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Ongoing Dem Debacle Thread: Commander will kill us all

ChrisL68 said:
Something that polls in the mid 50s in the abstract but drops considerably when you explain how it would actually be enacted is "immensely popular"?
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I guess we have different senses of humor. Why don’t Ph’s posts amuse you?
 
Ongoing Dem Debacle Thread: Salty

DeaconSig said:
Polling indicates that people like "Medicare 4 All." Polling indicates people do not like the idea of giving up their own insurance plans, given about 70% of the population likes their current insurance plan.

Democrats in general and candidates specifically can start the process of trying to convince the voting public that doing away with all or substantially all of private health insurance is a good thing, but I don't know that a majority of the country believes that now.
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I agree with this. It’s why I am not surprised that the public likes the idea of M4A and the Democratic establishment appears to be nowhere close to adopting it as a core item on its agenda.

ETA: rent control, to name another example, works similarly as a polling vs policy issue
 
"the Democratic establishment appears to be nowhere close to adopting it as a core item on its agenda."

Every candidate has voiced their support for it, specifically Bernie's plan. How is that "nowhere close?" Keep in mind, this was a fringe idea only 3 years ago and there will be at least two more years until anything meaningful can happen on it. M4A has had a meteoric rise.

I think the fretting over M4A "rhetoric vs. policy" polls is silly and premature. It's a good problem to have compared to Obamacare where the actual policy was more popular than the name. It's a good starting point for Democrats. M4A policy points can be debated in good faith in the House, on the campaign trail, and in Dem debates. Clearly the public wants something new, but they are fearful of change. Dems can work with that.

Sig, Democrats didn't promote those benefits of ACA. Pelosi tried but all that got quoted from her speech was "we have to pass the bill so that you can find out what is in it" which ended up being true.
 
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PhDeac said:
"the Democratic establishment appears to be nowhere close to adopting it as a core item on its agenda."

Every candidate has voiced their support for it, specifically Bernie's plan. How is that "nowhere close?"

I think the fretting over M4A "rhetoric vs. policy" polls is silly and premature. It's a good problem to have compared to Obamacare where the actual policy was more popular than the name. It's a good starting point for Democrats. M4A policy points can be debated in good faith in the House, on the campaign trail, and in Dem debates. Clearly the public wants something new, but they are fearful of change. Dems can work with that.
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Read my posts, Ph. I see candidates appropriating the rhetoric, but there is ample evidence that the meanings of M4A beyond sloganeering varies a ton. Look at Booker, for instance. He supposedly supports M4A, but already has wavered on what that actually means in terms of policy. Again, M4A is really popular as a polling issue, but like tilt and Wendell Primus make pretty clear, it’s nowhere near as popular as a tangible policy issue.
 
Strickland33 said:
Read my posts, Ph. I see candidates appropriating the rhetoric, but there is ample evidence that the meanings of M4A beyond sloganeering varies a ton. Look at Booker, for instance. He supposedly supports M4A, but already has wavered on what that actually means in terms of policy. Again, M4A is really popular as a polling issue, but like tilt and Wendell Primus make pretty clear, it’s nowhere near as popular as a tangible policy issue.
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You see that as a problem. I see that as promise. M4A is becoming a litmus test for a party that is quickly moving to the left. If the Cory Bookers of the party feel like they have to express support for M4A, that's a very good place to be. M4A is on it's way to being like pro-choice or support for gay marriage which were at one point dividing lines within the party and rather quickly became mandatory.
 
tiltdeac said:
If you look back at my posts, I think you'll see that I've tried to engage with you and MDH in good faith and will continue to do so, accusations aside.

M4A is *not* a Democratic policy goal. The policy goal is (and should be) affordable universal health care. M4A is one particular policy to achieve that, and it has been endorsed by some Democrats (though many of them have endorsed multiple pieces of possible health care legislation across the universal health care spectrum, and it's not clear to me they understand exactly what M4A would mean). We can have a separate discussion about M4A the policy. I'm personally not sure it's the right approach, it's to the left of essentially the entire world, and is very unpopular with the public once explained in any detail. But again, that's a separate discussion (we should probably have 1 or more threads about policy ideas, I'd enjoy hearing and learning about the ideas people have on here).

I wouldn't think it surprising that the Speaker of the House and the PhD economist who are representing her, both of whom were architects of the ACA, continue to support strengthening the program. I also wouldn't think it surprising that they would try to court the powerful insurance lobby to help with what is in this case a shared goal, trying to decrease drug costs. I think the purpose of the discussion of M4A and its potential difficulties is to try to keep them at the table (and I doubt any real promises were made) by (correctly) stating that there are ways to obtain universal health care that still involve the insurance industry (like most of the world does).

I do get that it can feel a little gross to see interactions between dem leadership and the insurance industry, especially if you see them as partially responsible for the past and current state of health care in this country. And if your position is that no dem should be working with *any* corporate interest, fine, I guess. But I think acting as if this is some betrayal of the party, or collusion again dem presidential candidates, just seems silly to me. Clearly some dems will still push for and support M4A regardless of what the Speaker thinks and that's great! I hope there is robust debate of lots of different plans to achieve universal coverage, and we can come up with the best one in the end. But in the mean time, I just don't think it's a big deal to take a stab at pitting the insurance industry against the drug companies to help drive down prices while we wait.
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It's difficult for me to understand how multiple presidential candidates and popular congressmen can openly support M4A by name, and yet you say its not a policy goal. That argument reads more as projection than interpretation.

Of course healthcare cost and access needs to be improved, in the meantime, because there are major road blocks before any major legislation like M4A could ever be passed - retaking the Senate or killing the filibuster, defeating the insurance industry.

As realistic as it is to recognize that healthcare progress towards universal coverage moves gradually, it's just as realistic to recognize that that gradualism is due to the heavily subsidized, for-profit insurance industry being an oppositional force to that progress.

Pelosi's advisor wasnt telling the BCBS execs new information, and you know that. BCBS is well aware of the difficulties of pursuing M4A, what they actually need from Pelosi is reassurance of her political support. Specifically, support in obstructing political movement toward M4A.
 
PhDeac said:
All the M4A polls I’ve seen indicate the center wants it. It’s just a question of how. What polling are you basing things on?
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Here's one example, but there are lots. When most people hear Medicare for All, they assume an expansion of Medicare. Something like a buy-in, or the ability of people without insurance to then get put on Medicare. It's a really effective idea and a great slogan. And in a vaccuum, it polls great, with the center and even some republicans. The problem is, that is *NOTHING* like what M4A actually is. M4A creates an entirely new health care plan (that is very different from actual, current Medicare) and eliminates employer sponsored insurance entirely, among other things. When people hear that, it becomes much less popular.


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It's easy to ask politicians about Medicare for all, but even when they answer, it's not entirely clear what they mean. Shamelessly stolen from Larry Levitt (doesn't someone on here know him?), the right questions to ask candidates about the health policy they support (regardless of its name) are something like the following:
Is everyone covered?
Would a plan be required or voluntary?
How is it financed?
Is there patient cost-sharing?
Do insurers have a role?
Are health care prices regulated?
 
PhDeac said:
All the M4A polls I’ve seen indicate the center wants it. It’s just a question of how. What polling are you basing things on?
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The center (and most folks) don't understand M4A. Most folks, at this point, do want HC reform, meaning real access to affordable and good healthcare that won't bankrupt or overburden consumers/patients. It's the damn politics that have hampered our ability to get there. The ACA was a decent effort and could have worked as a mechanism to get there over time if Pubs hadn't decided from the get go to lie about it and demonize it/Obama. Until something like a version of M4A can get passed (not happening in next two years for sure), trying to improve the ACA (also highly difficult but maybe more possible) is reasonable.

I'm pretty sure whatever version of M4A we may end up with will likely involve private insurance companies.
 
Y'all do realize that a lot of people were giant losers with ACA? If by some magic you did get enough votes to barely push through m4a as envisioned by progressives it would be that level of disruption times 50.
 
How could private health insurance even compete with a public option medicare, without being heavily subsidized? This notion that people want to keep their plan assumes their plan, as is, could even still exist. Here we are trying to be pragmatic realists, and the Health Insurance remainers still believe they can keep their employer provided cadillac plans? We have to face facts that these systems wont be able to coexist. Just polling people "Do you like your plan, do you want to keep it" is a joke. Do those being polled have any idea how the alternative coverage would compare to their current insurance?

I doubt anyone in the country truly prefers paying at point of care, having a deductible, having a coverage gap, or having to stay in network. So what is it that they prefer about their insurance?
 
ChrisL68 said:
Y'all do realize that a lot of people were giant losers with ACA? If by some magic you did get enough votes to barely push through m4a as envisioned by progressives it would be that level of disruption times 50.
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Because health insurance companies shifted costs directly to the middle class by raising rates and tightening coverage. The tax burden of M4A is necessarily and obviously much more progressive, not to mention the extreme rebalance of health care costs once the federal government becomes the only negotiator with providers and pharma.
 
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ChrisL68 said:
Y'all do realize that a lot of people were giant losers with ACA? If by some magic you did get enough votes to barely push through m4a as envisioned by progressives it would be that level of disruption times 50.
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Even the losers will have universal health care coverage.
 
Y'all realize the same people heard similar type pie-in-the-sky arguments about ACA?
 
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People are afraid of change. That's one thing Pubs tap into.

They also are afraid of being told, especially by the "government" what they can or can't do or have wrt healthcare (including insurance).

Dems and any well-intentioned folks need to spend the next two years educating the public as best they can about how all this works and what trade offs can be reasonable. Emphasis needs to be on the benefits of universal coverage, limits to consumer costs, etc. Some degree of "choice" will likely have to be preserved.

Decoupling health insurance from employment would be a HUGE boon to most folks. So talk about how that can be done and how it would help.
 
ChrisL68 said:
Y'all realize the same people heard similar type pie-in-the-sky arguments about ACA?
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In the UK they call it the NHS, its neither "Pie in the sky" or a "pony promise", and the largest obstacle for us implementing that same type of system is the damn health insurance industry.
 
People fear change because they've seen how implementing change can be very disruptive for their current economic situation and they realize that the massive benefits that people who propose something promise versus what they can actually deliver can be drastically different. It isn't just some irrational belief system.
 
myDeaconmyhand said:
In the UK they call it the NHS, its neither "Pie in the sky" or a "pony promise", and the largest obstacle for us implementing that same type of system is the damn health insurance industry.
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The UK instituted socialized medicine in 1948 when the complexity and cost of doing so little bit different than it would be today. Plus I wouldn't be transitioning from a completely employer-based system primarily to that. Apples and oranges.
 
Well, the fear of change is both rational and not, for most folks probably.

They also fear that "others" will reap (more of) the benefits that they will be among those paying for. So it has to be explained how the benefits are widespread and societal. And the costs bearable. Carefully, honestly, and hopefully successfully.
 
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