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To Be Crystal Clear: 'Medicare for All' Does Not Mean 'Medicare for Some'

Who is talking about remaking the entire healthcare system? I’m not. I’m for remaking the entire healthcare insurance system though. And with forward progress, I’m not willing to say we can’t get to the political majorities - more democrats that I don’t think of as all that progressive (like Harris or Gillibrand) are willing to speak for the idea than I would have thought 10 years ago. I know your soft polling position, but I think there is enough political will to make it happen - people hate their insurance company (I do too) and often like their doctor (mine’s fine). If we get the right bill and the right communication going we can move soft polling results in the right way.

On the court issue, this is a trickier subject. I’m not a lawyer and I don’t follow the court stories that closely. I’ve heard the idea proposed that if a ruling against the ACA mandating payment to private insurance happens even in the Supreme Court and strikes down the ACA, this cannot be used for precedence to overturn a bill that uses taxes to fund healthcare (which kind of makes sense since the payment going to a private entity is not a tax). I was/am in agreement with you that I wanted Clinton as president for Supreme Court and other reasons - I didn’t have to vote for her in CA but if I were still in CO I would have.

I’m not that knowledgeable about FDR and think he’s kind of overused as some sort of perfect example. Obviously he had huge flaws and on any particular thing he did, I might not support it if I had lived during his presidency (or even in hindsight) though I don’t deny that some programs he started evolved into better programs going forward.

I would not hold it against a politician who wants to sign on to other politician’s Medicare for Some proposals in addition to the main Medicare for All proposal I think is much more important, but it is a bridge too far for me to do personally.

I do not see any reality where Democrats have the votes to 1) break the filibuster or 2) doing so would benefit progressives anyway in the long run. What’s likely is a bare Senate majority and a smaller House majority with a Democratic President, if we are fortunate of course. Just as likely, is a Democratic House, Republican Senate, and a Democratic presidency at this point. Those aren’t going to be congressional majorities either way to ban private insurers and price cap provider side payments and drug prices, all key to making a single payer system work. And doing those three things, by definition, would be remaking our healthcare system, right?

And the Supreme Court makes its own jurisprudence. Progressives that want to pretend otherwise are just ignoring reality and 200 years of history.

I’m sorry to be a downer, but the Roberts Court in its current incarnation just got started. It’s tough to be hopeful when conservatives simply have a lot of power now. I enjoy arguing points as much as the next person, but we are in the midst of a conservative judicial revolution and lately, have felt like the single payer conversation is almost separate from reality.

It is Medicare for Some because of the four year phase-in. The unnecessary phase-in not only leaves some out for at least another four years, as I mentioned earlier the major problem with the phase-in is that it leaves the door wide opened for the insurance cartels to preempt complete implementation. Thus leaving us with a still dysfunctional multi-payer system that covers some and not all. There may be a time for compromise. That time is certainly not at the starting gate.

You are kidding yourself if you don’t think there will be a phase in for any system. Is Congress going to just breach multiple insurer and provider-side contracts across the country overnight? How would that even work?

Yes. We see that you fail to understand. Based from how you write (speak) it is clear that you are not mentally impaired. That leaves me with one inescapable conclusion (about you).

You seldom get a like vote because the readers of Common Dreams disagree with what you say. Because your words bolster the corporate position at every turn.

You characterize it as magic. The entire rest of the developed world enjoys the benefits of universal health care at a fraction of the cost as in the USA. But to you and the TV talking heads, “Pie in the sky! Magic!”

We know what you are.

Alright smart progressive, explain how you plan to rewrite the healthcare system with a bare majority Senate at best. I’ll wait. That means 1) provider price controls, 2) drug price controls, and 3) bans on for-profit employer provided insurance. Oh, and payroll tax increases. Revolution ain’t an answer either. Laws are made by the Congress you have, not the Congress you dream of. So tell me: how are you going to do it? Peel off some Republican Senate votes? Send Mitch McConnell flowers?

I admit I’m in a bit of a dour mood, but it’s clear we’re in for a rough ride. If Trump wins re-election, there go two more Supreme Court appointments in his pocket too. Answers would be useful for a change.

I have not considered an answer for price controls.

However, a display of unity by the Democratic Party, unity in support for a true Medicare for All single payer system would move us to where we want to go. The public is in favor!

We must voice our support in a loud voice, a very loud voice. This will give Democrats the opportunity to express their support for single payer any time they appear on TV or are heard on the radio. Millions of people don’t even know of the vast potential savings. Office holders should explain that the claims of higher prices are nothing but lies. This will increase support for a European style system.

Acting weak and saying, “Oh, we can’t demand single payer, that’s a bridge too far. We don’t have enough support in congress.” Instead we say, “70% of the American people support Medicare for All. That includes over 80% of Democrats, 70% of independents and even a small majority of Republicans.” If you talk like that public support will rapidly increase. On the other hand your weak sauce undermines our efforts.

Uh, I never said a candidate should not advocate for it. As a matter of fact, I’m the type who will vote for Sanders, Warren, whoever (Brown), happily if they come out the nominee. The Supreme Court, environment, judiciary, heads of agencies, etc. are way too important not to.

My point is the reality is Medicare for All (or really a true single payer system) ain’t happening absent breaking the filibuster rule (like Warren has said) at a bare minimum, and a whole lot of other things as well. Typically, our entire comment conversations assume a court system that agrees too. So I’ll happily vote for Sherrod Brown if he were to be the nomimee too.

Two points on the difference between S1804 and HR676:

  1. Neither bill is currently relevant since Sanders is rewriting S1804 and hasn’t yet introduced his new bill in the 116th Congress and Jayapal is rewriting HR676 and hasn’t yet introduced her new bill in the 116th Congress.
  2. I think the phase-in is one of the less important differences between the two approaches in terms of advancing an improved and expanded medicare single payer system. Overall, quick roll outs of big programs without lots of planning and accounting for the diversity of transition situations are doomed to failure from a logistics point of view. Not getting the logistics right creates way more political headaches than the kind of openings you are worrying about. Consider a 3-year union contract that has a great health benefit for its members - but a poor contract regarding wage increases. You need a way to allow that contract to terminate and be renegotiated for higher wages if the employer no longer has to pay health care costs at such high levels going forward under single payer.
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Here is a misleading article in that it ignores the Medicare for All bill previously submitted in the house, and would make the reader think that the corporatist faves of the DNC are in the vanguard of this fight. Tulsi Gabbard had already been working for this for 2 years by the time the polls changed the words offered by the Cory’s and Kamala’s of the party.

Don’t let the big donors and captured press impose another corporatist democrat loser on you.