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Monday, October 28, 2019

THE GANG THAT CAN SHOOT STRAIGHT AFTER ALL


The Beltway commentary on the Democrats has it that they are an unorganized group of feckless political ne’er do wells who cannot seem to fix on a message or follow through on a plan.  This is the twenty-first century version of Will Rogers’ famous old quip, “I do not belong to any organized political party. I am a Democrat.”  And yet, with a discipline and focus that would make a Republican proud, the House Democrats are proceeding steadily, deliberately, single-mindedly toward public hearings the week after next and a vote on impeachment before Thanksgiving.

I have no idea at all how it will turn out.  It begins to look as though much may depend on whether John Bolton testifies.  But the House will impeach Trump, and there will be some sort of trial in the Senate, all before the Iowa caucuses.

Say what you will about Nancy Pelosi, she is a Speaker for the ages.

I leave for Paris on December 6th.  I hope I do not miss the fun.

16 comments:

Jerry Fresia said...

No question, Pelosi is masterful when she wants to be.

Now if we could just convince her that the private health
insurance industry was an obscenity cooked up by Putin, we might actually get
medical for all in the next Congress.

David Palmeter said...

Jerry,

I see the private health insurance issue as the biggest risk right now to the effort to defeat Trump. I agree that, in an ideal world, there would be no such thing, and health insurance would be from a single provider--the government, as is the case in many European countries.

But private insurance is embedded in our system, and any change will produce losers as well as winners. Those who will lose will oppose any candidate espousing such policies. That’s why the “Cadillac tax” enacted with Obamacare in 2009 still hasn’t been implemented. Most of those high-end policies are held by members of the once-powerful CIO unions--auto workers and steel workers in places like Pennsylvania, Ohio, Michigan and Wisconsin, states the Democrats can’t afford to lose again.

But even if the Democrats win while espousing Medicare for all, the chances of its getting through Congress are non-existent, for the same reason implementation of the Cadillac tax has not occurred--many Democrats in Congress oppose it.

Medicare for all who want it, however, does poll well and seems to me to be the best option of getting to universal health insurance. Some European countries--the Netherlands and Switzerland among them--have universal coverage that is based on regulated private insurance. I don’t know the details of their systems, but if they can do it, we can do it.

Jerry Fresia said...

David,

Your reasoning is sound but my comment was tongue in cheek. However, I am of the persuasion that thinking big can galvanize the so called Democratic based, alienated and bored-to-death with endless triangulation and inauthenticity. I don't think anyone expects MFA to be enacted in one fell swoop, even if Maestra Pelosi reached way back to some long lost youthful exuberance and daring. Your multiple step approach might be the ticket. But even moving that far, I think, would require a full frontal assault now. Ditto GND.

Bernie made a rather strong critique of Israel the other day. Capitalism has become a dirty word for the youth and the majority of women and African Americans. As MLK used to say, "There comes a time." And not to be outdone, there was one famous American philosopher who, in reminding us, fondly quoted Marcuse:

"What in fact happens, Marcuse suggests, is that revolutionary change is energized by the utopian, siren call of liberation, which, whatever the language in which it is couched, is experienced subjectively as a promise of the gratification of those infantile fantasies of instantaneous, magical, total gratification which lurk within us all.

Christopher J. Mulvaney, Ph.D. said...

Jerry and David,
I worked in human services in Vermont for 20 years, and some of that time was spent in Medicaid. From the early 1980's the consensus among human service managers was single payor was what the state should aim towards in the long run. We used every option provided in Title XIX legislation to expand coverage which by the mid 1990's meant 95% of all children were covered. Adults were covered up to 300% of poverty and just over one third of state population was on publicly funded( federal 65%, state 35%) heath insurance. Admin costs were 12%, and providers, while they complained about reimbursement rates with some frequency, were extremely happy with a reimbursement system that paid claims within a week and a prior approval process that took days instead of weeks. Private insurers have never met those standards.

If the single payor system is more efficient, as we assume it will be, and legislative approval is unlikely, the road forward for us single payor types is simple. Let a dual system operate and as the data comes in we will be able to prove based on cost, scope of coverage, patient satisfaction, etc. that single payor is less costly, operates more efficiently, etc. People will vote with their feet, and in the long run, private insurance will wither away.

David Palmeter said...

Christopher, I agree with you on the merits of the dual system. I’d expect that over time, there would be gradual shifts away from private insurance toward Medicare buy-ins. Employers, it seems to me, would be the ones leading the way, particularly small businesses which can have a hard time getting affordable insurance. It has long puzzled me why people like independent restaurant owners don’t demand it. The only explanation that occurs to me is ideology. Small businesses have the hardest time dealing with government red tape and resent it greatly, and therefore oppose all of this “socialism.”

I also agree with Jerry that it is important for the left to keep the pressure on and to push for the best possible solutions. But it is also important for candidates to get elected and to get legislation through a Congress that is not overly progressive. I think it’s a tactical mistake to get too specific in a campaign about large programs that would bring about great change that will involve losers as well as winners.

jgkess@cfl.rr.com said...

I doubt not of the motives and purity of Nancy Pelosi's politics, worthy as they are, but as "a Speaker for the ages" (of the House)---please. She's not even a "speaker" of any merit of this or any other age. Her incoherence in press conferences sometimes rivals even that of Biden's, though it's still not as bad as Trump's.

David Palmeter said...

This is from Kevin Drum’s blog on Mother Jones. I don’t know how to send a link so I’m copying and pasting. Sometimes this works for me; sometimes it doesn’t. If there’s nothing below this when it a appears on Prof. Wolff’s blog, it’s not working for me.


David Palmeter said...

Here's another try:



David Palmeter said...

OK, that doesn't work. (I copied the text, pasted it into a Word document, saved the document, and then copied that. Still didn't take. Here's the link:'

https://www.motherjones.com/kevin-drum/

Scroll down past the lunch time photo. He notes that like most of us, he favors a single payer system, but realizes that that isn't in the cards right now, so this is his idea of what he'd do if he were president.

Dean said...

My take at copying Drum's post, titled What If We Can't Get Medicare for All?

Like most lefties, I would like the United States to adopt true universal health care. This has been my position for, oh, 30 or 40 years. However, I also accept the reality that this will never happen in one grand swoop. That’s why I was—and am—a big supporter of Obamacare, warts and all.

So if I were president and had to propose health care reform that actually had some chance of passing, what would it be? I’d go with a two-prong approach:

- Lower the Medicare age to 55
- Add Medicare as a public option to Obamacare.

Employers could keep their current private-sector plans if they wanted to, or they could enroll their employees in Medicare. The federal government would make Medicare available at its cost.

There are details, of course. Perhaps Medicare reimbursement rates would have to go up. Employers might need to offer Medigap coverage. Etc. But this would be a big step forward.

Dean said...

My take on Drum's kind of analysis... I marvel at the confidence with which so frequently "lefties" assert that "this will never happen" and that solution X has "some chance of passing," where other solutions do not. We are so certain anything approaching a wise solution "is not in the cards."

I'm not sure the confidence is misplaced in the long run. But it sure as hell is demoralizing.

David Palmeter said...

Dean,

Thanks for posting it. What was your technique to getting it work? When I pasted it into the comment box (where I'm typing now) it looked fine, until I posted it, then it disappeared.

I have to say I agree with Drum. He isn't saying this will never happen, ever, but that it won't happen "in one grand swoop." To me, that's hard to argue with. Where are the votes in Congress coming from, when all of the Republicans and a large number of Democrats in the House, and some in the Senate, would vote against it?

Dean said...

I'm on an old Chromebook. I highlighted, copied, and pasted into the "Leave your comment" field without trouble, so I'm not sure what hung up your effort.

To my mind, little occurs "in one grand swoop," and so it goes for me without saying. So why do proponents of policies foreground that fact, rather than emphasize how, despite the necessarily incremental progress we hope for or expect, a strong policy can be deployed?

howard said...

The dire need of the moment for a great figure to rise and go toe to toe and blow for blow with Trump would change all the political math in a heartbeat.
It is his street cred and charisma with a certain sort that is the spring of his power.
I find it hard to believe the left has no leader who can politically cut and slay this paper mache tiger Trump.
He is the dirty finger in the dyke of reaction holding us back.
He may be a great criminal but he is not a great leader, just a shrewd con man who electrified the degenerate right wing of this oountry.
He is not invincible.
I come from the same streets as Trump. He is not too big to fail or fall.
Publicly humiliate the man and he would be history.

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