Hillary's right. Bernie's specific version of Medicare for All has no chance of passing.

[pnwmom]

It's an extremely complicated plan with sketchy numbers. However, that doesn't mean another single-payer plan could never pass.

For example, instead of making massive changes to Medicare, and pretending it's the same program, we could simply lower the age for the existing Medicare program, step by step. And retain Medicaid for the people who need it.

Another possibility would be to amend the ACA to include a Public Option, as one of the choices on the exchanges. As more and more people opted for it, we could eventually reach the tipping point, where the country would decide that the public option should become the country's universal healthcare plan. Just as we finally reached the tipping point on gay marriage, we could achieve single-payer healthcare by starting one state at a time.

Neither of these plans would be done and finished in a year or two. They would take time. But they could both be achievable, unlike Bernie's pie in the sky plan. And they would build on what we have now, not replace it.

The ACA was a huge achievement for President Obama, after decades of failing to pass any kind of universal health insurance plan. We shouldn't be joining the voices claiming that it's a failure and calling for its repeal -- we should be talking about steady, incremental changes that can make it even better. This is why I support Hillary's healthcare policy. If we convince the voters that the Democrat's ACA was a failure, why would they ever trust us to develop another healthcare plan?

[Thinkingabout]

1. He has already sponsored a bill in Congress for the Medicare for all, he knows the result was it did

not make it out of Committee to get to the floor for a vote. When he talks about Medicare for all he does not include this fact. Medicare is still improving over the years, ACA will also be improving, I don't understand why Sanders is keeping his feet stuck in cement and not progressing into the twenty first century. He wants to reinstate Glass Stegall, it is time to move forward and this is where Hillary will take us. We need a honest candidate like Hillary and not one who says whatever a candidate needs to say to pander to voters.

[pandr32]

3. But-but...

He has been the same for decades! He never changes and is steadfast!
His supporters somehow twist his single-minded, resistant to reality, stubborn streak into a virtue.
He is "progressive" and "ahead of his time" don't ya know?!!!

[pnwmom]

9. Young people often like their grandparents more than their parents.

I think some of it's as simple as that.

He's the cool grandpa.

But to me he's the grump down the street who's always certain he knows better than anyone else.

[Hoyt]

2. I believe a Public Option for ACA will be easier to enact and will get us very

close to single payer if that option is good enough. A straight up attempt at single payer will be not get enacted anytime soon. With today's Congress, improvements to ACA are only thing possible - - more subsidies for poor, reduced out-of-pocket costs, public option, etc.

[Thinkingabout]

4. One of the problems with Medicare for all is many doctors are not taking Medicare because of the

pay structure.

[jmowreader]

21. With ANY Congress, improvements to ACA are the only thing possible

Every Member of Congress, regardless of how good he is, is very interested in REMAINING a Member of Congress. Fucking with people's health care - ESPECIALLY that of the senior citizens who vote in droves - is a good way to no longer be a Member of Congress come the next election.

[Hoyt]

22. Exactly.

[ismnotwasm]

5. Of course it won't

It's bizarre that anyone thinks it could. Hillary has far more experience in crafting health care legislation. I remember back in the day, one of republicans criticism of her plan was that it was too bulky and no one could read it.

I can tell you as a nurse, that nursing leaders are very aware of the ACA--it's a great opportunity for nurses, and we also see where it needs to grow, needs to improve.

Why is the ACA good for RN's? Because it opened a doorway for vastly improved participatory power in health care. There are not enough primary care physicians to step into gap of the newly insured, and nursing leaders are pushing hard to get Nurse practitioners ready to step into the PCP role. We are doing this by pushing for higher education for all nurses, trying to expand prescriptive powers in more states, having more and more nurses step into difficult to cover rolls (such as psych)

There is a expected shortage of both nurses and physician coming up in the next decade or so, any congress passing any healthcare plan or policy will need to work closely with the medical community, as well as the nursing community--as president Obama did, to describe a plan that works. To toss away the gains of the ACA, to even think about it, is bloody ridiculous and merely exposes the ignorance or arrogance of the opinion. As you have pointed out, building on what we have is very workable. I can tell you nurses all over the country are quietly getting ready for it.

[pnwmom]

6. Why do you think that Nurses union voted for Bernie? Was it because of

issues other than single-payer? I recently learned that there is another nurses union, the American Nurses Association, that hasn't endorsed yet. I wonder what they will decide.

P.S. I love nurse practitioners. They are so thorough and they take the time to do it right.

[ismnotwasm]

7. That's my 'mother' union--the ANA

I keep waiting for them to endorse Hillary. They did in 2008. The SEIU, which covers thousands of nurses HAS endorsed Hillary.

Here is the endorsement process

http://www.nursingworld.org/DocumentVault/GOVA/ANAforHillary/ANAPresidentialEndorsementProcess.html

And yes, single payer is why I'd imagine the Nurses Union endorsed Sanders, their couldn't be any other reason. I think it's beyond shortsighted

[jmowreader]

23. It's a different union, not the ANA

The union that endorsed Bernie is National Nurses United, which was founded in December 2009.

According to https://en.wikipedia.org/wiki/National_Nurses_United,

In 2011, NNU launched a campaign called the Main Street Contract for the American People. The national organization is working to create a movement – through demonstrations and legislative bills—that helps working-class people who are struggling during hard economic times. The campaign goal is to reclaim an economy with good jobs at living wages, healthcare for all, quality education, good housing, protection from hunger, a safe environment, and a secure retirement for everyone.

NNU supports a Wall Street tax on financial transactions, which the organization says could raise at least $350 billion a year.[5]

...which makes me believe this is more of a Sanders front group than a legitimate nursing union.

[yallerdawg]

8. Isn't one of the powerful goals of the American Medical Association...

to control, restrict and ration the quantity of "approved medical practitioners" so 'doctors' demand the highest incomes possible by controlling the supply?

If 'doctors' won't work for Medicare payments, the solution is medical practitioners who will!

[ismnotwasm]

10. Exactly

One of the things that is happening--although I am not sure of the overall effect, Is that physicians are burning out. A portion say they would not choose the course of residency and medical school again. This isn't tied to the ACA, as the RW would have you believe, but more of a soul sickness, trying to make a living while dealing with payments and regulations and pharmaceutical companies and insurances and the strict electronic charting that is required. Surgeons are still making gravy, but for your PCP, not so much although they make more that most in many cases.

I know many fine physicians.

There is feminist thought on this I won't get into, and had less to do with the perceived 'nurturing' aspect of women-- they are far and away the still larger majority of nurses, (although med schools are now at gender parity, and they're are more male nurses than ever) and more to do with power, and the proper application of power. Nursing, as a profession, is very good at the proper application of power. Nurses understand why preventative medicine and preventative intervention is so very crucial in order to save lives, and we've known this for a very long time. This is another reason nursing leaders are preparing to jump into that fast approaching power gap. Nurses save lives, not so much by dramatic TV show -like intervention, but in a thousand small ways, in listening, teaching, in making appropriate care plans for the appropriate situation. All the health care in the world won't help, if these crucial teaching and preventative care aspects aren't strongly emphasized.

[yallerdawg]

12. Feminism and power.

You know there is a lot going on here!

I was watching a show where a 'doctor' addressed every female as "Nurse."

I it: "I'm a doctor saving lives! There is no time to learn or even ask the names of the people I work with!"

What other 'profession' would tolerate not being known by your name?

[ismnotwasm]

13. Oh yeah

Although it's better than it use to be. Only a few doctors get to call me "my nurse" and only when they need me for back up!

The dynamic is already changing, although it will be a couple of decades at least to accomplish what nursing leaders are pushing. The health care provider shortage is another reason we can't have instant single payer--if it was passed tomorrow, there are simply not enough providers--Pure and simple. Sanders does NOT have the reputation of being a guy you want to work with in congress. I'm not sure he would consult with-or listen to-the best informed people when he pushes any kind of health care reform.

[yallerdawg]

15. He's already not listening to...

and challenging a woman!

Not a good start!

[ismnotwasm]

16. Heh!

[Politicub]

20. Great perspective- I haven't heard that angle

There's so much good about the ACA. Far more than the black/white binary thinking that so many people practice on DU these days.

[George II]

11. It won't even make it out of committee. In fact, he'd be hard pressed to find a Democratic.....

....Representative or Senator to sponsor it.

[ismnotwasm]

14. This is a fact

I don't know how people are fooled into thinking a rough outline is a comprehensive plan, it would be sent back again and again

[Ana Hauhet]

17. not many Senators or Representatives endorsing him

Maybe that's why! they know the process and they know him.

[yallerdawg]

18. The emoprogs argue we have lost our ideals.

We are 'jaded.'

You know who jaded me? Nixon, Ford, Reagan, Bush, Bush 2,0.

I never want to be 'jaded' again.

[jmowreader]

24. Actually, we've embraced reality

I'll be blunt: Sanders' healthcare plan is shocking in its audacity. I don't know of a civilian healthcare plan that is as good as the one Sanders wants. The VA sure as hell isn't. No deductibles? No co-pays? Dental and prescription coverage included with no deductibles or co-pays? And all we have to do is just raise taxes on the rich a little? I've said previously I think Bernie's plan will cost twice what he thinks...let's change that a little; "twice" is probably REAL cheap. Five to ten times Sanders' back-of-the-envelope estimate is probably closer to the truth.

The ideal plan is Public Option. People like choosing their own health plans. With Public Option, they could buy in the open market or the public-option market. Unfortunately, that's not what Sanders' supporters want, so speaking of it is anathema.

[ismnotwasm]

25. It is not shocking, it's unworkable within the current health care system we have

'Paying for healthcare" is just one part of it. Who do you pay, how much and under what circumstances? What about government "bundling" reimbursement does that stay the same, or does it need an overhaul. What of preventative health? What about end of life care? What about end stage renal disease, currently the only chronic disease covered by Medicare to 80%? What about durable medicine equipment, barely covered by many insurances now? How will we control prescription costs? Surgical costs, physical therapy, occupational therapy, speech therapy?

"Tax the rich" are you talking about the Robin Hood tax, the one where costs will be observed by the middle class, or the proposed taxes on portions of Wall Street profits, where the basic arithmetic says it isn't enough to cover costs? (On edit, I see you addressed that)

Who is going to provide the healthcare?

There is currently no purposed plan that will be single payer within reach in the current congressional environment. When George said "it won't make it out of committee" he was talking about a political process. We don't get to jump over political processes. They happen.

[jmowreader]

26. Oh, trust me: It's shocking.

NOTHING about health care delivery, in this or any other country, is simple.

I can see places where efficiency could be improved - why does Blue Cross and Blue Shield have a different billing procedure than Aetna or Mail Handlers? A centralized medical records database would be okay IF they could make it secure...y'know, we spend billions every year funding the National Security Agency and they have excellent cryptographers; why the hell can't we get them to produce something secure enough to make Grandma happy?

But seriously...single-payer? The Canadian system rations care and doesn't cover pharmaceuticals - which, for seniors and the chronically ill, can be the biggest part of their total healthcare bill - or dental. The British system is an agency of the federal government and has co-pays for meds and dental. Most of the rest of the world is on a system that's some variation of Obamacare. The only possible way I see Sanderscare working on a fiscal basis is if employers are required to send the same amount of money to the government that they're now sending to their health benefit providers...which would, understandably, cause every Republican in America to die of simultaneous heart attack and head explosion. This would be a very bad thing so let's not even wish for it.

I also want to know how Sanders plans to make sure people don't just export their stock trading to foreign countries.

[Politicub]

19. Abandoning the ACA is perhaps the top reason why Bernie doesn't have my support

It isn't perfect, but it's working for me and my family. The idea that we should go down a new path -- some ambiguous medicare for all scheme -- belies all of the hard work that went into getting the ACA passed.

Bernie is good with great sounding proposals, but he's thin on the details. As they say, the devil is always in the details. Especially for policy proposals.