Question for Hillary supporters re the future of single payer health care.

[Bonobo]

Bernie Sanders has come out and said, quite pointedly and rationally, that the US must join the rest of the industrialized world in giving its citizens a single payer health care system.

He points out that even with the ACA, the US has 35 million uninsured or underinsured and that our per capita health care costs are over twice that of other countries that have better health outcomes.

When we talk about a war on women, a war on minorities, we must also talk about out lack of health care rights for our citizens.

So my question for Hillary supporters is this:

If, as you say, ACA is an INCREMENTAL step towards single payer health care, then what is the next step? Because frankly I do not see it. What I DO see is that the Democrats have blown their entire load with the ACA and, as predicted, it is being called socialist medicine (a label that would be applied to an actual socialized medicine plan) despite it actually being actually a giveaway to the private for-profit healthcare industry.

Having already expended all our will and capital on ACA, my belief is that we have actually had efforts at joining the rest of the world harmed rather than helped.

So... again, what is the next step, Hillary supporters? Because I say it is time for a full-on press and I do think it is possible but ONLY if the center and right wing side of the Democratic party STOPS saying it can't be done.

[Agschmid]

1. I disagree that we have given away our political will...

Just look at the SCOTUS opinions and reactions to those this week.

And I think most of us here on DU, supporting both candidates would like to see single payer... but it won't happen overnight.

[Bonobo]

2. Can you elaborate?

ACA has been defended, but now that it is even more codified (along with the resistance to it), how do we now "double down" and get what it is we really need?

[Agschmid]

3. Elect a congress that can make it happen.

Has little to do with who wins the White House as long as it's not a Republican.

[Bonobo]

5. It requires the kind of leadership and determination Obama showed with TPP.

So yes, it DOES matter who is in the White House.

[azmom]

43. Or when they bailed out their banker buddies.

Trillions of money at stake, and it took them, I'm not sure, a week?

[Agschmid]

4. If you stick the word...

Third Way, Oligarchy, or Neo-Liberal into your OP title you'll get more responses... or just have WillyT repost it.

[redstateblues]

6. Until we Dems GOTV in the mid terms and statehouse elections single payer is a pipe dream

It is discouraging that the Democratic base is so complacent about voting any other time except in the GE

[1StrongBlackMan]

7. As an undecided ...

I have to ask ... if the will and capital is spent ... how will/would Bernie make good.

You really didn't think the frame through ... did you?

[Cheese Sandwich]

8. Hillary backer Claire McCaskill even said on TV Bernie is too radical because "socialized medicine"

Scare quotes.

Very scary stuff.

Proving health care for people. Terrifying.

[bunnies]

31. Yep. Gubmint healthcare. Too extreme.

We wont get any of that scary extreme healthcare if Hillary has anything to do with it! She's got our backs. Yessiree.

[dsc]

9. As employers stop providiing insurance

and more people get it through the exchanges I think there will be states which decide on public options/ single payer. That is how Canada got theirs Provence by Provence.

[frazzled]

10. How did that work out in Vermont?

Right, it didn't. In 2011 they passed a law to establish the first single-payer "Medicare-for-all-type" health bill in the country as their form of executing the ACA in their state. And then they completely abandoned it late last year, claiming inability to pay for it.

As Senator Sanders well knows (unless he hasn't told us something, or hasn't passed on the secret to his fellow Vermonters), saying something is a lot harder than doing it, even when you have the political support.

When he brings this up in debate, I'm afraid he's going to have to have a good answer as to why his state was unable to accomplish it. It's a great idea, but the failure in Vermont--for whatever reasons--makes this not a strong topic for him.

[joshcryer]

11. There's an argument that Vermont could've done it...

...if the SCOTUS didn't shut down subsidies (and if states didn't shut down subsidies).

[Dawgs]

21. Vermont is a really bad example.

Australia, Sweden, France, UK, Netherlands, and Canada would be better.

[TheKentuckian]

44. Yup, couldn't afford to save the people of the state billions. Fucking brilliant!

The real reasons we can hardly move the needle in this country is stuck on stupid with a heaping side of greedy and another of pitical cowardice.
More often than not the greedy masquerading as such because that spoonful of sugar helps cognitive dissonance of the suckers.

[joshcryer]

12. As a single payer AND an ACA supporter AND not voting for Clinton...

...in the primary, I can answer it rather simply:

Start with the public option. It becomes the most affordable insurer because it has Medicaid/Medicare-like margins. Once you have much more affordable insurance you can offset the costs of subsidies (which would impact states without them because even in southern states, government programs do not shrink in scope). Once you offset the costs of subsidies you can cover everyone, then you can clean up the legislation to get you there because there's no substantive difference between paying a public insurer and Medicare for all.

Sanders would not be against this approach as he was one of the most outspoken supporters of the public option. He talks about single payer because unlike other candidates he doesn't waffle and sees the solution down the road.

Clinton will likely not even touch the public option. She's going to act as if ACA is good as is and will give shallow analysis about "improving it" (no specifics). (Though as a purely policy standpoint the public option simply isn't going to go away, whether Clinton campaigns on it specifically or not. It might not even be a big deal, passing as a rider on some other boring legislation, but it's a money saving move and it'll have to happen in 5-10 years; be it through states getting their own waivers or what.)

[LuvLoogie]

13. The next step? Easy....

Vote for Hillary.

[BlueMTexpat]

14. My understanding is that Hillary herself

was always more liberal than Bill on this and that she would have worked harder for a single payer system when she had the chance, if it had not been for Dem "conventional wisdom," e.g., Third Way of the time that basically strait-jacketed her efforts. I was around at the time. Both in DC and working in the federal government.

You know, this is at least the third attempted slur against Hillary that I have seen this morning and I am getting pretty sick of it. So cut it out! Please.

I am a Hillary supporter and I don't try to slander Bernie or Martin. I would appreciate it if so-called Democrats would quit attempting to slander my own candidate. GOPers will do the worst they can with any and all.

Let's stop that circular firing squad here. Please It's unworthy of those "Dems" who insist on doing it.

[jeff47]

37. Yes, a question about policy is totally a slur.

Could the question have been written more favorably towards Clinton? Yes. But fundamentally it is a policy question. So what's Clinton's policy?

[BlueMTexpat]

40. Why don't you ask her?

If you are really interested in knowing.

[TheKentuckian]

45. Most folks don't have that kind of money laying around to purchase noncommittal platitudes.

[annabanana]

41. At one point she was left of Obama.

That was when I was ok with either of the two of them for candidate. Sometimes I wonder if SHE could have bent lonesome Joe Lieberman to get the public option stuck into corner of the bill...

[BlueMTexpat]

47. Was that perhaps a typo?

Did you possibly mean to say "loathesome Joe Lieberman" - a description with which I can entirely agree?

[CTBlueboy]

15. Great Question

I guess will have to see where the wind blows you never with HRC [link:|

[NCTraveler]

16. By force.

http://www.democraticunderground.com/10026634558

[Bonobo]

17. That video, at a minimum, shows her to be a poor speaker on auto-pilot.

She KNOWS someone is being roughed up, but is so socially awkward and tone deaf that she literally has NO IDEA how to deal with it other than a kind of stoic determination to drudge onwards.

I have seen Obama deal with the exact same situation with an acknowledgement of what is going on and sometimes an admonition to the guards to stop roughing up someone.

She did not do that. She would not do that. Keep posting that video. It does not make her look good.

[NCTraveler]

19. That's right. Preach it Bonobo.

That's how she is going to get single payer through. By roughing them up. lol. My mind wouldn't let me make this shit up. I love it.

[Bonobo]

20. Umm, no, she WON'T get it through. Why?

She is not dedicated enough to the cause.

[NCTraveler]

24. I have always been a little jealous of the imagination of some.

Clearly with that answer, you believe someone can get it done in the next Presidency. Who and how? This should be creative and imaginative.

[Bonobo]

25. Yes, I'm sure.

I have some suggestions for how to kickstart your life if you're bored.

Just PM me!

[NCTraveler]

26. That's ok. You seem to have missed a question.

I'm not bored in any way. I am just in awe at the imagination of some.

[brooklynite]

18. Next step: add a Medicare option to the exchanges

Now that ACA is an established program, Medicare becomes simply an option; if it's successful, it's because people want it.

[Sancho]

22. Bernie's plan has no hope, but we can play along...

First, Hillary wanted universal health care a long time ago...

https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993

"Once in office, President Clinton quickly set up the Task Force on National Health Care Reform, headed by First Lady Hillary Rodham Clinton, to come up with a comprehensive plan to provide universal health care for all Americans, which was to be a cornerstone of the administration's first-term agenda. Clinton delivered a major health care speech to a joint session of Congress on September 22, 1993.[1] In that speech, Clinton explained the problem as follows:

Millions of Americans are just a pink slip away from losing their health insurance, and one serious illness away from losing all their savings. Millions more are locked into the jobs they have now just because they or someone in their family has once been sick and they have what is called the preexisting condition. And on any given day, over 37 million Americans—most of them working people and their little children—have no health insurance at all. And in spite of all this, our medical bills are growing at over twice the rate of inflation, and the United States spends over a third more of its income on health care than any other nation on Earth.

Hillary Rodham Clinton's leading role in this project was unprecedented for a presidential spouse.[2][3] This unusual decision by President Clinton to put his wife in charge of the project has been attributed to several factors, such as the President's desire to emphasize his personal commitment to the enterprise.[3]"

Hillary's "incremental steps" were already introduced when it became obvious that single-payer won't pass.

--------------

You must be aware that even liberal Vermont couldn't pass single-payer:

http://www.forbes.com/sites/theapothecary/2014/12/21/6-reasons-why-vermonts-single-payer-health-plan-was-doomed-from-the-start/

Six Reasons Why Vermont's Single-Payer Health Plan Was Doomed From The Start

Last week, Vermont Governor Peter Shumlin (D.) announced that he was pulling the plug on his four-year quest to impose single-payer, government-run health care on the residents of his state. “In my judgment,” said Shumlin at a press conference, “the potential economic disruption and risks would be too great to small businesses, working families, and the state’s economy.” The key reasons for Shumlin’s reversal are important to understand. They explain why the dream of single-payer health care in the U.S. is dead for the foreseeable future—but also why Obamacare will be difficult to repeal.

Leading left-wing economists worked on Vermont plan

Shumlin’s predecessor in Montpelier was a Republican, Jim Douglas. In 2009, Douglas announced that he would not be seeking a fifth two-year term; five Democrats joined the contest to replace him. Progressive activists demanded that each candidate promise to enact single-payer health care if nominated; all five complied. Shumlin got the nod, and assumed office in January 2011.

Shumlin got right to work. In Feburary 2011, a trio of health economists, including Harvard’s William Hsiao and MIT’s Jonathan Gruber, sent Vermont a 203-page report describing the feasibility, and the alleged virtues, of single-payer in the state. Gruber signed a $400,000 contract to work with Vermont on the project.

Hsiao has spent a good chunk of his career helping governments install single-payer systems; for example, he helped the Taiwanese government install “Medicare for all” in 1995. He’s also responsible for Medicare’s Byzantine price-control scheme known as the Resource-Based Relative Value System, or RBRVS.

[Bonobo]

23. Especially with traitors on our side who act like...

it is fringe left politics for citizens to expect health care in return for their taxes.

[Sancho]

27. Get single-payer in your state and then we'll talk...

we all agree "for-profit" health care in the US has been a mess. If Vermont can't get single-payer; no other state is ready.

Hillary has experience with the reality of trying to pass health care reform. It's not possible for Bernie to have a chance to pass something in the US anymore than his home state of Vermont.

It may be that over time, Medicare and Medicaid can be expanded to include more and more people. There's also some possibility that some state might set up a public state-wide plan (likely by contracting with a current insurance company) that essentially becomes equivalent to universal coverage. It will likely be a long time coming.

[Bonobo]

29. Why would you believe the US is not "ready" when most other countries have a functioning system

The wheel does not need to be invented again.


You are comparing apples to apple orchards.

[Sancho]

32. The US Congress and most state legislatures will not pass single-payer.

likely because of the history in the US of employer based health care insurance plans.

Even Democratically controlled states have not, so far, passed single-payer. Of course it could change. Right now, most Americans still look to employer-based plans, but the ACA is certainly making a difference for those who are not covered!

There are lots of other "sub-issues" like the LIP funding for hospitals, undocumented immigrants who work but under the table so they don't have health care from an employer OR a tax-return for ACA. Of course, that's only 20 million people or so.

Single-payer may be possible, but it would most likely be an expansion of Medicare or Medicaid to include anyone "not covered" in some other way. There's a remote possibility that a state would finally pass single-payer in some unknown date.

[99Forever]

39. Don't just love it when defeatist give up without even trying?

Obama taught them well.

[JoePhilly]

28. 1) Blue states will start to add public options to their exchanges.

2) As those begin and become successful, a debate will occur in Congress to add a PO to the federal exchanges.

3) If we've elected enough democrats to Congress, that will pass.

4) And a Democratic President will sign it. And ironically, the red states that opposed the ACA will all get POs.

5) The success of the POs will make it tougher for the insurance companies.

6) The PO becomes a single payer plan by default.

Now ... if you think the the steps are ...

1) Elect Bernie ... 2) Get Single Payer ...

.... you are being naive.

[Bonobo]

30. No one said electing Bernie would get it done.

But it WOULD require people that claim to be democrats stop acting like simpering wimps.

[JoePhilly]

33. So those are your "steps" to getting to Single Payer?????

You wanted steps, from a Hillary supporter, I provided them.

You however, don't seem to have much of an idea of how it would ACTUALLY happen.

[Bonobo]

34. What do you mean "those"? I didn't offer any.

So you are responding with shock and indignity at nothing.

[JoePhilly]

36. "Nothing" describes your plan for getting to Single payer.

You want Hillary supporters to tell you the steps to get there.

We have.

You clearly have no idea for how to get there, nor were you interested in direct responses to your OP.

As you correctly point out, "nothing" is what your OP is really about.

[Sheepshank]

38. seriously, a false OP since Hillary actually fought for socialized Health care 20+ years ago

and since you have been proven wrong YET AGAIN just today, you move the goal posts to suit you need to bash incessantly.

What a fail this OP is!!

[DanTex]

35. The next steps in healthcare are getting the rest of the states to expand medicaid,

and then getting a public option. That way people can opt into medicare at any age, and can avoid private insurance if they want to.

Single payer isn't happening anytime soon, and this has nothing to do with ACA. They couldn't even get single payer in Vermont.

The fact is, we are much better off with ACA than we were without it, and it was completely worth the effort and capital spent on it. Progressives should be celebrating ACA, it's a monumental accomplishment.

[Doctor_J]

46. she has said out loud that she is against healthcare, and in favor of heritage care

She says that America is too diverse. Another issue on which she's evolved, I guess.

[Adrahil]

48. I'm not sure I want single payer. I'd have to see the details.

But I do want universal coverage, and a public option. Those are the next steps, IMO.