with it? WHICH PARTY IS KILLING THIS PLANET????

Which party is that thinks kids should go ahead and start working as janitors in their schools?

Who's against workers getting a fair shake and a livable wage? WHICH side is fighting this?

Which side wants guns in every pot and guns in every garage and guns in every coffee shop and guns in every school and guns in every theater and guns in every mall and guns in every church and...?

Which side is more likely to oppose your access to medical marijuana (doesn't matter if you need it and can prove it helps)?

Which side always wants to help those who don't need any help, at the expense of those who do?

Which side is desperately fighting to turn back the clock on ALL the progress our society has made, and in denial of all the problems that still plague us?

Which party is in full denial about the evolving population statistics - as America turns more brown. It's a FACT, okay? Things CHANGE. You can't undo it. This ISN'T a whites-only country, regardless how much ONE of the political tribes wants it to be.

I could go on...

[Doctor_J]

22. There are a lot of Dems fighting tooth and nail against single-payer too

(See reply 19)

And you might recall that we had huge majorities in 2009-2010, and the result was mandatory for-profit insurance. Big Insurance owns the White House and big majorities in Congress.

[Andy823]

41. So tell me

Do you "really" think that we could have gotten a "single payer" plan through congress? I don't, but what we did get is the building blocks to continue on to a single payer system. And as I sated, yes there will be some democrats that might fight this, but the more democrats we elect, the more republicans we replace, the more likely that the numbers will be on our side to get a single payer bill passed.

If the idea that pushing a single payer from 2009-2010 would have gotten us anywhere is completely wrong. All it would have gotten us would have been the same system we had for years. Sure the ACA needs some fixing, but the path to what you and so many of us really want. Doing the my way, single payer, or the highway scenario would have gotten us nothing at all to build on.

[merrily]

84. Been there, done that, in 2006 and 2008, esp. 2008.

If you think you are going to see a Dem in the Oval Office plus 60 in the Dem Caucus and an overwhelming Dem majority in the House, all at the same time, again any time soon, you are mistaken.

The New Deal coalition allowed things like that, because the New Deal was a bloodless revolution. But, a great deal of the New Deal been dismantled and they've been after Social Security for years. A great part of the Great Society is also gone.

2006 and 2008 were the result of people hoping for a drastic change from Bush, including ACA with a strong public option, increasing taxes on those earning over 250k a year, etc. 2010 was a signal that people did not get from Congress what they expected. Very unfortunately, that was a census year, and Republicans did a great (from their POV) job of gerrymandering.

[treestar]

156. +1

not voting for Democrats for Congress only means not getting single payer for a longer time.

[Fearless]

15. Agreed.

[daleanime]

23. K&R....

[HuckleB]

24. Single Payer is the end goal, no question about it. -eom-

[Enthusiast]

28. K&R! I would like to remind you....

I would like to remind you that U.S. health insurance companies do not contribute anything to health care. They are only a PARASITIC middle man taking a cut of "FREE MONEY".

Western European health care systems are far cheaper than the U.S. model. And they are more effective. The French health care system is one of the most expensive yet it comes in at less than 2/3s of the cost of that of the U.S.

The reason for this is profit. In the U.S. everyone along the line takes a profit cut. The health care service providers have to make a profit just as the insurance companies and the pharmaceutical companies.

This costs all of us. For one thing care is rationed to preserve profits for the insurance industry. And care is denied by the insurance industry.

This is why we desperately needed a strong public option in the new health care legislation. We needed a public option that could evolve into a system that did not include a parasitic insurance industry or for-profit health care services providers.

Before this can happen we have to remove money from the election and legislative process.

Well, you know what we are up against.

[Doctor_J]

33. The Middleman Multiplication and Profit Protection Act

That's what Krugman used to call it when it was Romneycare.

[BrotherIvan]

37. You're not clapping

[Enthusiast]

38. There is no justification for it.

Especially now that working people have had to take a pay cut. This Citizens United bullshit has got to go.

Corporations should have to demonstrate their worth to the general welfare or cease to exist.

[merrily]

85. The money is not going to be removed from the election process unless and until

both parties fear being ousted.

Even Udall's proposed amendment to the Constitution does not provide for that. It would only put things back where they were in 2008, when Obama collected half a billion dollars--not counting soft money--and Hillary got caught getting donations from China. IOW, McCain Feingold--totally voluntary on the part of the candidate. Obama broke his promise to be bound by it--and even McCain himself violated it (no prosecution just gave back the money).

[Enthusiast]

122. The American people must make it clear that we are sick of our democracy being co-opted.

I think most of us now recognize the central problem.

[merrily]

124. If the American people don't find a way to make that clear, the politicians won't guess we are sick

of it?

It is not a matter of us making anything clear to them. They KNOW.

It's a matter of us making it more uncomfortable for them to keep things they way that want than it is for them to change.

I don't think that will happen any time soon. For one thing, Americans don't seem to do that unless encouraged from the top, and that is not going to happen. For another thing, they are a lot better funded, armed and prepared than we are.

[Hoyt]

29. I'm for health care for all, but Medicare has some big issues, coverage gaps,

no out-of-pocket caps, insurers are still involved, etc. I doubt it will be cheaper without significant changes to entire system, including beneficiary expectations.

[Doctor_J]

32. Unlike our clusterfuck?

Medicare has some big issues

This, coming from a Heritage Care fan, is just hilarious. Really.

[justgamma]

35. As much as I wanted single payer,

Are you suggesting that Obamacare should never been passed? You know darn well single payer wouldn't get passed. So I guess we should have done nothing?

[Hoyt]

46. I'm saying Medicare is not much better, still have insurance companies involved, no cap on

out-of-pocket costs, partitial drug coverage, etc. Point is, most folks calling for Medicare better find out just how screwed up it is and ask for something better.

[DAMANgoldberg]

45. IMHO...

The best solution would be either Medicare or Medicaid for all, that covers the basics and life-threatening matters. You get it for be an American, period. If you want to speed the process, "jump the line", or something elective, then there is the private insurance market.

It is well known that preventive care and community based care will be much cheaper than acute / emergency room care that those of us without insurance utilize now.

http://www.rwjf.org/en/research-publications/find-rwjf-research/2009/09/prevention-and-value.html

At least here, the two hospital systems ('Green') and ('Blue') will only do what is medically necessary to keep you alive and then hound you for collections almost to the point of harassment.

My amendment to Medicaid would allow an generous allowance to a "Minute Clinic" type retail medical operation where you can see a Nurse Practitioner on site with a Doctor via Video Link to treat conditions closer to home and without the overhead of an ER. I.E. Co-pay of no more than $10.

[Laelth]

30. k&r for labor. n/t

-Laelth

[YOHABLO]

34. Let's fix medicare first. It is very limited and will only cover about 80% of medical costs.

What about eye care?
What about dental care?

[Enthusiast]

39. It would be doable if we could get a fair media.

People just have to start raising hell about the biased corporate protecting media.

The next step would be removing the influence of money from the election process.

If the people understood the advantages of a medicare for all system they would be all in.

As it is we are just paying armies of paper shufflers for nothing.

[Hoyt]

47. I agree. Folks think Medicare is the panacea.

It's a start, but not much more.

[SunSeeker]

63. I see Medicare for All as step 2. ACA was step 1.

Once we get everyone on medicare, we can make the changes needed. It will be the only game in town and doctors and hospitals will have to negotiate. That will bring costs down even more, thus freeing up enough money for 100% coverage, including dental and vision.

[Hoyt]

71. I hope so, but I think providers will strongly resist.

[SunSeeker]

74. Yes. Do you envision an interim step between ACA and Medicare For All?

Maybe dramatically expanding Medicaid? Then, when the vast majority of people are either on Medicaid or Medicare, combine them to create a Medicare for All.

Seems to me all this has to be done in steps, otherwise the resistance from the medical establishment and insurers is too much, as you note.

Regardless, the ACA is a good first step.

[Hoyt]

86. I agree about the ACA for sure. It would have been decades before anyone touched healthcare

if nothing had passed. Hillarycare, which was a pretty good plan, proves that.

[pampango]

36. Many want a National Health Service like in the UK. Single-payer is a step in that direction. n/t

[99Forever]

40. Personally...

... I'd even be fine with all health care workers being employees of the "evil" government. Decent health care in the richest nation on the face of the planet is a RIGHT, not a privilege reserved for those who can afford it.

I've got "insurance" via MNsure because of the ACA, which would help if I have a catastrophic event or illness, but with the $6000 deductible per year, I can't afford to use it. I might as well be burning the $245 a month premiums for all the good it's doing me. What a fucking racket.

[DavidDvorkin]

43. Yes, sure, absolutely, but how is this at all politically possible?

[MFrohike]

56. Easy answer, hard execution

Agitate loud and strong enough that the elected can't ignore you. Create the demand among the electorate and the politicians will break their necks in the race to create a single payer system. Rely on the politicians to do the job and you get what we've got.

It's a non-specific answer. Sorry, but it's a concise statement of what to do and I figured that was enough.

Edit: Treat politicians like employees on permanent probation. Don't make excuses for them and don't defend them when they get it wrong. Get rid of them and repeat the process until the new batch gets the message. That is the most basic element of democratic theory that exists.

[BlindTiresias]

60. Not according to some here

Politicians are to be vigorously defended against the slightest criticism and dissidents mercilessly purged.

Don't like it? Then vote for different people!

Criticize the new person for not promoting the interests of their base? BURN THE DISSIDENT!

Don't like it? Then vote for different people!

Criticize the new person for not promoting the interests of their base? BURN THE DISSIDENT!

etc etc

Another one: Yeah you disagree but there is an election coming up so shut up.

Don't like it? Then vote for different people!

Yeah you disagree but there is an election coming up so shut up.

Don't like it? Then vote for different people!

[MFrohike]

70. It's too emotional

It's like emotional religion, all caught up in the moment of the experience and not in the ultimate point of it. You end up running into the trees because you're too hyped up to even recognize a forest.

I distrust zealots of any stripe.

[Ron Green]

48. State by State. That's how it's gonna happen.

Please support your state's "Health Care for ALL" organization. Or send money now to mvhca.org.

[liberal_at_heart]

53. We must take profit out of healthcare. We must have single payer.

[BlindTiresias]

61. Incrementalism is a magic incantation

It always means moving in a progressive direction, and works bit like summoning a djinn or goetic demon.

No! You didn't close the magic circle! Now the malevolent spirit of Ayn Rand will intrude on the legislative ritual and push the incrementalism towards more mandates favoring private companies!

[kickysnana]

75. Many not in labor do too. n/t

[cer7711]

76. Without Single-payer, We Will Never Be the Social/Competitive Business Equal of Europe

Never.

You'd think enlightened, pragmatic business and labor interests in this country would make common cause on this issue, wouldn't you?

Labor is willing but the Koch-sucking Chamber of Commerce types would rather cut off their entire heads to spite their proletarian noses.

[merrily]

78. SOME in labor want single payer? Anyone who does NOT want single payer is misinformed or evil.

And my comment is not confined to labor.

[PATRICK]

121. Some unions run own insurance plans

and the bigger they are the less fire in the belly for single payer. Why on earth each of the three postal unions wasted the common sense opportunity to at least pool and combine their health plans is not beyond imagining. You can see why Labor backing of single payer is a bit tepid or compromised. Campaign finance reform is also a two edged sword. Being on the losing side in all these tainted systems means, theoretically, reforming away the current investments are preferable.

[merrily]

123. Good points. Self interest trumps again.

Postal unions had other fires to try to put out, so I wouldn't single them out.

What campaign finance reform are you referring to? McCain Feingold? Citizens' United?

But, while we're on the subject of campaign finance laws, I always wondered: How come the feds prosecuted John Edwards, who did not violate campaign finance laws, while McCain, who admitted to violating McCain Feingold (ironically), got to avoid prosecution entirely by supposedly paying the government the extra money he spent?

[PATRICK]

131. I take it the last question is rhetorical

Any punished politico or corporate criminal is usually one who does not play well in the system or with the right pals. There does not seem to be a rule of law in America. It seems more like a money game.

Unions would love to see the influence of corporate donations cease, supposedly even if they had to give up theirs. That is generally what I meant by real reform.Their own major strength in the past was boots on the ground.

What defines money corruption and the political game does not leave unions unaffected if they try to play the game legally. Supposedly if all the little guys, even the big money guys shoved aside by the few, pooled resources- even in the worsening money divide- they could beat the game designed for the few. Maybe. Then the few could always take more ruthless options more often.

[merrily]

132. "I take it the last question is rhetorical"

Let me put it this way: I do have a theory and dissuading me would require a degree of proof that no one posting here is likely to be able to provide. And no one with the proof is likely to be forthcoming with it anywhere, least of all this message board.

But, the question is not entirely rhetorical. Is the question "Does God exist" ever entirely merely rhetorical?

It seems more like a money game.

Neither McCain nor Edwards was poor, though. Granted, Mrs. McCain was probably richer than John Edwards, but I don't think the difference in their treatment had to do with money. At least, not directly.

Unions would love to see the influence of corporate donations cease, supposedly even if they had to give up theirs.

Maybe. Maybe they would prefer that their donations actually buy things they want their donations to buy, like EFCA. (Too late now, I think, given recent Supreme Court decisions on closely related subjects._

[Babel_17]

125. The cynic in me

The cynic in me thinks that the insurance agencies provides a benefit to the powers that be. They are there to say "no" and "these are the limits". With single payer, the "no" from your insurance provider sounds a lot like it's coming from the person you can vote out of office.

I think we need to get people to see the rightness of demanding Medicare for all. I think that goal recognizes the political reality on the ground, and it deals with how the electorate is changing. I see even a partial victory, lowering the age to 55, creating a tremendous momentum towards a more progressive system.

[DrBulldog]

138. You really want single payer?

Then two simple things have to happen:

1. Young white women need to get off their lazy asses and VOTE!

2. Ignorant Republican women need to wake up and grow up.

See? Easy-peesy.

[whereisjustice]

144. ACA improved quality of insurance, not the cost or quality of care

[hifiguy]

147. The last sentence repeats something

that the husband of a former colleage - he was a Republican doctor from a long line of Republican doctors - said to me. Lower fees would more than be made back by increased efficiency. He also told me it would lead to a higher quality of medical practice. Which is readily apparent to anyone with a functioning cerebral cortex. Middlemen add nothing but expense and inefficiency wherever they appear.

[Kablooie]

148. Health insurance is an 800 billion dollar industry and would suddenly be eliminated.

It would cause economic chaos to suddenly eliminate all those jobs and companies.
This is not something that can be done simply by decreeing single payer the law of the land.
There would have to be some kind of transition planned so all the insurance workers would not be sunddenly thrown out onto of the street. (Along with the CEOs and lobbiests.)
It's a more complex problem than some would lead you to believe.

[Romulox]

150. So...we can't have universal healthcare because it cuts into private corporations' profits.

Disgusting.

[Kablooie]

154. Not quite what I said.

My point is that it's not as simple as simply passing the law and you're done.
There are ramifications that would affect many people's livelihoods and therefore the economy in general.
All those effects must be taken into consideration before a law could be passed, assuming we had a majority in Congress that thought universal healthcare was a worthwhile goal.

While the Republicans hold so much power there's not a chance of anything happening but there may come a time when people see what the GOP really stands for and hand the reins over to Democrats. That's how the ACA became law, during the short time that Democrats dominated the whole Congress and if it happens again we may see more progress.