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Sanders' single-payer push splits Democrats

onthebottom

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You have to love Bernie Sanders, while I don't agree with him I respect him. He doesn't really understand Democrats (at least those in power), and I guess that's understandable because he's not one. He thinks they believe what they tell their voters, when all they really believe in is hating Republicans and power.

This has an uphill road, Vermont had to move away from this and even California blinked at tripling their budget to have single payer healthcare.

Sanders' single-payer push splits Democrats

Most liberals are on board with the bill being introduced Wednesday, but Democratic leaders and vulnerable incumbents largely steer clear.

ELANA SCHOR09/13/2017 05:08 AM EDT
Bernie Sanders is pictured. | Getty Images
As Sen. Bernie Sanders prepares to unveil his “Medicare for all” legislation on Wednesday, most of the party’s congressional leaders and vulnerable Senate incumbents are steering clear. | Aaron P. Bernstein/Getty Images
Bernie Sanders’ single-payer health care plan has won over most other liberal senators, including many weighing 2020 bids.

The rest of the Democratic Party is another matter.

As Sanders prepares to unveil his Medicare for All legislation on Wednesday, most of the party’s congressional leaders and vulnerable Senate incumbents are steering clear. Even as the left celebrates Sanders’ ability to push the Democratic agenda leftward after his primary challenge to Hillary Clinton last year, that success appears to have its limits.

Senate Minority Leader Chuck Schumer told reporters that he would be “looking at all of” the party’s “many good” proposals to expand health care access, but declined to back Sanders. House Minority Leader Nancy Pelosi declared that her priority is shielding Obamacare from a GOP repeal push that’s not yet dead for good.

Connecticut Sen. Chris Murphy, one of the few Democrats subject to 2020 speculation who has not signed on to the Sanders bill, warned against letting the party’s attention slip to “longer-term health care policy” while the future of the Affordable Care Act remains up for debate.

“I think the risk is that we get distracted,” Murphy told reporters. “September’s not done. They can still ram through a repeal bill.”

Wisconsin Sen. Tammy Baldwin on Tuesday became the single-payer bill’s first supporter from the class of Senate Democrats up for reelection next year in states Trump carried. But other politically imperiled incumbent Democrats have said no to Sanders.

Sen. Claire McCaskill said in a brief interview that lawmakers have more work to do to keep health care costs in check “before we would think about expanding that [Medicare] system to everyone.”

Single-payer on a national level would have “a lot of problems,” McCaskill added, although she came out in support of allowing individuals as young as 55 to buy into Medicare. That idea is also backed by Baldwin and two other red-state Democrats up for reelection next year who are declining to endorse Sanders’ bill: Sens. Sherrod Brown of Ohio and Debbie Stabenow of Michigan.

Stabenow, also a member of Democratic leadership, said Tuesday that she would keep working on her Medicare-at-55 plan “because I think there is some bipartisan interest in that.” She said the party’s first order of business should be shoring up the Obamacare markets, followed by other goals.

“The first thing has to be to protect the health care people have now and stabilize markets, no question,” Stabenow said. “But we need to focus on lowering the cost of prescription drugs and providing more health care, more health care options.”

Improving the Affordable Care Act is the core of a bipartisan effort in the Senate health committee. The panel's ranking member, Sen. Patty Murray of Washington, a member of the Democratic leadership, also declined to endorse Sanders’ bill on Tuesday.

“There’s a lot of Democratic ideas out there, and I haven’t had the chance to look at all of them,” Murray said, adding that she remains “very focused” on the committee’s work.

Republicans have already seized on the high costs of imposing a single-payer system — which Sanders’ presidential campaign proposed to pay for with new taxes on employers and wealthy individuals — to hammer Democrats for supporting the idea. The National Republican Senatorial Committee criticized Baldwin on Tuesday for backing “the left’s radical plans for government-run health care.”

Sen. John Barrasso (R-Wyo.), a member of GOP leadership, also reminded reporters Tuesday that Sanders’ home state of Vermont had to back away from its own single-payer health proposal after the economic burden proved too onerous.

Backers of the Sanders bill acknowledge that single-payer is a heavy political lift but describe it as an important benchmark for Democrats’ future. As the party hones its identity beyond opposition to Trump’s agenda, single-payer fans see enough room to set big long-term goals while waging the shorter-term battle to protect Obamacare.

“There’s nothing about the politics of the moment or the Affordable Care Act that in any way precludes supporting Medicare-for-all as the ultimate goal, and there’s a clear path to it,” said Sen. Richard Blumenthal. The Connecticut Democrat signed on to the bill Tuesday.

Sen. Al Franken (D-Minn.), who has been mentioned as a possible 2020 candidate, also expects to sign on to the single-payer bill, a spokesman said Tuesday. Franken noted that his cosponsorship reflects the bill's status as a long-term goal while the party continues short-term work on Obamacare.

"This bill is aspirational, and I’m hopeful that it can serve as a starting point for where we need to go as a country," Franken said in a statement. "In the short term, however, I strongly believe we must pursue bipartisan policies that improve our current health care system for all Americans — and that’s exactly what we’re doing right now in the Senate Health Committee, on which both Senator Sanders and I sit."

For other Democrats, however, the idea’s time may have not yet come.

Ben Cardin said in an interview that he supports universal health coverage but has "certain concerns" about using single-payer to achieve that goal.

“There’s the political issue, but there’s also the issue about how you make sure there will be adequate resources put into health care,” the Maryland Democrat said.

Sen. Joe Manchin of West Virginia, a member of leadership who's among the GOP's top targets in 2018, walked a fine line Tuesday as Republicans revived his past comments welcoming a discussion of a government-run health care system.

"I am skeptical that single-payer is the right solution, but I believe that the Senate should carefully consider all of the options through regular order so that we can fully understand the impacts of these ideas on both our people and our economy," Manchin said in a statement on Tuesday.

Sen. Dianne Feinstein, facing consternation from liberals in her home state of California — where an effort to enact single-payer statewide ran aground this year — said that she would want to see the price tag before taking a position on Sanders' bill.

"My understanding is, the cost of single-payer is enormous," Feinstein said, noting that she supports a public option for health insurance outside the private market.

Murphy and Hawaii Sen. Brian Schatz have offered their own ideas to shift the party's health care debate leftward without going as far as Sanders' plan would. The Connecticut Democrat is working on legislation creating a Medicare buy-in for all individuals and businesses, while Schatz told POLITICO he expects to release a Medicaid buy-in proposal later this month.

Murphy said he would not sign on to Sanders' bill before its release, urging "our party to take some time and look at all the options available to us before we decide on one unitary route."

And even as some Sanders-aligned activists spook Democrats with talk of possible primary challenges to candidates who don't support the single-payer plan, other liberals were content to cheer the Vermont independent for attracting more than one-quarter of the caucus to his legislation. Progressive Change Campaign Committee co-founder Adam Green, who worked with Murphy on the Medicare buy-in plan, said that "Democrats are increasingly wrapping themselves in the flag of" Medicare for all without closing off other options that advance the ball.

"This is how big ideas like expanding Social Security and debt-free college were moved into the mainstream — the North Star gets put up, solid organizing is done, critical mass is built in Congress and on the campaign trail, and party consensus falls into place," Green said by email. "It's happening now."
 

toguy5252

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Many Americans equate single payer with socialism which is political suicide at this time. Most Dems would support single payer but the leadership is afraid (and perhaps rightly so) that support will lead to a loss in seats. Purely pragmatic not philosophical.
 

onthebottom

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Many Americans equate single payer with socialism which is political suicide at this time. Most Dems would support single payer but the leadership is afraid (and perhaps rightly so) that support will lead to a loss in seats. Purely pragmatic not philosophical.
This my point about Sanders not really understanding Democrats in power. This puts them in a difficult spot, they will need to alienate the left wing to stay electable.
 

toguy5252

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This my point about Sanders not really understanding Democrats in power. This puts them in a difficult spot, they will need to alienate the left wing to stay electable.
He is an idealist living in a very cynical America which has become more polarized with Trump. Although I think the rank and file Dems would support single payer I don't think the leadership will take the political risk.
 

Butler1000

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Because the Republicans clearly aren't split?
Yup. But it ALSO shows the Dems aren't monolithic either. Not by a long shot.

And this will cause further fracturing, perhaps the eventual rise of an actual progressive party.
 

Butler1000

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Many Americans equate single payer with socialism which is political suicide at this time. Most Dems would support single payer but the leadership is afraid (and perhaps rightly so) that support will lead to a loss in seats. Purely pragmatic not philosophical.
Actually polls show a lot of GoP voters would as well.

But as to pragmatism thee Dem now take in almost as much money from private healthcare interests as Republicans. And in fact recently elected a former lobbyist for that group as California Party Chair. Then buried the California Healthcare bill mentioned in the article.

Quite simply enough Dems are bought off as well now that Single Payer will never get in so long as either party is in power.

The pragmatism isn't about putting it off. It's about election cash.
 

Butler1000

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This my point about Sanders not really understanding Democrats in power. This puts them in a difficult spot, they will need to alienate the left wing to stay electable.
Actually single payer would get people elected IMO. I've seen numerous pols that show "voter bipartisanship" would switch votes from people on both sides.

But this absolute bill won't fly. They need to introduce it either as the 55 option or even better for kids up to eighteen. Families will vote for this in droves as will their grandparents.
 

fuji

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Yup. But it ALSO shows the Dems aren't monolithic either. Not by a long shot.

And this will cause further fracturing, perhaps the eventual rise of an actual progressive party.
Welcome to big tent politics, no party ever was nor will be monolithic.
 

onthebottom

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Actually single payer would get people elected IMO. I've seen numerous pols that show "voter bipartisanship" would switch votes from people on both sides.

But this absolute bill won't fly. They need to introduce it either as the 55 option or even better for kids up to eighteen. Families will vote for this in droves as will their grandparents.
I'm not so sure once the costs come out. Everyone is always up for free shit as long as someone else pays....
 

Butler1000

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I'm not so sure once the costs come out. Everyone is always up for free shit as long as someone else pays....
The issue isn't with cost OTB. It's that when they model it they don't include cost controls. They assume healthcare professionals charging what they want and then having to cover it when the way it works is establishing a price for services and that's all they get to charge.

As well they don't include tort reform and the drastic reduction in malpractice insurance costs once it's in place.

It's not perfect, nothing is. But it's better.
 

Butler1000

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Welcome to big tent politics, no party ever was nor will be monolithic.
Yep. But with polarization we are now seeing people saying the two big parties are so far away from what I believe the rise of a progressive party may be inevitable.
 

onthebottom

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The issue isn't with cost OTB. It's that when they model it they don't include cost controls. They assume healthcare professionals charging what they want and then having to cover it when the way it works is establishing a price for services and that's all they get to charge.

As well they don't include tort reform and the drastic reduction in malpractice insurance costs once it's in place.

It's not perfect, nothing is. But it's better.
The issue will be costs (why CA and VT punted - and they are VERY liberal states), who sets standards for care (the death panel argument), and prices, which will dictate capacity.

One reason we don't wait for care is massive overcapacity, driven by high returns that are driven by high costs.
 

toguy5252

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The issue will be costs (why CA and VT punted - and they are VERY liberal states), who sets standards for care (the death panel argument), and prices, which will dictate capacity.

One reason we don't wait for care is massive overcapacity, driven by high returns that are driven by high costs.
Gee I hope I don't get caught up in one of the death panels in Canada. They are notorious. the fact is that the US pays more for healthcare than almost any other western country including all that have single payer systems and the US has generally inferior outcomes.
 

Butler1000

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The issue will be costs (why CA and VT punted - and they are VERY liberal states), who sets standards for care (the death panel argument), and prices, which will dictate capacity.

One reason we don't wait for care is massive overcapacity, driven by high returns that are driven by high costs.
Like I said. Not perfect. But when 60% of bankruptcies are medically related there is an issue.

The basic mindset shouldn't be about money, but healing people. That is the core difference of opinion. That it isn't a commodity but a human right.

And while some don't wait, others don't have access at all.
 

onthebottom

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Gee I hope I don't get caught up in one of the death panels in Canada. They are notorious. the fact is that the US pays more for healthcare than almost any other western country including all that have single payer systems and the US has generally inferior outcomes.
At dinner last weekend we were talking about the Canadian healthcare system, I mentioned that it's illegal to sell medical services in Canada. It was a shock to everyone - pretty funny actually. No way Americans are going to wait in lines for services, no way. It's not a system that would ever work here.

The other option is the U.K. System, where there is private insurance coverage for the upper half of the country and the rest are stuck with substandard care. That dog won't hunt here.

Bernies proposal, will bring the most expensive and over capacity healthcare to everyone - and when we do the math we will find its way too expensive. California looked at it, the Dems blanched because it would triple their budget - triple.
 

toguy5252

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At dinner last weekend we were talking about the Canadian healthcare system, I mentioned that it's illegal to sell medical services in Canada. It was a shock to everyone - pretty funny actually. No way Americans are going to wait in lines for services, no way. It's not a system that would ever work here.

The other option is the U.K. System, where there is private insurance coverage for the upper half of the country and the rest are stuck with substandard care. That dog won't hunt here eather.

Bernies proposal, will bring the most expensive and over capacity healthcare to everyone - and when we do the math we will find its way too expensive. California looked at it, the Dems blanched because it would triple their budget - triple.
The Canadian system actually works quite well. Of course there are problems and issues and it could be improved but everyone has access and even with the waits the outcomes are generally good.
 

onthebottom

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The Canadian system actually works quite well. Of course there are problems and issues and it could be improved but everyone has access and even with the waits the outcomes are generally good.
I'm not saying it doesn't work for Canada, I'm saying it wouldn't work here.
 

basketcase

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I think the corporate lobby for the insurance companies will the main force fighting it. Perhaps the AMA as well worried that their billing will be affected.

I wonder if people ask how the amount paid they currently pay in health care costs compares to tax dollars spent. A quick search shows Americans average $10,000 USD/year on health care per year while in Ontario, the health care budget about $10,000 CDN per person. Even taking into account extended health insurance and costs not covered by OHIP, the numbers look pretty close.
 

basketcase

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...
One reason we don't wait for care is massive overcapacity, driven by high returns that are driven by high costs.
As long as you guys are happy with corporate profit being more important than health care...

Of course the short wait only applies to people with the money to afford it.
 
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