Sanders, Clinton, and the Big Lie of the “Possible”

[eridani]

https://newrepublic.com/article/128464/sanders-clinton-big-lie-possible

From two demonstration projects, community health centers have grown to 1,300 networks in 9,200 locations, serving 23 million patients in 2014. As the National Association of Community Health Centers puts it, “In communities fortunate enough to have a health center, fewer babies die, emergency room lines are shorter and people live longer, healthier lives.”

And why do community health centers represent such a robust part of the health safety net today? Bernie Sanders.

In a well-known incident confirmed this week by Tierney Sneed at Talking Points Memo, Sanders made community health centers his cause in the Affordable Care Act debate, ultimately securing $11 billion in mandatory funding—instantly doubling the appropriation, which was previously made only through the discretionary budget. The number of patients served jumped from around 10 million in 2000 to today’s 23 million.

The way Sanders made this happen demonstrates how pushing big ideas outside the bounds of the possible can lead to tangible results, in ways that cautious centrism cannot.

The Affordable Care Act process, at least in the Senate, involved individual senators carrying certain pieces of the bill. Those senators could use the leverage afforded them by the razor-thin margins required for passage to force their favored items into the final product. Some used this power for ill (see Joe Lieberman scotching the Medicare buy-in), some for parochial needs (like Chris Dodd getting a grant for a medical school in Connecticut). But others insisted upon what became fairly vital pieces of the ACA’s infrastructure. Al Franken was synonymous with the medical loss ratio, mandating that insurance companies spend a fixed amount on actual care rather than overhead or executive salaries. And Bernie Sanders made increased community health center funding the condition for his vote.