"...being the “I’ve got a plan for that” candidate in a party that still fetishizes wonkery..."
Fetishizes wonkery? You mean, actually having concrete ideas about how to manage the big issues facing our nation, rather than merely screaming empty phrases such as "Build the wall!" or "Make America Great Again!!"? I'll take "wonkery" over meaninglessness any day of the week. I think you've forgotten that, once upon a time, people in both parties tried to figure out solutions to the daunting problems we face every day.
32
The far left’s faith in Warren’s and Sanders’ ability to defeat Trump and deliver M4A is so absolute it borders on religious fanaticism. There is literally nothing you can say that will convince them otherwise.
Everyone else knows that, should they win the primary, one of two things will happen:
1. Warren or Sanders will lose to Trump; or,
2. Warren or Sanders will not deliver M4A.
Until the far left faces these realities, and as long as it maintains a vise-like grip on the media, it will continue to divide the Democratic Party.
40
Medicare for all polls very well with Democrats and even a majority of Republicans favor the single payer healthcare plan. Does Mr. Douthat not read the polls? And Hillary Clinton ran a Republican-lite campaign, which was articulated by Chuck Schumer when he laid out her strategy of "for every blue collar worker we will lose in western Pennsylvania, we will pick up 2 to 3 moderate Republicans in the suburbs of Philadelphia. And you can repeat that in Ohio, and Michigan and Illinois." Remember that brilliant strategy? Trump ran a populist campaign in a time of major dissatisfaction with both political parties. Say what you will about Trump, the man knows how to read a room and he saw that a populist, anti-establishment campaign would resonate in the Brexit states. Meanwhile, Hillary ran one of the most centrist campaigns in history, even ignoring Wisconsin to campaign in Arizona. Arizona. Yes, that was not a typo. So please Mr. Douthat, get your facts straight.
12
Its time for science over profits. Healthcare is a right.
16
Your animadversions on Warren's proposals for health care cost coverage reform do not give any space or possibility for massaging out the difficulties in her and/or similar proposals, once there are solid Democratic majorities to override a Trump veto. But wait!! Who will be President? Elizabeth Warren! We have an app for that. It's called the Constitution.
3
Medicare for all may mean Medicare for none.
Stripping 100's millions of their private insurance and numerous new taxes is a sure fire elections loser.
When Trump is no longer campaigning after he wins a second term, don't underestimate Republicans desire to cut the deficit by cutting entitlements, specifically Medicare.
16
For-profit health care is not very old, and it has been a disaster. I was in an MBA program in the late 70s when Humana first became a Fortune 500 company. When I was a child, health care was a charitable and affordable system, mainly run by church affiliated organizations. The US has replaced that system with one which has reduced American workers to indentured servants who are often forced to work for government agencies or big corporations that can afford to insure them. Many have become unemployable due to a pre-existing condition. This has nothing to do with "free enterprise". It is simply a "protection racket" that sifts money out of the pockets of all Americans whether they are sick or not. A lot of people are getting very wealthy from this form of kleptocracy. A single payer government system will not make us a socialist country. The government will not run the hospitals, hire the doctors, or determine the care. The hospitals, employers, doctors and drug companies will be FREE to return to a more fair and competitive system. The government will simply cut the checks that pay for our care and they will be reimbursed by many of the people and companies that have been robbing us for generations. America will become a balanced, civilized country just like all of the other industrialized, first world nations that know how to take care of the health and education of their citizens.
19
Today the Times thankfully republished a column by Thomas Edsall which is essential reading for anyone who is thoughtful about our upcoming election. Douthat captures some of the thinking from that column also. In past weeks the Times has published columns by various others questioning the direction of the Democratic Party as if throwing out red warning flags. It is now too late for Warren, I believe, to unburden herself of her health plan idea, one that she adamantly refuses to reconsider. It is hers and she will be defined by it. Should she be the final candidate, it will bring her down and the Party with it. Tacking to more moderate proposals may not be popular among those who are considered liberal elites but those voters do not reflect American voters at large and certainly are not those who will determine the outcome of the election.
22
Albatross it is. Warren/Sanders medicare for all is not practical and will be destructive relative to our healthcare system. Obamacare can be retooled with a public option. Let us work with a program, the ACA, and build on it’s foundation.
17
Ross do this, don't do that.
All the industrialized nations on the planet do a single-payer system.
To be clear, single-payer healthcare is a type of universal healthcare financed by taxes that covers the costs of essential healthcare for all residents, with costs covered by a single public system.
Medicare is a single payer system.
Folly, tell that to Americans without healthcare, Americans who can not afford their prescription drugs, American driven into bankruptcy by their healthcare cost.
Folly is the current system that cost Americans four times what many other countries pay for as good or better healthcare.
6
In a world in which every single American is required by law to write a $10,000 annual tax check to fund the most wealthy individuals and corporations, who pay zero tax, I’m not the least bit surprised Republican messengers like Russell Douthat continue to ballyhoo that we can’t afford universal free healthcare. If we instead paid that in Medicare tax there’d be enough for every man, woman, and child to have not only gold plated healthcare plans, but gym memberships, and a good dinner out each month. Simple math: $10,000 per year x 325,000,000 (325 million) people = 3,250,000,000,000 per year (3.25 trillion). Add to that the average cost per person of our current healthcare system recently reported at $9,000 per year and we get another $2.7 trillion per year. $3.25 trillion $2.7 trillion = $5.95 trillion per year. Republicans and many Democrats hair is on fire because they claim over 10 years Medicare for All will cost $40 - 50 trillion. I just demonstrated a budget of $59 trillion and haven’t even factored in the cost savings of billion dollar bonuses to health insurance and hospitals.
6
I still keep reading many posts saying: "Warren would make a really good President" or "Medicare for all would work really well". The problem with both of these statements is that they jump over step 1 and go to step 2. Step 1 is winning the election which cannot happen if the Democratic candidate has unpopular policies. One payer health care is unpopular as are other policies mentioned in this article. There is a reason politicians poll the public on their policy preferences, they have learned from long and painful experience that good policies can lose an election if they don't have popular appeal. I agree that Warren would make a good President and that single payer is a good system but both statements are beside the point which is getting rid of a truly destructive President. Only then do good policies stand a chance.
7
Trump seems to have been blessed by opposition which refuses to embrace popular feeling where scintillating brilliance can make his stupidity seem all too congenial. Warren's only the tip of the iceberg. I watch in awe as the Party seems willing to settle for utopian fraternity in lieu of any whiff of modesty.
8
This is why Clinton will run and win.
Let’s admit:
- no one wants to give their good employer based healthcare
- no one wants to pay for others ( illegals m, DACA, etc)
9
“Luke! You’ve switched off your targeting computer! And you’ve changed course to make a frontal assault on the Death Star!”
“The Force is with us! 20 years ago we sent a message to the corporations. Only a frontal assault will send the message we must send today!”
“No! Please! 20 years ago we really needed to start working on climate change. Today, trust the Force to guide you but aim for the weak spot! The stakes are too high!”
“Never! I’m so tired of hearing people say that the Death Star can withstand power of the Force!”
1
The Republicans encouraged Republican voters to kill centrism, and now Conservatives are begging progressives to bring centrism back. If you're mad that the lemonade stand you work for is now selling moonshine, don't go around demanding that the hardware store down the block start selling lemonade. Change the management of the stand.
3
Oh give me a break. Don’t even go there comparing the Democratic Party to the GOP. Trump did not win a majority of the vote and is only president because of the outmoded electoral college. He won by a few thousand votes in three states. You’re really over-analyzing this to try to justify your party’s complete abdication of any type of civility or moral relevance.
9
Yes -- Why in the name of God does she want to run our lives?
8
There is a lot of administrative sleight of hand that doctors, hospitals, drug companies and insurance companies all do to squeeze the American consumer for Double what Europe, Canada and Japan pay for the same care.
Insurance companies — all they do is collect premiums and then pay providers for services billed.
And yet, they call these premiums “revenue” as if they were earned, and they call the difference between what is collected and paid out “profit” as if they had worked hard to add value to the economy. They do not.
Meanwhile, doctors, hospitals and provider networks add hidden “facility fees” to their bills — making the bills so high the average American is scared to death of getting sick, so they buy, out of fear, the best insurance they can afford, which is often a high-deductible/copay , low-premium plan — but the facility fees blow right through the deductible for Anything.
A biopsy of a benign mole — taking 2 minutes — gets a $4000 charge: $200 to look at the mole in the office and draw a circle around it, $1000 to “remove” it, as if it were a monstrous tumor, another $1000 for the “facility fee” because the biopsy was done in a pseudo-operating room down the hall, another $800 to “process” the tissue no bigger than a pea, and another $1000 for a pathologist to look at it under the microscope and say , “it’s benign.”
5
This is one of the many reasons Hillary Clinton will run and win.
All that the Republicans have to say is “remember if you like your Doctor you can keep your Doctor” and “you will lose your healthcare from work” and any candidate who backs Medicare For All will lose the election.
8
Warren should follow a very simple strategy: relentlessly promote her healthcare in Pennsylvania, Michigan, and Wisconsin. *Nothing else matters*. And if it doesn’t get a decisive majority polling approval in all 3 states, she needs to bow out early (along with Sanders) and let Biden or Buttegieg take over.
3
Right on. My biggest fear is that Warren's foolish desire to destroy the current medical system, and to replace it with a new, untested one, will push voters to wish otherwise as they reëlect Trump. Offering a public option is such a wiser choice, if one must take a stance on Medicaid For All!
11
Where's the column deriding the pie in the sky, never has worked, never is going to work, massive debt building, phony sham voodoo economics that has saddled the country in trillions of debt?
Why is it ok to throw trillions down the drain, as long as the bulk of that goes to billionaires of all kind?
Talk about an albatross dragging down the nation.
Time for Conservatives to voluntarily leave the witness protection program and speak out about that mess.
Healthcare won't bankrupt us.
9
Excuse me Mr. Douthat, but this analysis is bilge. Yes the gop swung far right, substantially further than you presented it. Although always misogynist and embracing racists, it turned the burner up full, producing the rolling boil of ugly hatred and fear, with no pretense of the redeeming social veneer you paste on.
And exactly how did the Democratic party swing far left? Hillary was an intricate part of the policies the nation embraced enthusiastically in 1992, which were hardly leftist. She lacked her husband's extraordinary charisma, and suffered four decades of vicious slime attacks by your side, all without the slightest shred of evidence to support the unconscionable character assassination.
Oh, yeah, Democrats favor universal health care coverage. Like exactly ALL the other civilized nations on the planet. And that makes 'em radical?
Sorry, Mr. Douthat, you have a vision problem.
You on the Right have a lot to answer for. We have the most expensive and least effective health care system in the world. While you invent clever arguments, 47,000
Americans die each year from untreated conditions that are routinely treatable. Is it worth it to keep our 'free market' system
11
Warren's Medicare for all plan will cost 27 trillion in wampum.
6
Warren has a lot of good attributes - but big-picture, long-view campaign savvy is not one of them. She didn't need to out-Bernie Bernie on healthcare. She would not have lost Democratic voters by beating Sanders like Hillary did (for one thing, Warren is not a closet Republican like Hillary and Bill are, and Biden, too). Maybe she and her advisors didn't anticipate the degree of Biden's fade and the failure of Klobuchar et. al. to rise, and that there was some room a little more toward the center for her. This stuff isn't easy.
Buttigieg's candidacy is a conundrum, but may help. There's no way America will elect a gay man yet (and gender is still a liability for Warren), but instead of being a spoiler he may force her to tack a bit to the center to counter his appeal.
I'm still not hopeful of beating Trump. The D bench is long but thin, and it's difficult to oust an incumbent regardless of his troubles. It's even more difficult when there isn't a strong challenger. I don't see one.
3
Ross:
Let me help you.
McCain lost due to (1) global financial crisis making Ayn Rand republicanism look really shaky, (2) he was willing to bet the country on Sarah Palin! as one step from the Presidency and (3), oh yeah, Obama.
Romney lost due to (1) he labeled 47% of the country as moochers and (2), oh yeah, Obama.
Trump won due to (1) many many people, right or wrong, really hated Hillary and (2) oh yeah, not Obama.
Medicare for all is an interesting, intriguing idea to be discussed and debated as a policy to reduce health care costs and provide certainty of care to many uninsured or under-insured Americans. What's so radical about that proposal and discussion?
6
It is so curious that so many people assert Warren will lose the presidential election because she is proposing to implement what a supermajority of Americans want.
Medicare for All is popular with people who want good health care without the possibility that it will bankrupt them if they have to use it. It is also popular with people who think all Americans should have health care. It is popular with people who believe that wealth inequality is a problem in America as it is at least in part a redistributive policy that makes the middle class and the poor more secure.
Mr. Douthat's citing the ironically named "Reason" magazine as his source regarding the numbers on Warren's health care plan is telling: his argument is weak.
MR. Douthat is exactly backwards in his analysis of why Clinton lost to Trump. He suggests Trump was more Centrist than Clinton and thus more popular. That has zero to do with it. Trump and Sanders had their hand of the pulse of Americans. The diagnosis of that pulse is AntiEstablishment. Clinton lost because she was correctly seen as a limousine liberal hypocrite. Aping sympathy for the downtrodden while courting and supporting the financial elite which does the trodding down. The liberal corporatist democrat is the ultimate traitor to the working class, which is 99% of America. That is why Clinton lost and why another corporatist Democrat will lose. It is why Warren or Sanders will mop the floor with Trump. Trump was a con. They are the real deal.
8
The problem with ideology is that it attempts to answer a question before it has been asked. - Bill Clinton at the Daily Show
All ideology leads to nihilism.-me
The ascent of Anglo-Saxonism is do to it constructing a system of civics based upon pragmatism, as demonstrated in the Common Law. - See O. W. Holmes
The ascent of China in the last 40 years is the greatest event of our times and is based upon them turning towards pragmatism in 1978 under Deng.
The basis of ideology is to persuade the dupe: get someone to believe in your premise & they conform to your conclusion. The Catholic Church makes the case that the purpose of love is to give birth to new life, ergo homosexuals cannot have loving relationships. Believe the premise & you are captive to the conclusions.
Pragmatism doesn’t fall for this head fake. It embraces situational common sense. 2 people really love each other, heart & soul, then they should be able to love each other, come what may.
The modern conservative has to be ideologue in order to persuade the majority to vote against their own interest. Duothat is down with that in spades. Moreover he doesn’t see that he frames civics in purely ideology terms.
M4A is not ideological, its pragmatic. It’s cheaper, comprehensive, more humane, & common sense.
What good is a system of heath insurance that offers no assurance of insurance (bc insurers seek loop holes to avoid paying out)? And it costs more.
Pragmatism. It’s what’s for dinner in 2020.
5
Maybe Warren's plan will be too hard to sell. Maybe the middle class will have to pay some in taxes, almost surely less than what they pay now in premiums, deductibles, and disaster when they discover their health insurance is much less robust than it seemed when they only needed it for routine care. But the idea that Warren's plan is in any way analogous to the GOP extremes is nonsense, because they are based on nonsense. Phony trickle-down economics where tax cuts pay for themselves. Phony climate change denial. Phony promises to replace, not just destroy, Obamacare. Phony voter ID laws based on phony assertions of voter fraud. Phony claims of immigrant sponging and criminality. Phony scare-mongering about infanticide. You name it, they've got a phony theory for that. There's plenty to argue about with the plans of Warren and the rest of the leading Democrats, but in general they are serious. A discussion that takes them seriously and considers their potential benefits and pitfalls is an hour with cogent experts on NPR. A discussion that takes the phony GOP premises seriously is a nonstop loop of inchoate bluster on Fox or InfoWars or Rush Limbaugh. The American people will have to decide which they prefer, and the outcome is far from certain.
4
I like Warren a great deal, but also worry that Medicare for All (and her ridiculous stand on illegal immigration) is going to be a very high hurdle she has set for herself.
Her main campaign focus should be cleaning out the corruption in Washington, trust busting, and doing campaign finance reform. The whole system stinks, and Americans from the far left to the far right all agree on this.
This would be of huge value in and of itself, while having the tactical benefit of contrasting the problem to the biggest crocodile in the swamp: Trump.
The more powerful will always be more powerful. But nothing good for ordinary people can be accomplished when big money has such an outsized voice. There is bi-partisan agreement on this issue.
3
The problem is not her platform, it is the polarization. Look north to Canada. Trudeau, inept & pretty with the integrity of a flea won again in a farcical election campaign, where he described his Conservative opponent, a quiet, father of 4 who is being criticized for not being bombastic enough on the internet, as a Trump & nobody batted an eye. Now, entire provinces of Canada are divided by party lines, ala Trump's walls, with a minority government.
1
I'm sure the Trump team is jumping up and down with glee at the prospect of having to face Warren instead of Biden in the upcoming election. We do not need another Hillary Clinton type loss. You climb a mountain, taking one step at a time. The first step is to beat Trump. For now, forget about Medicare For All, instead consider a public option. Forget about forgiving student loans or free college for everyone. Instead consider reforming an inflated, unfair, degenerating educational system from the bottom up. Back Biden in 2020. A half a loaf is better than none.
6
Medicare for all is a "pie in the sky" dream. This is like jumping from slavery to democracy in one generation.
If you are trying to lay the groundwork for its eventual acceptance, fine. But is cannot happen in the near future. Period.
Wake up! If Warren wins with this agenda, Donald Trump will win reelection. That should be the last thing Warren, Sanders or Biden wants. Drop the pabulum for the masses and get back to debating issues that are realistic.
9
@George W
Wasn't the Affordable Care Act supposed to be such a step toward Universal Healthcare? Isn't that what Obama said when he took the public option off the table to appease progressives? How many more baby steps do we have to take? Most people know that sometimes, something has to be fixed all at once. It's like the difference between finally putting on a whole new roof, or just fixing shingles where the leak is. Sometimes, you just have to commit and fix the darn thing.
4
Amidst the ongoing discussion of Universal Healthcare for Americans the question not raised often enough is why every other industrialized nation has universal healthcare in one form or another. Some have national plans. Some have mixed national and private. Surely there is a candidate who will show the US how to pick and choose the best and most appropriate elements of each system for use here. As a nation we spend more per capita for health services than any country but still many people without insurance or under insured. The first rule of universal health insurance, in fact any insurance, is that the pool of insurees must include those who need and those who don’t currrently need. If we can follow this fundamental rule in America we can reduce costs dramatically and provide healthcare for all. Every othe industrialized nation has done this. We can learn from them.
4
I'm more disturbed by Mayor Pete, Klobuchar, Biden, Harris--all of whom seem to have no real interest in universal health care and see it as a "pipe dream." Why is that an acceptable position for a Democrat at this point? Mayor Pete was practically sneering at Warren at the last debate with his "people like choice," as if private, employer based insurance is this great land of freedom and opportunity. If that's "choice" give me the shackles of Medicare. I would prefer free choice to work wherever I want than for my employment be determined by my health insurance plan. And I bet my employer would like the choice of not having to factor health insurance costs into every hiring decision.
10
Grandiose plans such as Elizabeth Warren's health care plan are fine as points of discussion, but shouldn't Democrats be proposing more practical programs that actually might get passed and still do some good. For instance, a better first step to improve health care might be an affordable, public health insurance option.
Similarly, grandiose plans such as the Green New Deal would be difficult to implement, so we might be better served going for something more straightforward -- like immediately changing all coal-fired power plants to natural gas.
It seems to me progressives can make a lot of progress by going the incremental, practical route rather than asking voters to accept complicated, expensive plans that most won't even understand in detail.
6
Unfortunately the Democrats are helping Trump more than Trump can help himself. Warren impressed me as a very intelligent and likable person until she was elected a senator. Her funding plan for her Medicare-for-all proposal is deceiving at best. I am afraid that in one on one with Trump neither Warren nor Biden or Sanders will defeat Trump. Buttigieg has a chance on his merits, but conservative Democrats may not support him because of his sexual orientation. All other candidates are quickly fading away. Sorry to say, Trump may be in for another four.
5
To suggest that Hillary Clinton lost to Trump in 2016 because she moved to far to the left, as Mr. Douthat does, is utter nonesense. She lost because she was an empty vessel with no message other than "it's my turn" and a complete lack of authenticity. And that was for those who supported her. Those who opposed her simply hated her guts. Add to that, her campaign's total miscalculation of the level of support (or lack thereof) she enjoyed in the crucial battleground states of Michigan, Wisconsin, and Pennsylvania and you have the ingredients for the national disaster from which we all now suffer.
Nor is "Medicare for all" the albatross Mr. Douthat claims it to be. "Medicare for all of us over 65" has worked pretty well since Lyndon Johnson brought it to life 50 plus years ago. It is generally popular, even with those recipients who consider themselves very conservative. Recall the rather bizarre Tea Party signs opposing Obamacare which said, "keep the government out of my Medicare." There is no reason why Medicare cannot work on a much broader scale. In fact, given the better overall health of those under 65 compared with those over 65, Medicare should work even better when made applicable to younger people.
9
There are two incorrect statements in Mr. Douthat's piece:
1. He uses the withdrawal of Vermont's efforts for single payer as "proof" that single payer is unaffordable. He's done this before. This parallel is nonsense. Vermont is a tiny state, and, in fact, has the smallest economy of the 50 states. It just couldn't be done in poor Vermont. That doesn't mean that is can't be done in the nation as a whole or in wealthier states.
2. Somehow, every industrial country in the world manages to provide their residents with health insurance. There are many different possible models, from Switzerland's private, non-profit insurance comp[anies all the way to Britain's, in which health-care professionals work for the government. Why is it that the U.S., the world's wealthiest country cannot afford to provide the same coverage? Could it be greed and corruption? The exorbitant military budget? A combination? Let's get to work and fix this problem.
4
I am starting to think that the Convention will have to draft a candidate. Keep an eye on Congressman Patrick Kennedy, Bobby’s grandson.
I saw Bobby. The world would be a different place had he lived.
There are a lot of folks like me still around.
1
Maybe the old guy who's likely never had to worry about having access to quality healthcare shouldn't be sharing his opinion about a way to actually provide quality, ACCESSIBLE healthcare to all citizens.
We can do it. Stop framing this in a Republican strategist's narrative. Try writing about how this and other M4A plans would work and help stop the voter misinformation.
4
Centrism is dead, and hopefully the Democratic nominee will bury it for good. Centrism has no place in the Democratic Party anymore. It’s time for new ideas, put the tax burden where it belongs, and rebuild infrastructure. Sorry, Ross, but nobody’s listening. Warren produced the plan, as promised and now it’s time for this country to make it happen.
2
This discussion seems disingenuous and unnecessary. But it is Warren who has botched it by failing to fully explain how it can be paid for at an overall savings despite imposing new taxes to pay for it.
What is constantly overlooked is how much will be returned to the employer/employee from all sources, premiums, co-pays, and deductibles. Even a conservative cost estimate of $10,000 per year per insured (family or individual) for 80,000,000 covered workers returns $800 billion per year. The actual cost for is probably much higher, due to ever increasing costs borne by the employee through higher drug costs and high deductibles that lower the employers cost and limit the insurer's exposure. When the opponents decry the "tax increases necessary" to pay for single payer they conveniently omit this significant detail which clearly shows the potential middle class savings.
Medicare's administrative costs are around 4% per year, compared to 25% for private insurance. That is a return on investment of 20% every year. And single payer insures that every insured person will have the same basic coverages at the same initial cost, with the ability to add additional coverages based on what one is willing to pay extra for.
No, it will not be an easy transition, especially not if the Congress remains divided and obstructs progress. But it can be done without breaking the bank as fearmongers claim.
3
When you see a proposal described as a dollar amount - a $20 trillion plan, say - you know it isn't a credible criticism.
A person in need of medical care gets medical care. The price tag of any plan is the amount we spend on health care every year.
The albatross is the present system loaded with fat for the pigs in the insurance companies, the trial lawyers, the pharma lobby/industry.
Warren's plan replaces the albatross with a system like the ones in other countries who spend almost 50% less than we do.
Why all the smoke and mirrors ? Advertizing dollars and campaign cash from special interests. Warren isn't taking corporate dollars for her campaign.
2
Ross, we've heard this line before. Ideology bad, centralism good. At lot of people want real change. And yes that's based on the 'ideological' position that justice is our goal, universal health care and the green new deal are means to this end. Seems that you are afraid of Warren or (heaven forbid) Bernie will be the Democratic candidate, not because of a Trump win, we will do everything in our power to defeat Trump except sell our souls so the one percent can continue to rule. This also means that you (along with Trump and Nancy Pelosi) will soon be out of business.
3
You can surely improve healthcare without Warren’s plans to remake society overnight. My problem with her idea is that I find no evidence that any government could carry it out competently. (And this assumes that her on-paper calculations of costs and taxes even remotely approach reality, given the years of flawed forecasts that the “best” academic economists have issued on topics A-Z.) Remember this is a government that could not roll out the Obamacare sign-up websites without months of fixes and re-engineering. That incompetence would be a thousand-fold if a Warren/Sanders plan actually passed into law. Medicare required nearly a decade before it was running smoothly. The chaos that would accompany an all-or-nothing switch to Medicare for All works doom public acceptance of practically all subsequent government initiatives.
7
Warren may be a bright, passionate speaker which is not the same as being a good communicator. Politics is about delivering simple messages, not promises that a president alone can never fulfill. Trump promised to “protect” those hurt by liberal identity politics and job outsourcing. He “felt” the pain of evangelicals and anti abortion Christians. They delivered and will do it again.
Warren needs to tell a story. Tell people that “capitalism made this country rich but we need to tweak it so that all Americans can benefit. It’s great for cars or smartphones, but not if you get sick. We need to make sure American ingenuity fixes this too”. And it’s ok to say “ as long as everyone gets the health care they need, it doesn’t have to be the government. There’s a lot of smart people that can help me fix this”. Like it or not, people don’t always trust the government. They just want their basic needs met, no matter how it gets done. Build on what we have. Elimination of the status quo ( we’ll ban private insurance ) instills such fear that people stop listening to so called solutions or plans.
I believe Klobuchar does this best, but unfortunately hasn’t gained traction.
4
I think that universal healthcare or "medicare for all" in a single-payer system has always been a reasonable idea. The problem is that for a long time, health insurance companies have had a pretty good run with paying Republicans to obscure its merits. Now, though, the cat's basically out of the bag. Losing your private health insurance is not the end of your healthcare: it's the beginning of getting that healthcare without having to deal with insurance. That's a pretty big deal to a lot of people. My wife and I are still in debt to at least two of the three major hospitals in our town because of a health issue that was treated and cured years ago--and that's with very good employer-provided healthcare. That's not reasonable. Just because you've identified a politically neutral "center" space on an issues doesn't mean it will hold forever. The center changes over time, and on the issue of healthcare, it's gone to the left.
7
In addition to their strong rejection of popular democracy, the Founders also disliked parliamentary systems and gave us winner-take-all elections and the antidemocratic Electoral College. This not only leaves all those voting for losing candidates with no representation, but also greatly distorts the range of political views among voters. For example, we talk about "wings" of the Democratic and Republican parties as radical, progressive or centrist, and establishment, conservative and what should be called reactionary. If we had a parliamentary system, we would have at least four major parties and voters seeing their choices represented in them and/or others.
5
Beware of never Trumper conservatives bearing gifts.
For the matter beware of Democrats like Joe Biden saying Medicare for All is too costly. The Times Paul Krugman, somewhat sceptical of Medicare for All, says Elizabeth Warren'snumbers work and Bernie indicates he would raise taxes a bit for middle-income folks, knowing the middle income cohort's overall medical costs would come down.
To my Saturday surprise, I saw an establishment democrat on MSNBC argue what appeared to be Heritage talking points in her zeal to support Biden.
My question: is either Warren or Sanders is willing to compromise? Because it will take some kind of compromise to get Medicare for All through the Congress. I won't pretend to tell them what compromise, though I have a preference. Even FDR (and these two are throwbacks) compromised; so did his older cousin, Theodore, another smart populist (some days).
My suggestion: Make Medicare for All today's Medicare, which doesn't cover 100%; also negotiate drug prices and provide room for supplementary insurance, like we have now. Do it on a schedule, switching 55 to 65ers immediately, then 45 to 55 in five years and so on.
5
The Democrats seem to be proposing more, and more, and more government spending on programs, whereas Bill Clinton focused t on reviving the economy for the middle class, and cutting down the deficit.
5
"...Hillary Clinton lost in 2016 in part because she abjured her husband’s popular legacy of centrism..."
Are you kidding me Ross? Hilary was as "centrist" as they come! And THAT'S why she lost. She was the "Queen of the Status Quo", in bed with Wall St. and the donor class who didn't want anything to really change. Her inability to promote a message of change doomed her. It should've been clear from the support that Sanders drew what the mood of the country was, but she ignored it as the privileged, entitled "queen" she was and lost.
"Centrism" will NOT beat Trump. Only bold ideas and action will. The majority of Americans have been dis-served by the system for decades, and have been given a steady diet of empty promises in return. We need big changes to return the working and middle class back to sharing in the prosperity that has been denied them. MFA is one of those changes.
If people don't have to spend so much of their money on health care, or worry about going bankrupt, or living with poor health, that would be a major step forward. Free tuition would enable people to get the education they need. And a Green New Deal would create millions of good jobs. Not to mention finally getting thee long delayed Infrastructure Initiative rolling. These aren't "centrist" proposals, nor will "centrist" proposals be enough to turn this country around.
"Aim at the stars. If you fall short, you'll still land on the moon"
The Democrats have been aiming too low for too long.
6
Over ten years on after the 2008 Great Recession, the quality of life for most people is bad. Inflation grows, while salaries are stagnant and jobs are not secure. The Healthcare system is crazy and expensive. Costs keep growing, but personal income doesn’t. There’s no real excuse for medications costing cents in Canada and hundreds of dollars in the US. This is where Senator Warren can begin to tackle the system. Medicare can be expanded; we know some people won’t give up their private insurance and that’s OK. Medicare expansion is not an ideological movement, but a reaction to a badly broken system.
When McCain and Romney ran, there was still hope that the system would readjust to bring back opportunity. It hasn’t and isn’t. Hedge fund fraudster, Leon Cooperman’s five-page letter, released a few days ago, challenging Senator Warren is what the status quo looks like. Leon is quite happy to continue as is. He’s made billions speculating the market, not manufacturing anything. He probably wants war with Iran as well.
4
Again,
The United States spends billions of dollars on the military. The nation finds money to invade nations. The US finds money to cut the taxes of billionaires. Yet, when it comes to healthcare this nation and its citizens cry broke.
"The Greatest Nation on Earth"
The US has an infant mortality rate comparable to nations we deem, "Third World". This nation and many of its citizens speak of being christians but when it comes to taking carry of those who are sick, that's another matter.
12
The Democratic candidates wanted to get left so they couldn't be outflanked on the left. That absurd pandering to the fringe of the party may give Warren the nomination which will force centrists(swing voters)like me to do something I couldn't do in 2016; vote for Trump. The more we need bipartisan solutions for the nation, the more radical the platforms become. I hope Biden gets a lift since Warren, with her plans for everything, has established herself just as scary as Sanders. The fringes do get noticed for their radical ideas but that rarely translates into a win in the Electoral College. Rather than complain about it, win the Electoral College.
11
Warren is highly intelligent but she is deluding herself thinking that her health plan will gain traction. If she's the nominee she cannot allow Trump to savage her as a socialist. She has a chance to rectify this. All she has to do is elicit feedback from voters, then use the feedback to revise her Medicare for All proposal to Medicare for those who want it, or propose to augment the Affordable Care Act to ensure that no one in this country is left without health coverage.
5
First we have to admit that we now have is a dysfunctional system .Tens of millions uninsured or under insured,hundred of thousands end up bankrupt because of a medical event.We spend the most among industrialized nations by far and results are uneven.
So how do we fix it?Don't count on republicans for help. Their only objective is to dismantle whatever is left of the ACA.Trump is only a charlatan therefore not to be believed.
The debate now is public option vs medicare for all.I prefer a gradual implementation to medicare for all.Medicare for seniors and the disabled works fine even as it covers the most vulnerable among us.Tricare,the program that cover our military and paid by the Department of Defense works fine.Health care providers get paid.Money comes from somewhere whether from Medicare,Tricare,insurance companies,private payers or Medicaid,ultimately all paid by us.It will take time but it can be done but only if people demand it.
1
First we have to admit that we now have is a dysfunctional system .Tens of millions uninsured or under insured,hundred of thousands end up bankrupt because of a medical event.We spend the most among industrialized nations by far and results are uneven.
So how do we fix it?Don't count on republicans for help. Their only objective is to dismantle whatever is left of the ACA.Trump is only a charlatan therefore not to be believed.
The debate now is public option vs medicare for all.I prefer a gradual implementation to medicare for all.Medicare for seniors and the disabled works fine even as it covers the most vulnerable among us.Tricare,the program that cover our military and paid by the Department of Defense works fine.Health care providers get paid.Money comes from somewhere whether from Medicare,Tricare,insurance companies,private payers or Medicaid,ultimately all paid by us.It will take time but it can be done but only if people demand it.
Warren is sane? She sees conspiracies everywhere (hospitals, banks, energy, insurance, technology companies) while making up easily disproven claims about her heritage and employment history. Her medicare for all calculations are trillions of dollars short but she is not sane enough to respect the voters with the truth.
We have had enough of conspiracy theorists trying to lead the country.
5
There are lots of ways to organize medical care for all, and lots of ways to pay for it . Other countries have been able to do so, with less expense and better outcomes than in this country. Are they really that much smarter and more compassionate than we are ?
4
Not necessarily smarter or more compassionate, but their situation is incomparable to ours unless, of course, they are spending $600 billion a year to support a military that serves as “policeman to the world,” as the US does.
2
Ross, you’re absolutely right. I’m shocked and terrified that so many active Democrats don’t seem to realize at all that their eager embrace of what seems to most of America to be highly extreme, scary, and possibly disastrous solutions will just lead to victory for Trump. I can’t believe that after seeing this horror move before in 2016, they’re just so eager to do it all again. They seem to be saying, “Let’s nominate someone whom most of America will like even less than Hillary! What a great idea! That way we can really express our discontent” … and lose the election They just can’t see that there are sensible, moderate Democratic candidates out there, like Steve Bullock or Amy Klobuchar, who are definitely worthy of their support and who could actually win in flyover country. Democrats, please, before it’s too late! Instead of getting caught up in endlessly discussing whether Warren, Sanders, or Buttegieg is the one who expresses your profound ideas about the problems of society perfectly correctly, just realize that mainstream America won’t vote for any of them and think about nominating a candidate who could actually win.
4
Many of the left don't want to admit it, but Warren's huge garden of plans, especially Medicare for All, will bear some unappetizing fruit. Funding all kinds of government programs on the backs of the wealthy may sound appealing, and is certainly a winning idea in progressive circles, but no one knows the short or long term repercussions of Warren's fixation with punishing the rich. And make no mistake, that is exactly how Trump and the GOP will portray her mindset, all tied up in a pretty "she's a socialist" bow.
Warren has twisted herself into a pretzel to stick to the ludicrous premise that her plan will not force the middle class to pay more, but increasing the payroll tax will hurt the average worker. She is going to struggle to explain and justify her math, and the only thing voters (including auto workers with terrific, hard-fought-for health insurance) in the states Democrats desperately need to win will hear is that private plans will be going, going...gone.
The truth is that Warren may be "pure" and ideological catnip for leftwing kitties, but she is a tone-deaf politician who thinks condescendingly dumping on the other candidates for their lack of fight and willingness to upend the system will win her the nomination.
It may well work, but most voters don't want big leftwing structural change any more than they want big rightwing structural change. Most of us just want to return to some semblance of normal.
2
Many folks say in their comments to Douthat that we should fight for what's right and make the oft-repeated point that if so many developed countries can do it we can too. I agree with these arguments in principle. Unfortunately, they have nothing to do with winning a general election in the United States. I have nothing but respect for Elizabeth Warren but I cannot vote for her in the primary because I think the odds are too high that she would fail to get the votes of swing voters and anti-Trump Republicans who delivered the House in 2018 and who will determine the outcome of the presidential race in 2020.
2
I can't find the original quote, but I believe it was Ralph Nader who said something like: Every year in the US we graduate bright people with math and statistics degrees, who could be contributing to science and research, but who take jobs in the insurance industries, where they spend their whole careers figuring out how to deny or limit services to the insured. And yes, those in health insurance will lose their jobs. But I think we can and will find something better for them to do.
5
Sure Warren's plan isn't perfect and has virtually no chance of becoming law, but at least she's given serious thought to fixing our inefficient, inadequate, expensive health care system. What is the conservative plan other than to sit back and criticize anyone who tries to fix it?
3
This is Douthat in 2014; " . . . when the government moves to help people at the bottom of the income distribution, its assistance often creates perverse incentives, both by making it easier for the beneficiaries not to work at all and (when the assistance is means-tested) by imposing a steep marginal tax rate on upward mobility of any kind."
Does he still believe this? If he does, he should quit giving advice to any Democrat. If he doesn't, he should just do the same thing and aim all his advice at Republicans in the Senate.
2
None of the leading 4 Dem candidates can beat Trump a year from now, certainly not Bernie or Warren. I've a bridge in the desert to sell if someone thinks America will elect Biden or the gay mayor of a 5 stoplight farm town. Within a few weeks or the first primary 3 months from now, Harris, Booker, Gabbard and Steyer will be gone.
Does not mean any of those won't be a veep choice or good cabinet picks, but they'll not be "the one" candidate to capture the votes that matter: the middle - moderates, esp. college educated women in the midwest and even in the GOP territory of the south.
The NYT/Siena poll in Iowa:
Warren 22%
Sanders 19%
Buttigieg 18%
Biden 17%
Klobuchar 4%
Harris 3%
Yang 3%
Booker 2%
Gabbard 2%
Steyer 2%
2
@Maggie Interesting expression. But we do have many bridges in the desert, usually small ones. We do have flash floods, lakes, trains, and steep mountain passes.
1
@fionatimes
Then, go ahead, back a losing, extreme and/or befuddled candidate + pay for an almost never used bridge.
Just don't expect most of the voters to follow + help you pay for it.
2
Well, except that the GOP ideology was and is demonstrably counter to human progress. And a sham on top of that, as the ultimate goal -- as we are seeing it play out and what Warren is fighting against outside the circular firing squad -- is wealth distribution to the few already in charge of most of it. So there's that.
1
Warren's plan has many flaws like tax increase, elimination of private sector insurance policies and jobs, lack of competition, Govt. take over, etc. These flaws can be solved if money is collected by a central agency and paid from it to private insurance companies to issue a health policy to individuals. Money source to the central fund will be the money spending on Medicaid and other social programs by various levels of Govt., by employers to provide health insurance for employees, by individuals to have insurance, etc.
Under this plan everybody will have a private insurance policy by spending less money, paying less tax and without Govt. take over of this business. Hope Trump or other Democratic candidates will embrace my plan.
2
I worry about a candidate who has says she has a plan to fix everything, especially when most of her "fixes" will wind up in endless congressional debate. I much prefer a more moderate candidate who thinks about finding realistic, workable solutions that can actually be implemented...one who can be elected.
4
Speaking from an Australian standpoint I can't recommend a tax-funded single public healthcare system enough. Private healthcare companies are focused first and foremost on making a profit. That's no way to ensure the proper care and dignity that you as a patient deserve regardless of the people who work in the health system. Thankfully private health insurance in Australia is now dying a slow death as the young opt out, and we'll gladly see its end in the next decade.
Whichever system the US go with just remember that under your existing private system you don't live as long as people in many other western countries. The market doesn't care about lives.
8
Mr. Douthat,
You speak of the Democrats' move to the left. I think a little context is relevant.
I happened to be travelling in Canada on Oct 20, the eve of their national election for prime minister. I was fascinated to watch the candidates on TV in my hotel room.
The conservative PM candidate, Mr. Scheer, would probably be a Democrat if he were in the United States. He did support lower taxes and deregulation (like conservatives in most countries).
But Mr. Scheer, as a conservative:
- believes in climate change, and wants to do something about it;
- supports the Canadian universal healthcare system;
- was respectful and civil toward all Canadians.
Aside from his conservative views on tax cuts and deregulation, Mr. Scheer came across as very similar in policy positions to Pete Buttigieg.
It seems that the U.S. Democrats only look like they are far left because American conservatives have gone completely off the rails. The Trump Republican Party has jumped the shark. The G.O.P. has moved the goal posts so far right that anyone to the left of Attila the Hun is branded a socialist.
Dwight Eisenhower would be run out of town and tarred and feathered if he tried to run as a Republican today. None of today's Republicans would support the Interstate Highway System if it were proposed today -- and would decry it as a tax increase by big government socialists. Chew on that.
8
Actually, a flat income tax is not a bad idea at the state level, because rich people can easily move from a state with progressive taxation (see: Donald Trump, Tiger Woods). Progressive taxation is best done at the national level, and even then it's a good idea to coordinate it among countries.
This might all be true. But isn't more likely that she changes the plan in the general election, and no one even remembers the details of this version? I already don't know the details of this version, and in theory I'm an informed voter!
Donald Trump is not going to be able to remember the details, that's for sure. He thrives on fluid moments and pithy insults, not in depth analysis of his opponent's inconsistencies. He'll call her Pocahontas and accuse her of being weak because she doesn't hate Mexico enough. He'll accuse her of colluding with Vladimir Putin, just to relish the irony. Policy is actually a safe zone when running against Trump because he lacks the objectivity to criticize it effectively.
4
I wish Warren or Sanders would have a speech that explains how Medicare works and show how their plan improves it (e.g. adding vision, dental, hearing) and expands it to younger folks. Plus the associated costs compared with current costs. I do not think most people understand original medicare at all or the costs that you still have to pay, either by getting supplemental insurance or co- paying as you go.They also do not understand that the Advantage plans are restrictive irrespective of the rash of ads that emphasize how much they cover and the maybe $0 premium. Some education is needed. A few charts that graphically show some salient points would go a long way.
All the news stories focus on is how implausible it all is. Where is the American Dream wrt healthcare; certainly not with the op-ed columnists. Doesn't anyone in authority except a few want us citizens to just relax and not have to worry about cost of healthcare when we need it. Thank goodness for Sanders and Warren for being out there with Medicare for all, even if it has to be incrementally phased in. The reluctance to embrace medicare for all, which would save $$ by having a healthier and more relaxed citizenry escapes me; it is truly a no brainer.
7
Let's face it:
No matter how they package Warren's plan, most people w/at least decent health insurance will panic & probably in the end stick with Trump. Because as bad as our system is, the only thing worse (for the insured at least) is the possibility of it being interrupted--no matter how unlikely that possibility.
We can look back now & see that Americans made terrible mistakes by supporting supply-side Republicans who have no plan & WANT no plan to provide health care for people who can't qualify for insurance thru their employer--unless of course they are absolutely destitute.
Ultimately the Republicans & their supporters are the reason so many people have to live on the edge of doom year after year. And even when one of their own showed them a way to create a better system, they still bawked!
But we can't make up for 40 years of bad choices overnight, b/c dramatic change is simply too frightening to most Americans--especially when there is so much uncertainty & instability all over the world, made much worse, of course, by the current president.
The Dems always divide over how to reform, precisely b/c their opponents have ZERO interest in reform, and that forces all reformers into one large tent. But we need incremental reform, & we need to be rid of Trump. Don't make the same mistake as in 2016 & check out if you can't elected Bernie or Warren! Choose a moderate option, win, & let the Repubs explain why we can't provide health care for millions of people!
5
Except it's not ideology Ross, it's brutal reality for many people when it comes to health care. It's the fact that we have too much money funneled into our political process and money is the driving principle. Wall Street and corporations have already stated that they will never back the likes of Warren. We are doomed, in this wealthy country, to be the victims of our own wealth: bankruptcies due to medical bills, hospitals, pharmaceuticals, insurance companies, doctors all making obscene amounts of money while we pay and pay and pay because what else can we do? At the very least, whoever the Democratic candidate ends up being, please for the love of God, enact some price controls on pharmaceuticals and on medical practices and institutions. Price controls on the "wealth" care business is not left wing folly it's a common sense measure.
5
I expect that people would be willing to pay towards universal healthcare. I know a woman with excellent Union healthcare - a PPO. She paid $20,000 in copays last year and has had procedures denied because of outside review. Warren’s Free everything needs some constraints. Trump as a “moderate” first I’ve heard - he’s a reactionary - and his 1830’s Robber Baron policies disrupted every facet of the economy, encourages a slaveowner mentality and penalizes those who dare disagree or counsel.
4
You and your fellow Trumpists masquerading as Never-Trumpers just don't know how to think about healthcare. Right now, we have by far (close to double) the highest per capita expenditures on healthcare in the world. About 30% of those expenditures could go away if we got rid of profiteering. And the remaining 70% could easily pay for healtcare for everybody. That 70% rest is not going to go away, and is being paid for now. The question is, how will it be paid for and who will get the health benefits? Warren's plans give the benefits to the entire populace and have the government taking charge of receiving the money. If you come up with where the benefits go and a different way of receiving the money, I'll listen to you. Until then, you have nothing useful to say, including the entirety of this column. By helping get us to where we are, you need to come up with an apology and a new vision to earn the right to tell Democrats anything.
4
"Hillary Clinton lost in 2016 in part because she abjured her husband’s popular legacy of centrism."
That statement is patently false.
1. Hillary Clinton's policies were all moderate and center-left, very similar to those of Obama and Bill Clinton.
2. Hillary lost the election because took many voters for granted, most pointedly the 77,000 voters spread across MI, PA, and WI -- where she didn't even bother to seriously campaign.
3. Hillary also lost the election because (fairly or not) she had high negative sentiment, even among many Democrats.
And yes, I voted for Hillary Clinton in Nov 2016.
11
I don’t think Trump was ever thought of as more moderate than Clinton. People thought he was outside the establishment, which Clinton represented. People wanted a change candidate and bet on Trump.
5
It will be enough of a change: 1) to get the country to nominate a Democrat given the entrenched Trump voter base and then 2) to select a woman. Add Warren's whole health insurance debacle, which would upend the current system AND add unpayable taxes, and the result? Another four years of Trump.
4
The problem I have with Elizabeth Warrens, Bernie Sanders style Medicare healthcare for all is some folks don't need government healthcare coverage. But those who cannot afford healthcare coverage MUST be afforded coverage and a Medicare style program should be tried.
Statistics show that Obamacare/ACA cut the numbers of abortions drastically, because preventing unplanned pregnancies by funding birth control, worked. And areas of the country where the ACA covered programs that also provided access to fresh fruits,vegetables, programs for stop smoking/drinking, as well as dental care resulted in healthier communities and lower medical costs overall.
Some of us know from personal experience that lifestyle choices, be it unhealthy food choices (high fat, high sugar, processed foods), smoking, alcohol, drugs, being sedentary, not getting enough sleep, are where most of our healthcare dollars go each year.
How do we incorporate prevention of medical problems into the system? Personal responsibility must be in the equation.
2
I do not think Elizabeth Warren has the slightest chance of winning the presidency in 2020. I do not think any of the Democratic presidential candidates do either. They have gone so far to the left that they will scare away the moderate voters.
The costs for Ms. Warren's progressive policies will have to be paid somehow and the middle class will get stuck footing the bill. She is unrealistic to think that voters will go along with these liberal plans of hers. She is up there in the clouds and needs to come down to earth. She needs a heavy dose of reality but it may be too late. She is handing President Trump a second term in the White House. And do are all the others.
10
The idea of universal health insurance and universal access to decent care is “too far left,” only if you yourself have gone so far Right that you couldn’t see the political center from Sarah Palin’s house.
I’d agree that Warren’s health plan is politically a terrible idea—it’s only sane, rational, and workable. Not my choice, no, but love makes the worldgo round.
Speaking of which, aren’t Christians SUPPOSED to have their heads up there in the clouds, focused on Jesus’s teachings and compassion for their fellow human beings? You know...not trying to serve two masters, God and Mammon? Golden Rule?
Any of this ringing a bell?
1
Correction: the last sentence should read: And so are all the others.
Read the article today about what the EU has allowed governments to do after they have amassed great assets (land in Eastern Europe). After they nationalize the assets, the governments divvy them up among the leaders and their friends and family. This is the dirty little secret of socialism. With years of lessons as to how and why socialism doesn’t work, why would we allow Warren to effectively socialize our biggest industry? Don’t get me wrong, I believe that there is tremendous waste in our healthcare system. That can be properly countered by effective regulation. I also believe that all legal residents and visitors have a right to affordable healthcare. That can be accomplished by expanding the ACA, requiring state buy in (Medicaid) and a Medicare for all who want it option. I am also not opposed to higher tax payments for the very wealthy. A wealth tax, however, hurts savers, 401k contributors, people who have acted responsibly and paid off homes over 30 years and successful small businesses. Not to mention how difficult it would be to determine someone’s wealth. Could I mortgage my paid for house, and thereby remove my house from the “my wealth” column? Could I distribute stock holdings to others to hold in trust for me? Could I just move money offshore? How on earth is a wealth tax going to be calculated and enforced. Warren is a socialist who wants government control over everyone and everything. She believes that she knows best. She is anathema to our democracy.
5
Victor Orban, featured prominently in that article as the worstin Europe, isn’t remotely a socialist.
He’s a right-wing Trump crony, who rose to power by screaming at the EU while cheerfully getting rich off its farm subsidies. And speaking of Trump cronies, why IS Trumpy palling around with a corrupt KGB colonel who’s done pretty much the same in Russia?
1
$21T in new taxes? No problem.
2
Premiums and out of pocket costs are taxes.
T.R. Ried makes it clear in "Sick Around the World" that the best way for the US to realize massive health care savings is with single payer. It saves a TRILLION dollars every single year. (As of the book's writing, now a decade hence. More now.) That's ONE THIRD of our health care budget. That's called a NO BRAINER!
Elizabeth Rosenthal takes Reid's work and expands mightily on the disgusting excess in "An American Sickness." Profit and out of control fee for service schemes have made a mockery of the Hippocratic Oath: Do No Harm. So apparently financially ruining patients isn't doing harm. Yes, physicians and health care providers need appropriate compensation, but it can be within reason. And as long as you are providing value, make a nice salary. But not at the expense of the patient population at large.
One commenter in yesterday's Warren Medicare for All article whined, "But what about ALL those jobs?" R U serious? You want to preserve middle-man jobs that bloat health care costs for all Americans? Save an insurance bean-counter's job so a family can face bankruptcy? Not a chance!
Plus righties, you're FAMOUS for shouting "Then find another job!" whenever someone falls on hard times, or a job goes away. So just like buggy whip workers are extinct, we can not only afford, but are DYING to get rid of these ripoff artists who put profits in front of affordable, universal health care for all Americans.
5
Choice ... why does she want to eliminate choice? Why eliminate private health insurance from those who have it and like it?
4
Compared to the GOP plan to bring down healthcare costs. . . oh wait.
2
Ross is a man of faith, reality has never been his forte.
4
I'm so tired of 'conservative' commentators mischaracterizing Vermont's experience in exploring a move to a Single Payer health care system, falsely using it as a cautionary tale: "See, they tried it and it didn't work." Comparing Vermont's experience to the abject failure of Kansas' tax experiment is comparing apples to oranges. Vermont realized that it is too small to go it alone while in the rest of the country corporations suck up to 20% in profit out of the health care system and dictate the costs for health care to the other 99% of the population.
Obviously a Single Payer/Medicare for All health care system is possible and affordable at scale, see other developed economies and choose the successful approach you prefer. Obviously the health care patchwork that has sprung up in the U.S. is not effective and affordable for all. At least Elizabeth Warren has proposed a plan with supporting economics. What have the Republicans proposed? The 'conservative' approach seems to be, "What if the wolf came out of the forest? What then?" ie. better to do nothing.
2
sick of insurance! The middleperson with hands out on both sides and another meddling hand lobbying and disrupting politics. Warren needs to declare war on insurance companies and drain their coffers.
3
Warren, who is definitely sane, clearly doesn’t want to make it her centerpiece;
------
This is a piece of real good news.
The prospect of becoming a first women President, if she becomes the nominee, provides a unique competitive edge given the track record of the incumbent. The societal perception change process on gender equality can be fundamental.
Mr. Douthat is right about giving priority to issues like income inequality, and cost of education. These are achievable and non-controversial tasks.
The "Albatross", can not be shot, lest as in the 'Rime of the Ancient Mariner" the outcome may end up being "Instead of the cross, the Albatross // About my neck was hung." !
Given the reality that US allies and friends all over the world are in bit of a fuzzy state at present, the Democratic candidate has to assure not just the voters, prioritize them as well. Only if the global supply chain can operate unfettered, US can lead the free world into the "5G' economy, thereby open up the prosperity road to hundreds of millions in US and elsewhere. A policy wonk, she has the ability to really fix it.
1
There is something awfully familiar about this specious line of reasoning. Sounds a like like those economists in the ‘30’s who argued against the WPA He’ll, some of them probably opposed soup lines
1
Ross, the Republicans should be running on a platform of finally making their cozy multi-billion dollar corporation donors provide decent wages and healthcare to their employees, so the average man isn’t taxed and robbed to provide for their shareholders.
2
Republican conservatives are the group destabilizing the center. And they have been obviously been doing so for over 30 years.
What actually doomed Bush I? Forcing an untenable "no new taxes" pledge as the price of nomination, when EVERYONE in the US knew he would quickly have to break the pledge if elected. And then penalizing him for doing the necessary and obvious thing.
Since then, Republican governance has consisted of throwing bigger and bigger grenades at the center, destabilizing everything, followed by Democrats coming in to mess, having to pick up more and more of a mess after each one.
Much of the initial Obama enthusiasm that generated crossover enthusiasm was that perhaps he was The One to tackle the big problems. But he either chose, or honestly, was forced by McConnell et al to play small ball, with walks and sacrifices.
But the crowds want homers. So Warren is swinging for the fences. She has to.
Why? Because - Republicans succeeded in completely destabilizing the center. And wishing for its return is a fool's errand if McConnell is still Majority Leader in the Senate come 2021. Any doubt that his objective is a one-term Warren presidency? Or a one-term Biden, Pete, Bernie, Amy, Kamala - whoever?
6
Our "system" of health care costs about twice as much per capita as that of any other prosperous country and the results are not as good. Is this what Mr. Douthat wants to preserve?
3
@Cassandra: Yes, that ludicrous state of affairs is precisely what “conservatives” wish to “conserve.” Oh, and they’d love to eliminate Social Security, Medicare and Medicaid, food stamps, school lunches for hungry kids, the National Parks system, public arts funding, public education and most regulation of food, drugs, securities, banking and lending (especially the legalized brand of loan-sharking called ‘payday loans’), consumer marketing fraud, employment wages hours and working conditions, voting rights and guns, guns, guns. Deregulate all of it!
Because regulations and public funding of essential services are an unwarranted burden on the freedom to plunder, profiteer and defraud. Trump’s spiritual advisor has made it quite clear: those who are filthy rich are God’s chosen; those who are not get what God has ordained for them.
Now if we’re talking about regulating womens’ bodies, that’s a different story, of course. Because women are chattel. The ‘Good Book’ says so, didn’t you know that?
Only then will America be “great again.”
I like Warren, I will vote for her. But if she cannot find a way to reframe or re emphasize what she stands for in the service of winning then I agree with the commentators who suggest she may not be strategic and wise or flexible enough to lead the free world. And I'm a die hard liberal
3
@LM I have been a believer in M4A for years, but Elizabeth Warren’s plan is just not the way to get there. If she is the nominee, I’ll vote for her, while knowing that the Democrats will have given Trump another 4 years.
Too many people have forgotten or simply don’t know what happened when George McGovern ran against Nixon. The Democrats nominee has to be able to win in Florida, Ohio, Pennsylvania, Wisconsin, Michigan, etc.
I live in Massachusetts and it has reached the point where I decided this morning that I cannot even vote for her again for senator.
3
This is going to be an unpopular post. The reason US medical care costs more than in Europe are principally three: (1) Prevalence of obesity -- 30% of US medical costs are due to obesity-related treatments. See this peer-reviewed article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359159/ 38% of the US population is obese, compared to 12% in Scandinavian countries presented as models of medical care. (2) Higher drug prices compared to rest of the world. This problem is very fixable WITHOUT nationalizing health insurance, and will reduce heath care costs by 10%. (3) End of life and esoteric drugs, that most people would like them and their families to have.
If you get sick with an illness like breast and prostate cancer, five year survival rates in USA are about 25% higher than in UK. So our medical care for those who have insurance is top notch, and 92% of Americans have health insurance (private or medicare, etc.) Why would most of them trade that for a three-year wait for knee replacement in UK or wait six months to see a cancer specialist?
People naively believe that if government provides insurance, unlimited and on-time treatments will be available at no cost. Dream on.
7
@RSSF If you look at the stats, those countries get better overall health care outcomes for less money. Look it up. I've also heard the opposite of what you say re cancer in the UK.
I can't address the obesity issue, but we certainly are fat, I'll give you that. Otherwise, you're all wet.
Why does the Corporate Media insist on labelling any person who has done some homework as "Wonkish"?
5
"...and Hillary Clinton lost in 2016 in part because she abjured her husband’s popular legacy of centrism..."
Wrong-o. How many people, like me, voted for her despite perceiving her as a middle-lane Davos incrementalist, simply in the hopes of keeping Trump out of office?
HRC looks like a left-wing nut only if you're viewing her from the far right. To any real progressive, yes, she is smart and capable, and when the team needs two yards, she'll get you three. And when the team needs four yards, she'll get you three.
1
"festishizes wonkery"???
As opposed to what? The vacant, aw shucks approach of Bush, or the violent know nothingism of Trump? Since when is competence a bad thing?
America's health care system is broken. We pay more and we get less. No one understands how it works, which is great if you're a rent-seeking hospital or insurance company. Not so much if you're a patient (or even a doctor in many cases).
The only people who think it's impossible to pay for universal health care are the ones who refuse to cut military spending even as it dwarfs the combined spending of all our adversaries and allies, or who want to make us believe that going back to the top marginal rates of the 1950s, an era of stellar economic growth, would somehow spell doom for American capitalism. How stupid do they think we are?
3
Ross, what is a real Albatross is how much you and the NY Times consistently represent the corporate view above the public view on a consistent basis. When the two are aligned, then you will position it with a public spin.
U.S. citizens have been raked over the coals by the insurance, pharmaceutical and other industries for over a century and in recent decades paying 2 or even 4 times as much as citizens in other nations.
Let's make it clear, the way we fund Healthcare for all is to take all the money being spent on lousy "healthcare" that pads the pockets of people who are richer than ever before, and instead provide a single payer system where the people define the terms and pay half as much and end up with better health care and full coverage for everyone of our fellow Americans.
Let me say it again: "We pay for single payer health care by taking all the money we waste now on disjointed, pure profit based healthcare, and we spend on a single payer Healthcare for all plan, based on the highly successful Medicare model, with improvements."
Stop being a propaganda machine for the insurance industry NYT Times!
4
This country wastes so much money on the national security state. We have watched 100s of billions of dollars wasted on failed stupid murderous military interventions. Pitiless propaganda fueled waste. It has been proven that Medicare utilizes resources more efficiently than private insurance companies. The US penalizes small business making them pay for employees insurance which incentivizes them to go for the cheapest product. But the magic of the market place myth dies hard. Then there is the hackneyed claim that rich people will be unfairly singled out to pay for it. The economic royalists are wasting billions of dollars given out in tax cuts for stock buy backs in order for them to increase their own personal wealth. This, the country cannot afford decent medical care for everyone, is another cheap easy to sell product to a foolish electorate.
1
Insurance cost is merely symptomatic of healthcare costs. If you only tackle insurance by proclaiming medicare for all and don't go after the cost of health care you haven't addressed the problem.
I agree that a single payer system will out some costs -- the profits that insurance companies make, for example -- and the redundant bureaucracies that administer insurance (corp benefits staffs, insurance staffs, government staffs). But that's assuming that medicare for all actually does that. If you have medicare, you still have to purchase private insurance to cover things medicare doesn't. And remember, Brits still have private insurance.
And the ACA was supposed to reduce total HC costs, but that has happened. And insurance companies have flourished.
You also have to ask -- will healthcare in the US improve with MFA? How are we doing with the VA for example?
But once you take out whatever costs that going to a single payer accomplishes (TBD) unless healthcare costs are addressed, costs will continue to grow at a rate much faster than inflation.
How do you take costs out of HC? Is it cost transparency, better automation, more efficiencies (why do my docs still have paper files?), more doctors, fewer law suits, lower drug costs, lower cost of treatments? Better preventive medicine? And managing end of life treatment so we don't spend zillions to add a few months to the elderly (anyone for that?). But things like that have to be done to lower costs.
2
Another column from conservative Fantasy Land.
Where's the GOP-Conservative-Religious Right plan to fulfill Jesus' commandment to us that we heal the sick? WHERE?
I've been waiting a decade for the GOP health care plan.
I've been waiting a decade for the GOP immigration plan.
I've been waiting a decade for the GOP infrastructure plan.
I've been waiting a decade for John Boehner's GOP jobs plan.
I will vote like my life depends on it. Because it does.
3
@Mike
Americans voted for all those politicians since the 1960s - Democrat and Republican - who've favored the AMA, Nig Insurance, Big Hospital, Big Pharma over the U.S. citizenry.
In 2020 (and in the big picture 2022 midterms + 2024 prez election), Democrats need every Dem vote + to lure home some of the centrist GOP voters who used to be Democrats. That's only possible with a moderate centrist who can do math. Showing patience with the left is also necessary, but anyone with basic parenting skills can do that.
The problem here is that everyone is conflating universal coverage with government run single payer healthcare. Many countries achieve universal coverage with highly regulated private insurance. Germany and Switzerland are two examples. Both countries have excellent healthcare systems. With the ACA already in place, it makes sense to move in that direction by strengthening the ACA. I think it would be far more popular with the majority of the American electorate, and allow us to achieve universal coverage more quickly. Why upend the entire healthcare sector when we don't need to?
4
It is hard to know what Mr. Douthat thinks about positively, except not moving too fast. Maybe we can point out the obvious issues that have already started and ask him to make some suggestions. Let’s start with the most certain: Climate Change. California is burning; crops are underwater in the Midwest, street drains in Miami overflow with seawater, even of lovely sunny days. How are you going to fix it, and where are you going to get the money?
The job situation for truck and taxi drivers, auto mechanics, and farmers and oil riggers are not favorable. How are you going to assist them when they lose their jobs through no fault of their own.
Many Americans think that other forms of government may offer more benefits for us than the kleptocracy now in Washington. In 1950, the USA was the best country in the world, but today we are somewhere in the middle of world ranking except for mass murders, obesity, deaths from pharmaceutical pain pills, and our ability to kill anyone anywhere on earth. Having voters expect their votes to be actually counted is an extremist view, but some people think that a change in government is needed. How are you going to improve the faith in our government and our future?
3
Medicare for All has three glaring defects. First, no other country has banned private insurance. Great Britain and Canada both started with a single payer system with no private insurers and medical providers. Both found it did not work and allowed private insurance and medical providers. Everyone else started with a mixed system and have stayed with it.
Second, it implies a god like knowledge. It assumes that the legislators and administrators can design a perfect system one that meets the needs of all people. I don't know of any perfect system.
Thirdly, is that many people and groups have given up pay and benefits to get a cadillac super duper health plan. Asking them to give that up is not a good ideal and not likely to attract votes. Related to that is the fear of loss. People and afraid to give up what they have.
7
I like Warren, but cannot vote for her when she acts to despite free markets for socialism, the complete takeover of a huge industry by the government.
If she'd stick to her wiser understanding of capitalism and liberty and equal protection and ensuring corporations don't get favorable treatment over regular people, I'd vote for her. But I can't vote for someone who wants to destroy free markets for more government control, thinking it okay to forcible take trillions from others to pay for services other people want but have no actual right to have. You have no right to stuff or certainly no right to take from others so you can have your stuff "for free."
4
Am I wrong in thinking that the biggest scam is that people who live by a paycheck not only pay for their own future medicare but also pay into it to fund those who are poorer and poorly employed? So it's really the middle class subsidizing the poor and the wealthiest, those who inherit wealth or are the investment class and do not have payroll deductions do nothing for the overall good of the American population? What is wrong with this picture? Everything. Universal healthcare should be based on a tax that is progressive and covers every American. Elizabeth Warren would do well to pay attention to the fact that health care is the major issue now and her wealth tax should completely cover the costs of universal health care first and foremost but she is getting herself bogged down in free college and other less life-or-death issues. Medicare for all is Elizabeth Warren's albatross all right as it just won't work, politically or economically and she is doing a terrible job of trying to explain it. Most middle class people would be bankrupted by the 20% that medicare doesn't pay if they had a catastrophic illness or injury and many would find it difficult to afford the supplemental insurance needed to cover that huge gap, which is of course a major issue with retirees on medicare right now. I abhor the "medicare advantage" loophole because in fact it only "advantages" those who can afford to buy yet more insurance to supplement what medicare doesn't pay. Another scam.
Having good health is a sufficient if not necessary condition for living a free and good life,to attaining your goals.
If governments' goal is to promote the freedom of its citizens than seeing that they have the good health to actually live freely should be one of its top areas of focus.
Why should the freedom to retain their wealth of a few be more important than the freedom of 99% of the people? Why should the only freedom that matters in America be the freedom to have wealth?
A government plan that would support the current benefits that people have will be cheaper because it eliminates the middlemen both in the insurance industry & in doctor & hospital administrative costs.Are you saying Americans don't want to be able to have the same but cheaper healthcare?
You can't be saying that! What you are saying is that it will be more expensive to give people better healthcare than they are currently getting & you are against that.
People are not getting healthcare that would prevent so much suffering, bankruptcy & dying because they can't afford the care.
Why can't they afford it? Because healthcare is not a product that you can take or leave, so it is free to charge whatever it wants. It is not a product like any other.
Unless you are callous enough not to care about Americans suffering and dying from inability to afford the healthcare they need to prevent that, sticking with the current way that we pay for our healthcare just means that will only increase.
4
@Christine
The U.S. could've done that up to the point the govt. and citizenry decided to double the population with 120 million 3rd worlders.
@Maggie Actually she seems to have a plan for that as well. Tackling the immigration system to make these people tax-paying workers will do several things that the GOP voters want: provide more workers for corporations; provide younger workers to keep Social Security solvent; provide more workers paying into the system and not being the freeloaders that the rightwing likes to paint them.
1
I do not often agree with your opinions, but I believe that your assessment of Senator Warren’s “Medicare for all” proposal is sadly probably correct. Your column should be required reading for all Democrats, if they want to defeat Donald Trump. I’m afraid that too many Democrats are purists who are too far from the center to defeat the president. It seems that too many Democrats are eager to run up the vote totals in CA and NY creating a win in the popular vote but losing badly in the electoral college vote.
10
Warren is not adequately addressing the fear that her proposals engender. People are afraid that they'll lose what they have and that the replacement will be worse. they might be right. I don't hear Warren saying anything to assuage those fears. Bernie is no better on this point.
No unintended consequences? Really?
Buttigieg and Biden have proposed approaches which are less scary. People already accept Obamacare (Biden) and don't mind additional choices (Buttigieg).
My recommendation to Warren and Sanders is to talk about accomplishing the goal more gradually. I think their approaches are built on a strong foundation, but they can still terrify voters into casting their votes for someone else.
I also think they'd be wise to counsel voters to talk to their relatives who have Medicare and ask about their experiences.
Here's a quick anecdote that's concerning. My dyed-in-the-wool Democratic wife would vote for Romney over Warren.
5
Yes on Romney vs. Warren
@RickP
Sorry Rick, but if your wife would vote Romney over Warren, she is hardly a dyed-in-the-wool Democrat. We can only be grateful that Romney isn't running.
1
@RickP
#1. People did NOT accept Obamacare at first. A Medicare for All program, covering ALL Americans, could follow the same trajectory.
#2. If your wife would pick Romney over Warren, she is a very centrist Democrat.
After ms warren reinvents our medical industry into the utility it ought to be, maybe she'll take on Facebook and amazon and turn them into utilities as well. I support her fight now, and I’d support her fight then.
1
While we have healthcare insurance issues, her "plan" is extraordinarily bad and will make things worse. If after all this time this is what she's come up with, she's not ready for prime time.
Republicans are probably rooting for her to win the nomination so they can call it for four more years.
3
The truth is healthcare is expensive in a country that proves how rich it is at every meal. Americans eats portions that would shock most people in other countries and that gluttony results in a population that needs more medical care for all their illnesses. But the real reason Medicare For All cannot be afforded is the media has decided to lie to the public on a daily basis and praise the economy and the low employment figures. Moodys even announced that the economy is doing so well that Trump will win in a landslide in 2020. Besides a 20 trillion debt the cost of realistically dealing with climate change will be even greater and no one is taking that into consideration when discussing our "booming" economy. Anyone whose head is not buried in the sand can see that glaciers are melting, storms are stronger, flooding is greater, fires are more frequent and devastating and the cost of rebuilding is already a major issue when some devastated areas can no longer be rebuilt. And Trump's EPA is rolling back anything that can help in the future because fossil fuel companies are demanding attention to how they are struggling under a blanket of life-saving regulations. Paying for healthcare is not the issue. Saving the planet comes first. Warren will be a great president but she has some serious heavy lifting to undertake before Medicare For All will be the most serious issue on her plate.
it is specifically because they're running against Trump that this is the best time to be pushing proposals like Medicare for All.
Elizabeth Warren is doing the smart thing - putting it out there early to see how it is received.
Over time she will get a good idea whether to make it part of her platform or not. Well done.
2
When Trump’s healthcare plan now requires that he be re-elected before he will unveil it (and still not yet fulfilling his 2016 campaign promises), while he and his minions have waged a campaign against the ACA, yet claim to be for it, I’ll take my chances with Warren’s plan or anyone’s that does not involve private health insurance.
If Warren gets the nomination & debates Trump, what is he going to say when asked about his healthcare plan?
2
Elizabeth Warren health plan is on life support her new proposal on my Friday that the middle class will not pick up the ticket for the healthcare that the billionaires and Corporation will pay for the care of the American people.
There's only one thing wrong with that idea billionaires like our Pres. Donald Trump do not pay taxes they have lawyers to find every way to get out of paying taxes. So the burden is laid at the feet of the middle class to pick up the ticket.
What she needs to do Elizabeth Warren is to get Wall Street, pharmaceutical barrons, and how to care barrons out of medical for the American people. Doctors only receive 10% of the gross budget from Kaiser, United healthcare, and Pfizer.
But there spending billions of dollars to not let her win Elizabeth Warren unfair campaign practice. So good luck Elizabeth Warren I pray that you win.
Rather than get wrapped around the axel in debating your specifics, I’ll focus on the big picture (Democratic voters take note):
Our party wants to implement the same standard of healthcare coverage for all that is currently functioning normally in the rest of the developed world. We are wealthier than all of them (even many of them combined), we are more populous, and we are absolutely capable of making this work.
Dems: over Thanksgiving, keep returning to this point when chatting with your relatives. No need to make yourselves crazy getting into excessive detail. They do it, so we can do it.
2
@X how about starting with NOT lying to the American people? Warren’s plan is not the same as universal healthcare. It has no equivalent in any civilized country. All these countries (even the UK and Canada) allow supplementary or alternative private insurance. Warren would outlaw it. All these countries have higher taxes on everybody. Warren claims her plan won’t raise taxes. All these countries ration healthcare. Warren promises not to. If you think the average American voter is incapable of grasping these simple facts, you have a very low opinion of your countrymen.
2
Americans on the whole simply don’t want more fighting—in DC and across the country—about, in particular, health care.
So, fortunately or not, the best “solution,” near term, is the one that can be implemented with the least amount of fighting. That is, the solution that will lead to minimum political fighting should be any health-care reformer’s/progressive’s goal, presently.
In other words, we’re in a moment in history when the political calculus really must outweigh ideas concerning what “best” might look like; or, as the saying goes, “perfection is the enemy of good enough” (for now).
Medicare-for-all is a truly wonderful idea. But it’s not going to fly, politically. It just isn’t.
Wake up, Dems! (For what it’s worth, I’m a progressive liberal living in a progressive liberal bubble, the Bay Area.)
The good news is two-fold: Warren is pushing this (so at least we’re thinking and talking about it openly); and, as a result, she’s effectively sinking her candidacy. Alas, and regrettably, she never stood much a chance, anyway, so she’s the ideal candidate to die on this particular (ideal) sword.
4
Warren's plan makes a lot of sense. We had to wait a long time, but now I see it is do-able.
4
Ross,
I thought I had heard it all, when it comes to Donald Trump:
“enabling Donald Trump to appear to many swing voters as the more moderate candidate in the race.”
This is the first time I read a statement making the argument that Trump appealed to some voters as more moderate...
The pen is mightier than the sword, and the internet post is deeper than the bottom of the ocean, I guess...
3
The irony is that Trump's rally stadium base would most benefit from Warren's health care plan. And Warren's "coastal elites" would be most taxed.
2
When are Americans going to fully wake up to the fact that millions of people stay in jobs they detest, millions stay in marriages that are unfulfilling, millions live in a state of perpetual anxiety about their finances after receiving a bad diagnosis, millions more don’t get married or don’t take that dream job because of health care, and hundreds of thousands file for bankruptcy because they, or a loved one, got sick? All because of access to health care, and ability to pay for necessary health care. Heck, the state of US health care is enough to make a person sick. All this said, I am in 100% agreement that Medicare for All will be Warren’s Achilles’ heel. Yes, eventually, the US should have a single payer system. But, sadly, I do not believe we are ready. We weren’t ready for FDR. We weren’t ready for Eisenhower. Nixon. Clinton. Or, perhaps, WE are ready now ; but the insurance companies and the drug companies ( getting more intertwined and indistinguishable every day) have so much financial power we can’t wrest control away from them. If there was some way for Warren to declare that single payer is our destination, but for now, the ACA will be strengthened and Medicare will expand coverage down to 55+ year olds, this issue would alienate fewer voters. There is nothing wrong with fully supporting single payer against a backdrop of expediency: in this case, to unseat Mr. Trump. We might not have any ACA left if Trump gets another 4 years in the White House.
6
Medicare for All (MFA) is the WRONG policy focus for 2020 Dems ..... the focus needs to be 100% on facts & issues that will remove Trump and many of his GOP enablers from office. Period.
Keep your eyes on the goal... a massive defeat of Trump and Trumpism ideology.
Dems can win big in 2020 by tabling (now) this unsustainable MFA.. and promising INCREMENTAL improvements to Obamacare and the existing Medicare.... over the next 4-6 years.
Dems should promise to develop & propose into legislation a fully vetted, bi-partisan universal health plan by 2024... after (again) reviewing plans being used in other western nations... that actual work better and cost less than current US health plans.
Finally, Dems need to bend over backward and drive their 2020 platform/policies to the MIDDLE (moderate) of the electorate... to peel off Independents and formerly progressive/moderate pre-Trump Republications. Continuing to sound like flaming liberals/progressives, will only continue the political polarization in the electorate today... and risk Trump winning in 2020.
9
If the government pays for everyone's health coverage, what prevents private healthcare providers to jack up costs to bilk the taxpayer, while heavily profiting themselves? Perhaps the reason universal healthcare works in European countries is because they simultaneously provide public funded care as well. That way prices are kept reasonable and private care for those that can afford and need it is cherry on top of public options. However any such system, if not set up right, will suffer from similar problems as public schooling system. If the government doesn't want to get mired in setting up a nationwide care system, then Mayor Pete's plan of 'Medicare for all who want it' sounds reasonable. But we need to see the numbers on that.
1
MFA would definitely have pricing regulations. Otherwise it would be unworkable. All European countries have pricing regulations.
@Mary Sampson Medicare reimbursement rates do not cover costs for most doctors and other providers. These providers would have no choice but to disband their practices. If you don't have enough providers, insurance is meaningless. That is another detail not addressed in Warren's plan.
3
@Mary Sampson Of course, it's so simple! Congress would just regulate the heck out of providers regardless of their lobbying. /s
If the government pays for everyone's health coverage, what prevents private healthcare providers to jack up costs to bilk the taxpayer, while heavily profiting themselves? Perhaps the reason universal healthcare works in European countries is because they simultaneously provide public funded care as well. That way prices are kept reasonable and private care for those that can afford and need it is cherry on top of public options. However any such system, if not set up right, will suffer from similar problems as public schooling system. If the government doesn't want to get mired in setting up a nationwide care system, then Mayor Pete's plan of 'Medicare for all who want it' sounds reasonable. But we need to see the numbers on that.
Warren addresses this in her plan. Pay attention.
The long term care coverage will be one of the main issues.
Will people who can no longer care for themselves or by in-home care have to give up their assets to be admitted to state nursing homes? (This currently falls under Medicaid)
What are the limits of in-home care? Will the plan pay for assisted living care which currently costs about $4k/month or more (in Michigan) for a person with mainly mobility problems? I think the answer here is probably not.
What will be the impact on current long-term care insurance be?
And getting back to classic Medicare...
Does this mean no more Medicare Part B premium?
No more IRMAA for Part B or Part D No more Part B deductibles?
No more Medigap insurance?
This could effectively be "an Albatross". Yeah, the number of folks with these sort of concerns might be relatively small but keep that in mind when the NYT blames the Russians for elections decided by narrow margins.
1
Covering everyone for less money is not ‘ideological’, it is common sense.
4
@KW
$34 trillion added to the $22 trillion national debt is not common sense, nor is that only half of America pays the taxes that funds everything - including that debt.
2
20t in ten years. That’s the projected cost, which is less than Americans are projected to pay on healthcare under the current system.
1
@Maggie
That's because the other half has no money to pay with. And that's because the system is utterly broken, keeping people in poverty. And that's because our spending priorities have been backward under 50 years of conservative policies.
Time to fix it: you can't squeeze blood from a broke stone so its time to return the tax code to something close to what the country had during the 50's. What's not fair is current distribution of wealth that has absolutely nothing to do with talent or worth, but with the failure make education and fairness real priorities in our country. Warren's plan takes us in the right direction.
1
This is my second response to this op-ed. While were talking about "radicalism," I do not consider any candidate now running sufficiently radical. I am not certain any would lay the foundations for American domestic and foreign policy that would effectively prevent another Donald Trump from rising to power. Yet, as Trump is a traitor- I agree the dangers he presents are somewhat unique.
The incrementalist approach on climate change has been tantamount to looking the other way in the face of eco-holocaust. Our opportunistic and corporate dominated foreign policy has resulted in unnecessary wars and the deaths of millions in other countries. Our corporate dominated politics has contributed to the anger from displaced classes. Only in the third area just mentioned do I see Sanders and Warren articulating policies that are strong and clear enough to remedy excesses. In the other two areas, they either waffle, give it lip service or refuse to take strongly principled positions.
1
Democrats would do well to focus on the ideas put forth by the GOP. Why? Because they have none. Where is their healthcare plan, or any plan for that matter? The only thing they are interested in is finding some time machine to take us back to the 50’s - the 1850’s. No regulations, no equality, no safety net, no decent living conditions. They don’t even want facts. They are the most useless bunch of reactionaries this country has ever produced. What Ross calls an albatross is actually just an alternative idea to the current dysfunctional system. But when you have no ideas, any idea seems radical.
4
So you tell me, Mr Douthat, why the media --including this newspaper-- generally give Warren every break while trashing Sanders at every opportunity?
Beyond that, Mr Douthat has himself written about the fallacies of the 'median voter' model where there are supposedly 'all those folks in the middle' whom you have to win over to win a general election-- a model that has been wrong for decades. It's about 'mobilization,' and to mobilize you need big and serious ideas.
2
Warren's ignorance of math and insurance, and her proposal to confiscate 50% of 401k and IRA balances--aka "unrealized capital gains"--should make her a scary laughingstock, not the front runner. Proof of how far gone the Democratic Party is.
3
The fact that Douthat dislikes Warren's plan makes me so much more enthusiastic for it.
Also, Douthat could do himself an immense justice by at least pretending to engage with Krugman's recent article instead of posturing as an intellectual in front of a movement that has long repudiated intellectuals.
4
Ross fails to mention that eventually all of these people who "love" their private health care will end up on Medicare, whether they like it or not. He also ignores the fact that people who have Medicare love it. If not now, when?
4
@Francisco Garriga
That's not true. Most of the 70+ year olds I know avoid Medicare like the plague and buy their own or receive free VA care. Others are still on a corporate plan. Not everyone retires at 65 or ever till death takes them. There are a growing number of doctors who will not take Medicare, as there are now many corporate conglomerate hospital clinics that also do not take government insurance.
1
Ross, what’s the Republican plan? Take more people off insurance, stop food stamps for kids, and more tax cuts for the rich?
Strange that you are not writing about that. You and David Brooks, the “reasonable” conservatives on the NY Times, obviously will keep hammering away at the top Democrats - it’s what you do - and keep creating false equivalences - Beto O’Rourke is like Michelle Bachman?
We need big changes in this country, one’s that will leave your status quo thinking behind.
6
I despise Trump and at this point the whole dumb, holier than thou freaky Republican party.
The truth, however, is that the base and driving force of both parties are those marginally sane obsessive types. These folks tend to be low on reality and high on zealotry.
I have begun to identify myself as a moderate again rather than a liberal. The liberals don't have my vote -- I am ha ha heteronormative, highly educated, pay mucho taxes, and am very practical -- obviously no longer a definition of the granola crunching liberals.
2
Highly educated and common sense don’t always go hand and hand.
Thanks Ross but I will stick with Dr. Krugmans math over yours.
4
Neither Warren nor Douthat grasp she is not running for the office of The One Supreme Legislator. There is no such office so her trial balloon means little. It is just a minor thought experiment in Maybe We Could.
But DC hacks know no better.
The Office of Supreme Sectarian Legislators is now filled by five right wing Roman Catholics who belong to the federalist society cult and are on the Supreme Court where they are going to Get Even. With Douthat’s loyalist royalist approval. Spread with all the power of the Times to spread rot across America three times a week.
2
Everyone has to remember that Ross Douthat is a committed Republican Conservative. He may write nice editorials telling us "Liberal" how we should act to get elected but he actually has unswerving loyalty to the Republican Party. He would be better service to start writing editorials about how the Republican Party has become far right protop-fascists.
4
Everyone with a functioning cerebral cortex knows that no Democrat President will pass MFA during her first term in office. Even with a Nobel Prize and both the House and Senate on his side Obama struggled mightily to pass OC. The charlatan now in the WH couldn't and can't build a wall and Hillary Clinton remains unincarcerated. The 64$$$$$$$$..questions are (1) whether the fooled once crowd will not heed G.Bush's dictum about being fooled twice,(2) whether wizened white males will ignore Rex Harrison's rhetorical question in MY Fair Lady:"Why can't a woman be more like a man?" and (3) whether the alphabetic generations (XYZ) will get off their soap boxes, register and vote if they want some semblance of a world for their children and grandchildren.
1. The last three published polls for the nomination generally have Biden still ahead by between 7 and 15 points.
2. Warren has ZMS- Zero Minority support.
3. Middle of the road Dems are not going to say “...gosh, Biden lost in Iowa and NH, two of the whitest states in the nation, so I guess we all have to Move Left...”
4. Once the race gets to SC and the South generally, Biden’s latent strength will show itself.
3
Warren wants to tax billionaires and corporations and spend the revenue on eradicating health care costs for all Americans, which would instantaneously change, for the better, the way we all think about and have to plan for our lives. We wouldn’t have to spend our days socking away hundreds of thousands of dollars for retirement out of fear that an unexpected major illness might wipe us out financially in our old age. We wouldn’t have to stay in jobs we hate out of fear of losing healthcare for our families. It would also happen to put us in the same situation as most of the rest of the modern western world, where state-covered health care is the norm and where citizens are increasingly healthier, at less cost, than are Americans.
Meanwhile Trump actually already raised my taxes, while giving tax cuts to billionaires and corporations, and is spending my tax revenue on a wall that, even if it were to be built, would change nothing, help no one, and create a towering symbol of fear and hate.
Guess which one I’d vote for.
2
Oh come on Ross, it's simple ! All her plan requires is immigration reform so the undocumented can be documented and pay into the system, reforming the IRS so it has the resources to collect more taxes ( which also sounds like taxes will go up on the middle class) get MD's to all agree to work for less, get people to vote to give up their healthcare and to abolish the millions of jobs of the people who work for health insurance companies, force the very rich to stay here and pay taxes ( lots of loopholes there to be closed) get employers who MIGHT get a 2% tax break ( compared to what they now spend on healthcare) to back it, get big PHARMA to charge about 70% less for drugs, reduce Medicare administrative costs by about 2/3 while ADDING 280,000,000 people to the system. Easy-peasy ! /s
What her plan DOES do is demonstrate how an incremental approach to a national health care system is the ONLY thing that has a chance of succeeding.
2
Ross, the albatross is the current health care system that drives people into bankruptcy and low quality care, that is bankrupting hospitals in rural areas, and which lowers productivity by trapping people with their current employer. The Republicans had EIGHT YEARS of non-stop complaining to come up with another idea. The result? No idea but finding a way to ruin the lives of those with pre-existing conditions and attempts to break what little system we have.
It's time for a national health care system paid for by fairer levels of taxation on the wealthiest and by reforming our corporate tax code which allows too many to dodge taxes, period.
1
It's an "albatross" that will be hung around the neck of Donald Trump who has repeatedly tried to repeal, with no replacement, Obamacare. The voters next year will have a very stark choice: Trump and no health care insurance or Warren and Medicare with no co-pays, deductibles, or restrictions for pre-existing. This has nothing to do with ideology, but everything to do with human decency. It's not that complicated if you want health care insurance do NOT vote for a Republican.
5
Why is that 800 dollar health care insurance premium and the 3000 dollars deductible and the refusal to cover certain drugs not considered a “tax” ? . If Warren can slash those costs while raising taxes then it may not be a increase after all. Consumers could in fact see a decline in health care expenses.
3
There's just no way to "pivot" away from her medicare-for-all stance in the general election. She's already staked too much on it, is too known for it, and the plan is too specific for her to step away from it. This is the, to me, genius of Mayor Pete's "medicare-for-all-who-want-it" framing -- he taps into the "medicare for all" idea and language, but moderates in a way that emphasizes choice and flexibility, making it palatable to the huge number of Americans who don't want to risk having to change a plan they're happy with. By any prior standards, it's still a pretty radical plan, but one that actually has the support of a majority of the populace. For this reason, I fervently hope that Mayor Pete is able to overtake Warren. I think Warren is a brilliant, compassionate, dynamic, charismatic person, but she has made a fatal, un-undoable miscalculation on this one very important topic. And for this reason, I sadly cannot support her.
1
Beto O'Rourke's plan to "seize guns and tax churches" (only some high rate of fire guns and only those churches who have disqualified themselves for tax exemption by violating the relevant law) were not doomed to unfulfillment "by the expiration of his campaign". The causation worked in the other direction. These positions, unpopular within the party and never to be fulfilled even if he became President, were major factors in the dooming of his campaign.
This is an example of a bigger problem. Douthat likes to take those on the Democratic Party fringe and act as if they are the party's mainstream and are forcing the rest of the party to follow them. For example, in 2018 the Democrats elected many new members to the House, most of them moderate. But there are four far left blowhards, all women of color and two of them anti-Semitic. The Party leaders have rebuked them, and they have had no influence on policy. Yet Douthat focuses columns on them and tries to claim that they are leaders of the Democrats.
This plan by Warren is almost singlehanded the way good O ashore Donald Trump's re election. The 180 to 200 million people that have private insurance are gonna vote in droves for trump before they give this up. The Cadillac Union plans that their members have fought hard for over the years are going to turn out and droves to vote for trump before they give that up. When people find out the cost and tax increases such as almost doubling the capital gains rate on their I arrays that they're going to depend on to retire when they find out their stairs going to be taxes when they make a stock trade that lowers their returns and drastically lowers their Ira when they retire when they find out they won't have the freedom of choice to pick what doctor they want if they can find a doctor because the system will be so overwhelmed they will vote in droves for trump This is why Biden has to get the nomination if there's any chance of beating trump a public option is a way more affordable way without running the system
4
No, Ross, Trump did not, never has, and never will appeal to voters as the "more moderate candidate." He delivered on what both Mr. Putin (Do not forget that fact) and the darker souls of our electorate wanted: They were a return to the comfortable bigotry and racism briefly in remission during the Obama administration, and for the greedy and amorally wealthy, the rise of the oligarch at the expense of our bodily, social, and economic health as well as our environment's health. Don't get me started on the evangelical so-called Christian. Putin is joyful while watching the division and pain he so much counted on with the "rise" of his puppet, Donald Trump. I will take the "liberal's vision" any day over the corruptness of Trump and his Cabinet and McConnell Inc. The "liberal" is about helping all of us. So Senator Warren has hope? So did President Obama and under his guidance we had the beginnings of accessible and affordable health care, equality for women, the gay, the Black and Brown skinned. We are far, far from fanatics. We are about the heart and the soul of this nation, its progress, its Constitution, its democracy. And trust in Elizabeth Warren and her counterparts. What they are not able to do soon, they will do in increments. They will deliver, I promise.
6
“Team Warren and its many adjuncts in the press”: Amen. Back when Joe Biden was being hammered 24/7 by everybody with any kind of press pass, the excuse was: he’s the front runner, and this kind of scrutiny is normal. But now that Warren has been proclaimed the co-front runner, she is stilll getting mostly kid glove treatment.
Yesterday’s Saturday Night Love cold-open, for instance, was mostly a Warren love fest that included a slam at Biden’s detailed health care plan as something with no content. Of course, SNL is a comedy show whose first responsibility is to get laughs. But its attitude toward Biden reflects that of most of the media. Polls showing Biden ahead continue to be downplayed (“it’s just name recognition”) while those showing Warren surging continue to be trumpeted.
I would still infinitely prefer Warren to Trump.i would run to the Voting location to vote for her. But the media needs to do its job of cold careful analysis—and careful comparison with alternatives—of every major proposal from the candidates.
2
Weird, I was unaware that “Saturday Night Live” was part of “the press.”
@RGT I know SNL is not part of the press. I pointnthat out in my comment.... My point is that the cold open epitomized the attitude of significant segments of the press. More specifically, they epitomize the attitudes of most commentators. But the line between reporters and commentators is increasingly blurred as folks report by day and go on CNN or someplace else to act as pundits by night.
The essence of a leader is to guide the electorate to rational and needed conclusions, not the other way around where polls of voters, confused by right-wing propaganda, set the agenda. When a full and honest presentation of single-payer is made, people understand that it will be cheaper overall and, finally, include everyone. There are powerful lobbies to obscure these facts including pundits like Douthat.
6
The problem of "for all" is that "all" are not convinced that such a plan is workable especially when supplemental private coverage, something every national plan in the world has, is ruled out. That ruling out of private coverage is what killed Hillary Clinton's plan years ago. There is nothing wrong with a standard plan "for all" covering the cost of procedures but without a private supplemental plan there are simply too many short comings for it to be acceptable to "all" especially those who are being taxed to pay for it.
1
No issue is more important to me than health care. I have struggle to get it for 10 years before the ACA happened. Now I deliberately keep my income below a certain level to qualify for Medicare. It's the best health care I have ever received. It's possible I'll earn > $17k this year and have to purchase a shoddy, high deductible, only covers 70% of expenses insurance plan that will make the policy essentially unusable. That really scares me.
I wonder if Ross has ever wondered where his health care would come from, or if.
4
@The Canterbury Nails Why didn’t you go on Obamacare?
1
I’m Canadian and I am always amazed by the healthcare debate in the United States. It seems so obvious to me that healthcare is a basic right, yet the conservative establishment seems to have convinced too many Americans that it is a service that one has to pay for.
I guess this subject will be a staple of every presidential race until every American understands that healthcare for profits is morally wrong and goes against the very nature of a democracy.
8
@Michel Forest
Canada = 35 million well-educated, well-employed, taxpaying, low crime, gender equal, low on the diversity and immigration scale
U.S. = 330 million undereducated, underemployed, half non-paying, sky high crime riven, misogynist, half of the nation full tilt diversity and immigration.
Take 150 million of ours and we'll talk.
M4A is an aspirational goal, a clear statement of policy. Like every single bill going through Congress it requires multiple sponsors and a great deal of compromise.
Medicare is currently definitely NOT a free give-away. Every recipient pays anywhere from $3,000 to $7,500 out of pocket just for PREMIUMS, depending upon income in retirement and whether the person chooses a private insurance Medicare supplement. Moreover, a 6% tax of total income from employment is split and paid 50-50 by the employer and the employee.
M4A will become, as Buttigieg and Biden are suggesting a "Medicare for those who want it" meaning a public option to be offered by employers. There is no incremental cost over the current system (180 million people enrolled) which is privately run. In fact, there is likely to be a small decrease in cost and Medicare negotiates new rates for this segment of the population which will be lower, and will not incur the marketing costs and profit percentage laid on top of the plan by the private insurers.
The cost to move the currently uninsured from the hodge podge of current special programs should be a wash, provided that no new benefits, i.e. prescription drug plans, dental, vision are added. This is where all of the costs in Warren's plan come into play.
She will get the country moving down the road toward a more equitable, and affordable system of health insurance which maintains private physicians and health care providers.
But not full M4A.
Do you really believe that the people of this country do not desire to have universal health care?
Really?
6
@Dr. Planarian Yes, Dr. we DO want universal health care. The point of the article though is a) how to pay for it, and b) the government ALWAYS introduces its own inefficiencies into whatever it touches. I’m on Medicare and like it, but there are many doctors, generally specialists that I’d like to see who just won’t accept it.
@Dr. Planarian Yes. We don’t want to give up our private insurance for something run by the government.
1
@Jackson So, you think people think that their providers and coverage should be dictated by private insurance company clerks whose promotions depend on their ability to deny care?
3
The organizing principle of Warren's policy and ideological thrust seems to me to be wealth redistribution. How many innovative techniques are we willing to adopt and how far are we willing to go with them in order to make the US a society in which the potential of all citizens is allowed to flower?
How far we are willing to go determines the size of the pot for education, child care and universal health care. Filling that pot of funds for the most basic societal needs will also require an integrated economic restructure toward a green economy and the related changes in education, manufacturing, transportation and infrastructure. The necessary social mobility for the economic restructure needs to be undergirded by a strong safety net—universal health care being one key component.
How far we can go also depends on an ideological shift, away from American Individualism toward a more realistic view of interdependency. Stop making materially successful people into gods and stop blaming the less successful (especially if that means blaming yourself). The successful have managed to stand on the shoulders of a lot of other people—that's all.
This ship of ours has a lot of ballast—it won't tip over and it won't turn fast either. But it must turn if we are to become the America we imagine had the founding documents of the nation applied to all citizens and residents. We need a serious course correction. Warren is the captain whose vision and competence gives me confidence.
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@Yojimbo No, she’s trying to destroy any reason to work.
Even a liberal like me doesn’t disagree with the idea that Warren has painted herself into a corner with her stance on Medicare For All. I would like to see it, but I also would like to see world peace, income equality and social justice for everyone. Medicare For All might be a bigger stretch than all of them.
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I'm a moderate Democrat who is on Medicare and very happy with it, and I can't wait for the day that Donald Trump retires to Mar-a-Lago. I agree with Ross, in this case, that the proposals to eliminate private health insurance and replace it with Medicare for All, is too extreme for most right-leaners, many moderates, and even some liberals to sign onto. I wish the Democrats would coalesce on what Mayor Pete refers to as "Medicare for All who want it." I am concerned that Warren's numbers will prove to be optimistic Giving consumers a choice between the private insurance market and Medicare will be accepted by many voters. The stakes are too high in this election for the Democrats to risk alienating a large percentage of the electorate.
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@GF: The "All who want it" caveat means the insurance companies will do all they can to shed pre-existing conditions onto Medicare and Medicaid.
3
@Steve Bolger of course, that would be illegal.
Imagine it is 1935 and a politician proposes some level of guaranteed health care and income for senors after the age of 65. And, in 1935, social security was signed into law in the US. and 30 years later, after many deaths and much suffering experienced by those that slipped through the safety net- Medicare/Medicaid was passed.
The pundits such as Douthat looking back in 2020 would say- these were not radical measures and of of course they or something similar should have been in place in 1935.
But I would argue the selfsame in 2020 are using the same Darwinian, fear of change excuse they would have used in 1935/65 to consider universal healthcare somehow radical. Even, when in the cold economics clearly show that the current corporate dominated system is failing- with out of control costs, lowering life spans and significant coverage gaps.
So I would argue that not only is Medicare for All not radical- preserving the current system would be reactionary and radical.
Americans have a natural suspicion of government run programs except for education, protection, regulation, parks....Actually the exceptions for out weigh the areas they want to avoid government control. Yet somehow, through some trick of corporate media brainwashing- when it comes to health care- they carve out an exception.
We can debate the merits of various medicare for all proposals- but not the necessity. And, private insurance may yet play a limited role.
1
" ... the complexity of our [health care] system imposes a huge administrative burden — not just the overhead of insurance companies, but the sheer number of people doctors and hospitals have to employ to deal with multiple insurers. I’ve been puzzled at the reluctance of other studies to credit Medicare for all with big savings on these fronts." (Paul Krugman, NYTimes, 1Nov2019) The key point. I've been on Medicare for several years and it works very smoothly. The only people who want to keep the current "system" (or lack thereof) for non-seniors seem to be the companies (and their heavily supported politicians) who are making huge profits. Extorting money from our society via the health care racket.
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The math is a losing proposition not just for Warren but for any candidate of any party that attempts this nonsense, instead of fixing what we already have that supplies health insurance and health care to 90% of the nation that's on private and govt. plans.
The last hope of the U.S. having a functional national universal health care program was the early 1960s, when our population resembled more of a large European country: educated, majority homogenous, taxpaying, well-employed and just 180 million in population.
We are none of that now at a bloated 330 million (set to be 440 million in just 30 years) with half not paying taxes into the system.
3
Twenty trillion and off we go America including the 50 plus percent of the nation that is in way ready for such monumental upheaval in the hands of a serially dysfunctional Congress.
Medicare For All subsumed by Warren’s wonky assertion about having a plan for everything. A very worrisome combination when thrown into the Washington colosseum with its menagerie of ravenous flesh eating predators.
Think back to the breach birth and muddled launch of the ACA and its Herculean attempt to juggle hundreds of complex, competing, and countervailing interests. All of which went down like swallowing a pack of razor blades.
3
Healthcare is not the albatross, her underlying beliefs that capitalism is inherently evil and those who have been successful within a capitalist system are crooks and immoral anchors her policies. Massive taxation of success indiscriminately applied whether the person earned it (creating jobs and opportunity for others), her view that taxes on businesses are simply absorbed with no effect, a hollow promises of healthcare for all, education make for an easy Trump win. If Warren is chosen as the nominee when so many other centrists are cast aside, they will once again be the Party snaps defeat from the jaws of victory
3
If it became customary for American children to bring an extra package of cupcakes to school in order to buy protection from bullies & a brave spokeswoman decried this abominable situation, the nation would become outraged.
Yet when it comes to "health care" profiteers are allowed to grab 10 times the administrative costs of Medicare with large sectors of the population defending criminality.
This malaise is a sickness beyond the pale.
6
@Apple Jack Wow, you really don’t know how Medicare prices are determined.
You can't bandage a sinking ship of state or toss the last life preserver overboard. America needs a fiercely intelligent solution based approach to our massive healthcare; housing, child care; education and opportunity gaps between those who have and those Americans who have not. warren speaks to America at large. It's time to accept the smartest choice is the woman with big ideas and the energy to implement them. too many Americans fear a woman President more than they fear an ill prepared incumbent who has crowned himself our king.
3
I guess Ross didn't notice that Trump ran to Hillary's left? You know, the crusader for better and cheaper health care? The slayer of crony capitalism? The $1 trillion in infrastructure? Th protector of SS and Medicare? The guy who was going to make everyone rich because only he knows how badly the system is rigged against working people?
Funny, what Republicans will do, to promote the "never, ever" no-deliver Democratic party centrism which ensures Republicans will always control the country.
Bill, Hill and Chelsea forever?
2
Thanks, Ross, very well said.
My own fear is that Democrats will, indeed, become lost in policy.
Trump is trumping DEMOCRACY, while Democrats debate policy.
Trump threatens DEMOCRACY, daily, and Democrats are clueless.
I suggest a new DEMOCRACY wave, with a Trump defeat in 2020.
Democrats might use the DEMOCRACY song, of Leonard Cohen.
"Democracy is coming to the USA"
-------------------------------------------
The NY Times might discuss the words of DEMOCRACY, now:
"Democracy is coming to the USA"
-------------------------------------------
2
The biggest USA albatross is the 3 generations of gop debt on the backs of working families to fund billions in tax write-offs for the 1%.
5
One can determine the strength of an analysis, even when a mere political narrative like this here, by quick tests of the arguments major links. This analysis fails in its prime point- that Hillary took a huge left turn that was fated for defeat.
Anyone with a passing memory of the 2016 campaign recalls that Ms C was the centerist who beat back the surge of a "crazy socialist," then lost to the Corporate brand billionaire who stole the Socialist thunder.
Health expenses are actually projected to cost near $50 Trillion over the next decade. Any plan that comes under and covers more is, perforce, an improvement. The advantage of a plan without a lot of moving arts is clear. People understand it, get lost in devilish details otherwise. Single payer is the least moving parts, gives Gov the power to reign in costs. And eliminates profit, corruption, and the like...which has to be a major theme in any Dem win, as it always has been. In wins...
The meme- "you will lose your insurance" needs to be gunned down on stage now. It is a propaganda line invented by the Insurance hired guns. No one loses anything. Any candidate mouthing that line is a shill for the Corporate interest.
Right to their face. On stage.
The problem with Ms W's whole approach is "no new taxes". Someone talked her into a hopeless corner with that.
Finally- Mr Douthat- look at what your side is stuck running. I'd bet against any of top 3 Dems the end is 54% v 45.
340 EC.
3
This column is a classic case of Conservatives trying to dictate the terms and the language of political discourse. It fails miserably in that it does not mention that on virtually every single major issue of our time--gun control, taxation, health care, immigration, women's and gay rights--the GOP represents only the interests of the very wealthy or by proxy the rapidly shrinking base of white rural voters and Evangelicals. Quite simply, the GOP endorses policies which are unpopular with the majority of Americans or are just blatantly inhumane, unjust and doomed to miserable failure. Don't buy this load of hokum Democrats--and stop letting Conservatives try to tell us what is "good" for our party.
8
Winston Churchill has been credited with: Americans will always do the right thing, after all else fails.
Face it: Our health system has failed. MFA is the answer- get busy America!
5
"Popular and responsive to the voters" you said about policies that the people want but aren't medicare for all.
This whole piece fails because polls show a large majority of dems and republican voters want Medicare for All. The problem is not there; it is the powerful health care organizations, both insurance and providers, who fight against it because they are the cause of it high cost, poor outcomes and human pain. Data everywhere shows the high costs per-capita and as a percent of GDP compared with other wealthy countries -- but our med outcomes are equal or lower. You remember the famous statement which James Carville coined as a campaign strategist of Bill Clinton's successful 1992 presidential campaign: "it's the economy stupid," referring to what he thought people should focus on in the 1996 election. So now for the Dems it should be "It's Health Care Stupid." Our health care is causing pain, confusion, bankruptcy, poverty and death in America. Cost is due to the horrid capitalistic model for something as critical and existential as health.
If Warren keeps it as a centerpiece and the dems explain it properly and portray the Republicans as the corrupt organization they are, she can win and the people can get Medicare for All. Noam Chomsky, has stated that the Republican Party is the most dangerous organization on earth.
Here are the second and third policies Carville promoted for the 1996 election: "Change vs. more of the same" and "Don't forget health care."
3
Republicans are frightened to their core that Warren has a chance to defeat their criminal President, as evidenced by the lockstep attacks on her by the Professional Republican Commentariat. Douthat lazily employs the standard GOP tactics of alternate history, false equivalence, Gingrich style epithets and rejection of human progress. Republican litmus tests for ideological purity became commonplace under Reagan. The flat tax was nothing more than a sleazy attempt to hide a massive tax cut for the rich. The supposed leftward march of Democrats is just a Gingrichian way denying and reframing the decades of progressive Democratic programs, that the Republican base has come to believe have always existed and are their birthright, as something both recent and evil. The only sincerity evident in Douthat’s and other Republicans’ attacks on Democrats is their total rejection of the words and deeds of that hippie leftwinger Jesus and their abject fear of anyone not white and not male having any power in America.
3
Bernie and Warren's proposals for increased social services such as healthcare are bringing out the knives of the retro, anti-gov. crowd, some demos and definitely all repubs. Reminds me growing up in the South when fellow whites would flare up with anger whenever actual racial protest and demands for change occurred. Southern whites would say "let the natural progress change things", "don't agitate and upset our communities, our feelings of good will." Of course we've learned that w/o the protests, the pushback nothing would have changed. St. Reagan screamed our nation would become socialist and decline if LBJ and demos' Medicare was implemented. To demos I say go long or go home. Talking to you too Pete.
2
The issue has never been whether single national payer is a good idea or not, any more than whether Hillary Clinton is a more sane and rational human being than Donald Trump. The issue is whether a candidate can win 50.1% of the vote in Wisconsin, Michigan and Pennsylvania in the face of Russian-generated Facebook advertising and Fox News echolalia. The bumper sticker of “taking away private health insurance” will be on enough cars in those states to sway the Electoral College. The time for Warren to begin the pivot away from Medicare for all was a month ago. Her perseveration and the book-length plan to balance the books, valid or not, is just digging the hole deeper. With Putin and Zuckerberg going all in for Trump, adding the albatross of single payer seems nuts.
1
O.K., Steve, can you please tell me how many people have to unnecessarily die or go bankrupt, and how many TRILLIONS do we have to waste before we can push for an efficient universal government run healthcare system as all other developed countries enjoy?
I really would like to know.
PS - Here is a statistic everyone who opposes supporting M4A now should know. It is called "amenable mortality to healthcare". It is mortality, deaths per 100,000 population, that result from medical conditions for which there are recognized health care interventions that would be expected to prevent death. It is a measure of how well healthcare is delivered in that country.
The latest figures I could find are for 2014, but here are some
US - 112
UK - 85
Germany - 83
The Netherlands - 72
Canada - 78
Sweden - 69
Australia - 62
France - 61
So when I ask people how many people must die before we should push for an efficient government run system of healthcare such as enjoyed by other wealthy countries, I am not just making a rhetorical point.
https://www.healthsystemtracker.org/chart-collection/mortality-rates-u-s-compare-countries/#item-amenable-mortality-2004-and-2014
2
The GOP pundits have been marvelous over the years instilling fear in the serfs. I am constantly amazed that such simplistic and false musings are effective, but they are. Of course, it's obvious now, given the current president, that many people are super easy to fool and are the perfect citizens for an authoritarian state. You know, say something modeled on Russia where they say they have a democracy but it is clearly not.
The albatross here is a healthcare industry that gouges sick people and is protected by the GOP and moderate democrats. The majority of voters want universal healthcare. Politicians who don't have a plan to get everyone covered are the ones who have a problem. They are the ones with an albatross around their necks. Healthcare was a big issue in the midterms, and the progressives win on it.
Technically speaking the DFL has been on a rightward march for the last 50 years. We all would be far better off now if they had stayed true to a progressive agenda, but they haven't. I believe moderate democrats should join the party of Trump where they belong. If the DFL moves somewhat back to the left, they will still be far right of FDR. Which is quite pathetic really, but the only choice we have other than the GOP party of the moneyed overlords.
Yes, the Democrats can lose this race with Lizzie. If you subscribe to The Boston Globe, read the comments of readers after "news" articles on her - she cannot win even here in MA. Both she and Joe Biden need to fall on their swords soon so the party can rebuild in time for our primaries in March.
2
I am madly in love with my Health Ins. Company.
I can’t help it. No matter how much they raise my premiums, deny claims, and tell me which doctors to go to, I still love them.
“Unrequited love differs from mutual love, just like delusion differs from the truth.”
– George Sand
1
Man...a lot of revisionist history here, so lets clarify just one of the loose thoughts emanating from the Grand Oracle. Vermont's foray into single payer healthcare was in no way similar to the debacle in Kansas, and your equating the two is facetious at best. Vermont studied the single-payer option and tried to put together a plan. It was found impossible for a single state to implement and the plan was never implemented. Kansas followed the wisdom of a dope in Sam Brownback and implemented the daft plan he and his nitwit republican snake oil salesman created. It was doomed from the start, they knew it and they did it anyway. So I guess the difference is the VT liberals were willing to pull the plug when they knew their plan for single-payer would not work, while the ultra right wing goofballs in Kansas went whistling right along without bothering to recognize the potential for failure. Two completely different results, which isn't surprising, because only one of those groups doesn't really care about those who have less.
1
Never listen to your opponent's advice when he tells you how to play the game.
2
Hey Ross. Your premise is flawed. You argue against health care for everyone and how the left is tying themselves to a losing argument. In so doing, you forget that a Christ himself defined those who would not care for the sick as being unworthy to sit at his right hand. Then he went to have lunch with the Pharisees, a significant seat of power in Palestine, and told them that they were not sanctified by washing their hands, but rather by caring for their fellows (nations as men, Ross; nations as men). So instead of whining about the left’s focus on health care for all, why don’t you do an article about how fundamentally anti-Christian the GOP is. That would be a more meaningful use of your God given writing talents.
1
Mr Douthat, please write about the GOP Healh Care Plan. We're long past 2016, and it's still not posted.
1
I have been an RN for 50 years. I remember to the day when managed care began. The managed care person (utilization care)
arrived in my dept with a list of pt’s with dates of dc. “I’m not asking you I’m telling you to dc these pt’s.”- didn’t matter what the md attending had to say! So just like that - this huge ‘middle man’ was inserted into the medical care scenario. Oh boy, here we go, I thought. I have the same negative sentiment today.
People who work in corporate America have a false sense of security about their health care. Everything is great when you are healthy...
But when ill health hits look out. Many lose employment, assets, homes etc due to illness. So very many Americans live with anxiety associated with lack of adequate health care coverage. So yes, I will vote for Elizabeth Warren for her stance on Medicare for all. It is greatly needed in our great country.
344
@Marti Williams
All these Times columnists no matter how many times they hear it, no matter how powerfully and eloquently stated, no matter the lived experience of the person saying it, it just doesn't penetrate their consciousness.
They exist in some type of fantasy world. Embracing a fool realism that gives them a programmed sense of their own relevance.
33
@Marti Williams Well said, Marti. I am a retired RN, and I hear you. We have both seen so much unnecessary pain and suffering because too many have not had adequate health care. I was a hospital floor-nurse who worked in both ICU and Acute Rehab. I can not emphasize enough how often I thought that if only these patients had affordable health care they would not end up at death's door or would not become victims of life-long debilitating illnesses from which they will eventually succumb. It is no longer an option, we must follow our European and Canadian counterparts in providing universal health care. If our health continues to be at risk and threatened by the greedy and corrupt from within and outside of government, then we are complicit in the death of a healthy nation which can not and will not thrive.
53
@Robert Roth Not all. Although I really respect both Brooks and Douthat and always read their columns, they seem to be the only two who are, in my mind, too conservative in their views of health care. Did you read Krugman's latest about Senator Warren's Medicare for All plan? It is worth a read and is reassuring that something will indeed be done to stop this present health care crisis. I am convinced that if we do not achieve universal health care in the near future, we will eventually reach that goal. We have little other choice.
15
If the Democrats cannot sell a product that delivers significantly better results at at HALF the price of the competition (ACA), and, in addition, has one of the best loved brand names in history, why then, perhaps they should find a different line of work.
A comprehensive universal publically funded health care system is a worthy objective that, in one form or another, all other advanced, modern, prosperous countries have achieved. The US can start many decades later, but some key facts, based on the experience of other countries, are not being discussed
1. These systems in other countries evolved over decades to met the changing norms of each society & changing health care needs & practices. Telescoping that long progression into a rapid transition in the unique US situation will be expensive, prone to bottlenecks & unforeseen challenges & take longer than many now assume.
2. These systems in other countries are more efficient & effective & therefore less of a cost to the combined private & public sectors (i.e. paid from public revenue or by patients directly to health care providers or insurers) of those countries than is delivery (or denial of needed delivery) of US health care. Thus, under an analogous new US system, US taxpayers typically would pay more in taxes than at present, but that cost would be more than offset by reduction or elimination of the current cost of services.
3. The net savings & benefits mentioned in point 1 & 2 will not be fully evident during the decade(s) transition from the current state of US health care delivery & payment because the initial costs & problems arising during that transition will be high & immediate while benefits will not be fully enjoyed & generally evident for some years.
@bob adamson - Not so. Many of the other countries plans are much the same as they were when started. And look at Twain. Although the desired plan was never fully implemented, they began to get results from their universal government run plan almost immediately.
@Len Charlap
Taiwan adopted the Canadian system in large measure. They had a major advantage for transition purposes as I understand matters in that prior to adopting their system,
(a) there were few, if any, significant private or public health care plans, &
(b) doctors & other health care providers welcomed the new plan not only because it helped their current patients but also because healthcare became more affordable for those patients & many new patients (i.e. it increased doctors' income & security of collection & reduced the trouble & expense of collecting fees).
The US will not enjoy these advantages & the scale of the transition endeavour is much larger, more complex & unpredictable.
I'm not arguing the US shouldn't do this, only that people appreciate that this is a massive transformation.
@bob adamson - It may be a large tranistion, but since we already know how to run Medicare, it is only an incremental one.
And why, like Taiwan learn from others?
Elizabeth Warren shouldn't be President because in a time when everything cries out for a person who will just beat this corrupt, immoral and politically weakened President, she is doing her best to help him to win.
She would rather indulge in pie in the sky ideas than be President. To be clear I would love Medicare for all but right now we need to beat Trump.
In short Warren is not savvy enough, not smart enough,and not strategic enough to be our President.
Too bad! If she wasn't way off in the clouds I would love to vote for her. Now my greatest hope is that she fails.
113
@cort So you really believe that healthcare is "pie in the sky"? So sad how you have been duped by the propaganda of the 1% who laugh at you for your submission and willingness to continue to support their royal lifestyles in lieu of healthcare for all. We can only hope that others are waking up and discovering the truth.
55
@cort Not smart enough to be president! Then explain the existence of Donald Trump.
52
@cort Thank you for your Republican, Trump supporting opinion. Of course you don't want Warren to run. She is probably the strongest Democratic Candidate. Haven't you have enough of the Trump "Greatness?"
52
I don't understand why progressive Democrats are so in love with true single payer--meaning no private insurance whatsoever. Imagine if the current government had a monopoly on health care. I have to admit I can't even name the head of HHS but judging by the rest of Trump's appointees, I doubt that he or she would make good evidence based decisions. And even with a Democratic house do you really want decisions about what medical care you receive, and where, and who delivers it left to the machinations of Congress, with all its wheeling\dealing, trade offs and lobbying? Under single payer, the government will control every detail of your care. Will you be able to go to any doctor or provider you choose, or the hospital you will use? No way that could work.
1
@Jake - You are confusing health INSURANCE with actual health CARE. I am 81 and have been on Medicare for many years. It is far better than any of the many private insurance plans I had before Medicare. I would rather Medicare have what control the have than a for profit health insurance company.
2
Looking at the big picture, a world where many successful national healthcare programs exist, why do US journalists still think Medicare for All is a 'far left' idea? I think Democrats need to work harder to get out from under the false branding Republicans have been up to.
2
Warren has backed herself in a corner to Trump's delight. Do we want to change the world or save the world from Trump? I fear we are giving the 2020 election to Trump. In what Congress will Warren's plan have a chance of passing?
2
What are Republicans doing about improving health care for Americans? They are trying to demolish Obamacare completely in the courts currently. They have no plan. At least Democrats are formalizing plans for future health care in America.
2
With the current system and demographics of aging Americans, most of the middle class will outlive their savings and home equity due to healthcare costs either due to catastrophic illness or old age. Medicaid kicks in when savings and home equity are depleted and it's a good thing it does. After seeing this happen twice with our families all I can say is thank God for presidents Franklin D. Roosevelt and Lyndon B. Johnson for Social Security, Medicare and Medicaid! Where would we be without them? I will be voting for the candidate who offers the most help to the middle class, the poor and the young future generations.
2
@Laurel
The largest demographic is millennials, many still living with their parents and on their parents' health care, those not already on Medicare.
Moreover, Obama gifted another 30 million able bodied millennials with Medicaid in 2010.
The GOP's health care albatross: Caring about the profits of big pharma and insurance companies rather than the welfare of American citizens. The GOP could have worked with Democrats to lower costs. The ACA is based on plans the GOP favored until Obama proposed the ACA.
Years of shouting, "Repeal and replace!" What was the GOP replacement? To cut health care for 30 million, while cutting taxes on the wealthiest. McCain's vote helped put a stop to that vile nonsense. Because the GOP has tried to gut the ACA in any way it could, the time has come for Medicare for all. It is long overdue. Ross is wrong and tiresome, again. Sen. Warren is the second coming of FDR.
1
America has a health care albatross.
Our politicians who don't have a plan, never had a plan, never will have a plan, they have an albatross.
Check the log in your own eye.
Americans are becoming ever more upset over the lack of health care, and those like Douthat think that just doesn't matter. That's an albatross.
6
This is an absurd statement: "Hillary Clinton lost in 2016 in part because she abjured her husband’s popular legacy of centrism, enabling Donald Trump to appear to many swing voters as the more moderate candidate in the race." Hillary Clinton lost because she ran a terrible campaign in which she came across as insecure and arrogant. She lost because she failed to campaign in the swing states that mattered.
2
@Claire Schneider
Clinton lost because 80,000 GOP voters in 70% Catholic/evangelical Pennsylvania, Wisconsin, Michigan were hell bent to finally after 40 years repeal Roe v. Wade abortion rights + family planning and birth control, if possible, for American females via pasting more conservative Catholic men on SCOTUS, courtesy of Putin's degenerate puppet, Donald Trump
The argument began to lose me early when it posited, bizarrely, that Hillary Clinton lost because she was too far left:
“The party’s leftward march began in Barack Obama’s second term, and Hillary Clinton lost in 2016 in part because she abjured her husband’s popular legacy of centrism, enabling Donald Trump to appear to many swing voters as the more moderate candidate in the race.”
While Clinton’s loss was a perfect storm many factors — ”Russia, if you’re listening...” — one of them certainly wasn't that she abandoned the centre-right ”establishment” wing of the Democratic Party. And she might have won had a sizeable chunk of Sanders supporters not stayed home or voted for Trump as “disrupter”.
And yes, Clinton proposed modifying the ACA, whileTrump promised universal free healthcare (while also promising not to touch medicare, medicaid and social security). Promises, promises...
(Doughat, to make his point, would be better off looking at the *popular* vote and arguing that slightly more Americans voted for a safe centrist, establishment candidate, even though America's appetite for a radical disruption bordering on political anarchy —let’s bring the whole stinking house down and see what happens— ended up taking the day.
No end to 'centrist' republicans like Ross and David Brooks to tut tut Democrats for their ideas.
Not once do we see a similar article about how trump still has no healthcare plan AT ALL, despite his ridiculous campaign (and presidential) promises. No discussion of competing plans, just pearl clutching about details that can be changed with cooperation. You know, how Congress has worked since roughly 1777.
It's crazy to read comments admonishing Democrats to just run a likeable, knowledgable person, and they'd automatically win. Have you met today's republican party? Anyone who would support the disgusting venom against Lt. Vindman, has no honor. We knew this back when John Kerry ran for President, and the odious 'swift boat veterans' took a good man's reputation and turned America against him, with lies and lies and lies and malicious lies. VETERANS!
I'm not interested in hearing trumpies scold us for any candidate's plans. you don't care that trump concentrates only on his own personal enrichment, but you care deeply that a Democrat wants sick Americans to get simple medications without going bankrupt. You folks will happily hate on higher taxes for the .01%, if it means poor people will suffer.
Trump's minions control two of three branches of gov't, but there are no infrastructure jobs by the millions, like he crowed. No healthcare improvements, no filing taxes 'on a postcard', no wall, no nothing. NOTHING except abortion and extortion.
6
As a lifelong Democrat, I don't recall ever agreeing with an article by Mr. Douthat. But this one, yeah.
He's right on.
2
Warren is DOA in the general. The Dems have to nominate Mayor Pete or Amy K.
3
It is hard to imagine that people actually want to be governed by anyone as close-minded, spiteful and vindictive as Trump is.
A majority of Americans expect a president to be a heterosexual male. That is a fact.
Mr. Douthat, when you say "Clinton lost ..." please remember to add that "Clinton lost the electoral college..." It is worth remembering that she won the popular vote by near three million. She lost because of an 18th century institution that was created to protect the power slave states.
2
There's no need to add "in the electoral college," because everybody knows that in the US, presidential elections are always determined by the electoral college. Well, everybody accept the Clinton campaign, that is.
Very hard to know which Ross Douthat is going to show up these days. One Douthat believes that ideas matter, that doctrine, particularly in the Roman Catholic church, is fundamental and sacrosanct, and that liberals would sure be better off if they believed in various things, including the Trinity. But then there's this Douthat for whom belief and values--"ideology," here--are nothing but trouble. It's striking how many homeless conservatives, alienated from Trump's Republican party, now have to condemn the Democratic party for believing in anything.
5
The difference between Kansas's flat tax experience and Vermont's single payer experience is that Kansas enacted the flat tax laws and decimated the state, while Vermont never enacted its hopes for a single payer system, thus never damaging anybody. Vermont is a very small state and probably doesn't have the resources for a go-it-yourself single payer system, but Medicare-for-all has been successful in dozens of advanced countries and it can work here as well.
3
Warren is a train wreck for the Dems.
If nominated, I have no doubt she will be the main reason Trump will be re-elected.
Her promises of free everything ( free college, free childcare, forgiveness of all student loans, and lots more) as well as her many costly plans ( untold trillions of dollars) are the ultimate leftist utopian vision.
The middle class will not only pay through the nose but 147 million of us will be stripped of our private insurance.
She is a my way or the highway ideologue who is along with Bernie leading a Trojan horse attempt to hijack our party.
Mayor Pete, who is now about to eclipse her in Iowa, will be our next and best president.
2
@Simon Sez
Warren has already explained that she would increase taxes on the wealthy, which in a democracy, is how it should be.
Don't forget that in the past Trump has bragged -- bragged! -- about being so smart he hasn't had to pay taxes. This, from your president.
Make no mistake about it, the super-wealthy in your country are able to use tax-avoidance schemes that aren't available to the middle class.
I know. If the wealthy paid more tax the poor darlings might have to suffer the horrible fate of having a teensy bit less money. They might even have to tighten their belts, maybe foregoing buying one less luxury car this year, and maybe decided not to buy that $30,000 Birkin purse, and maybe even not buying that third mansion, but the US would have ample money to pay for the things you mentioned
2
Imagine that, a party that "still fetishizes" wonkery.
I'll take it over a party that gleefully wallows in it's own willful ignorance.
Do I have a lot of problems with our most extreme, puerile "woke" members? Absolutely.
They do concern me, greatly.
But conflating Warren's "Medicare for All" plan with the worst impulses and ideas of our far left mob is misguided.
There is a lot of daylight, both ideologically and psychologically, between her and the idiots on our left flank.
If she just keeps doing what she's doing, she'll be fine.
I know that's a bitter pill for you and David Brooks, who continue to live under the delusion that "conservatism" actually has something to offer anybody.
2
What is it about Republicans and conservatives that all they seem to focus on is how the Democrats are out of touch with Real Americans and just too liberal for Real Americans.... America has moved so far right we are closer to Nazi Germany than FDR's America.
Isn't about time that a political party propose Big ideas and policies which help all Americans and improve the general welfare of our ALL of the people in the country not just the 1%, big business, wall street and banking....America used to do that until the right wing and the rich bought off and took over both political parties.
Americans are Sick and Tired of waiting on conservative policies to trickle down to us. We are not willing to wait any longer.
5
I dare you, Ross Douthat,to survive for a year, no lets say two years, as a WalMart worker, or Amazon worker, our nations's biggest employers, and understand how health care is for the rest of us.. You have no clue, as is apparent from your opinion pieces..
3
What I don't understand is this: America needs a healthcare system that works for everyone. Nobody should be forced to declare bankruptcy over medical bills. In our wealthy country nobody should live on the streets or die because of lack of care. Pharmaceutical companies should not be charging Americans multiple times more for drugs available everywhere else for much less. Can't we all finally agree on this? Can't we join the rest of the first world countries in guaranteeing this basic security? It is irrelevant what proposals are put forward, it should be a policy goal for all political parties to make it happen. So what if Warren proposes one solution, others have different ideas, the goal should be the same. This is a problem that anyone grown up in Europe, like myself, can not fathom. The endless debates without a common sensible goal. For something as basic as healthcare. Makes me realize that many of you think it should be a privilege not a right which logically follows that many of you feel it's ok for Americans to die and/or lose everything because they can't afford care. Please explain!
3
Lets look at this radical leftward lurch and compare it to the so called conservative agenda.
Conservative-
Cut taxes mainly for the rich. Result? No increase in jobs, more corporate profits, less revenue,1.5 trillion deficit,280 plus corps paying NO taxes, 400 folks have more wealth then the 90%. Thats not radical?
Reduce regulations- Boeing crashes, oil spills in Keystone country, toxins in water in coal areas, less food inspections. Thats not radical?
Health care. Reduce people covered, increase cost, more deductions, drug prices increased this year already.
Liberal ideas.
Fair taxes back to 1980 levels where high tax was 50%, Corps paid 36% (now pay 11%) billionaires pay up fairly.
Regulations to protect people not businesses
Health care for all rather then billions wasted on defense.
Thats radical?
Seems things are turned around as to what is radical or not.
2
Please please tell me the health care plan Trump if he is not impeached or any Republican is running on. Just a simple question and not the AFC is an answer. Plain and simple. No policy at all will not cut it this time.
3
“Highly ideological parties and candidates can win elections in the right circumstances, and a race against an unpopular, unfit and impeachable incumbent might be one of them.”
Ross sees the world through his religious prism framing everything as an ideology. And the problem with ideologies is that they give you an answer before the question can even be discussed - like his religion.
Capitalism is a tool, not an ideology. When we make it an ideology (like Reagan did) it leads to the idea that government is bad, taxes are bad, unions are bad, taking care of the needy is bad.
Sheesh! People pay for their kids going to college; if one child needs more healthcare than the other, parents pay for it without adjusting their will or forcing the kid to fund it. Socialism is what we practice within our family- it’s the effective practical approach but not the guiding ideology.
1
Let me pile on. I frequently disagree with Ross, but on Warren's health-care prescriptions, he is on the mark. Warren is proposing a health-care overhaul that (a) stands no chance--none--of passage in Congress and (b) will substantially increase the changes of a second Trump term if she is the nominee. And of course, the reason is that, in her battle for the nomination, she is battling Bernie, a 78 year-old socialist who just suffered a heart attack, for the support of the Democratic party's left-wing.
2
In my view, democracy in the US is already almost dead. But I would like to see it survive for a while at least in weakened form.
Elizabeth Warren is infinitely better than most other Democratic candidates because she focuses on pocketbook issues, like achieving universal health care.
Make no mistake. Trump is the worst US president in history. Being less bad than other candidates makes it a no-brainer to vote for her in the general election.
Will she fail to achieve universal health care? Probably. But the goal is worthy even if the timetable is stretched out.
The most important issue in this campaign should be global warming. That's because global warming threatens the long-term survival of the human race.
But both parties are wrong on this issue. Trump denies global warming outright.
Democrats preach about global warming but they don't understand the cause.
The reason for global warming is population growth. We were warned about that in 1968 with the publication of Paul Ehrlich's Population Bomb. But we did NOTHING.
Now 50 years later the world population has doubled once again. Other things equal that doubles the production of greenhouse gases.
If democracy is to survive we need to confront the problem of overpopulation. And that means actually discussing its long-term implications and finding ways to encourage smaller family size.
We need to make contraception available in places like Guatemala and encourage people to use it.
2
The next time I see a ZPG-er who knows the current numbers, let alone how hard the liberal types have worked on pop control plans, will be the first time.
@Jake Wagner: The US is an unreconstructed-un-democratic state-level scheme of liberty to enslave. US states conspire to avoid adult supervision by a national government elected by all on an equitable basis by sending drones to Washington.
A candidate pushing MFA will not defeat Trump. Let's get our priorities straight.
1
US health care is really a make-work project on the scale of the defense industry. It devours everyone's time in administrative overhead, especially doctor's. Every time a drug isn't on a patient's formulary is likely to consume some doctor time.
2
The problem is once the ball gets rolling on a proposal like Medicare for all people in a party get ostracized by other party members if the they don't support it. Bernie Sanders should be credited with getting the ball rolling on Medicare for all and Democrats not supporting it were then subject to being labeled corporate Democrats or Republican lite. In other words Medicare for all was turned into a litmus test. For any Democrat wanting to be considered progressive not supporting Medicare for all became a liability as did not claiming every American has a right to health care coverage. If the Democratic nominee doesn't support Medicare for All there will almost certainly be a big fight at the convention over the platform which could lead to many progressive Democrats not voting for the nominee in the general election which could wipe out any gains in swing voters.
You are right, fixing something does involve change and people don't like change. What if you have a broken window? Well first you need to get a new window, cost, and either tools, cost, or hire someone, cost. So, no one likes the costs aspect but many want the window fixed. Then, the disruption while you fix the window; no one wants the disruptions. Finally, there will be a substantial number of people who just don't want the window fixed; they just moved to a different part of the house. Our repsonse to health care is exactly that, we want all the gain without any effort.
1
Maybe it's just me, but I still think the Public Option is the only sound, and workable way to better healthcare.
When Medicare and Social Security were off to shaky starts, neither was scuttled and started from scratch, all over again; the bugs were worked out over time, and the rest is history.
So, what about now? Work on improving ACA (it CAN be done). Another thing; require the medical community (i.e. doctors, hospitals, and the drug industry) to disclose fees/prices for their services.
There is no reason why a given pticedure, hospital stay or prescription should have the kinds of disparaties they do, outside of maybe greed.
And, don't respond with "well, how would you do it?"
If I had a solution, I'D be running for POTUS.
3
As a conservative, who worries about big deficits and high taxes, Mr. Douthat would feel more comfortable with a centrist Democrat like Joe Biden. But Elizabeth Warren and Bernie Sanders and their supporters are upset about the growing inequality between average Americans and wealthy ones. They want to do something about that. That many Americans are concerned can be seen in the huge sales of such books as Capitalism in the 21st century.
If the current polls hold steady--a big if--either Sanders or Warren should win an election with Trump as opponent. However, once they become president, it is unlikely they will be able to enact their big plans into law.
1
Having practiced adult medicine for over 30 years the only patients I have encountered who seem pleased with their health insurance are either Medicare recipients or Tricare for Life (military benefit). I can not recall the last patient who was happy with their 'private insurance', especially after they get their bill. The current piecemeal approach to healthcare doesn't work yet many are quick to criticize any attempt to change the status quo. Mr. Douthat does us a great disservice by not offering a better solution of his own.
2
Ross, it’s really disappointing when intelligent opinion columnists don’t take the time to understand the complexities and challenges of healthcare reform. As an avid listener of The Argument, I don’t know why you and your colleagues find time for all this outside reading of fantasy fiction, then go on to repeat fictions around how beloved private insurance is to most Americans. That’s the real fantasy. No, people love their doctors and would love to have secure access to healthcare without financial hardship. Period. Once you start reading the history of healthcare in America you will find out why Payers have played an outsized role in the healthcare system since they entered the space in 1929. Elizabeth Warren’s plan is the best any American politician has done to reconcile three popular but until now independent ideas: (1) Every American deserves healthcare; (2) healthcare costs and complexity have spiraled out of control; and (3) voters want to understand how a healthcare solution will be paid for in terms they can understand. Time to give Tolkien a rest and start reading about the history of our broken healthcare system. You owe it to your readers.
1
It's difficult for any gov option to be competitive with group insurance as long as (1) employers can deduct their payments for employees' insurance from their taxes and individual employees can't deduct theirs and (2) employers are not required to offer employees their cost of group insurance as an addition to salary if employees choose to pass on group insurance and source insurance elsewhere. With a level playing field on taxation and employees able to compare their employers' plans with the gov option on coverage and after tax cost, we'll soon see if single payer is more efficient. Perhaps the Dems should focus more on these changes and let the market work, let employees see how good - or bad - their group insurance really is.
4
I am on Medicare that works well for me. I can't understand why Americans are opposed to it. Anyway, they will end up on medicare after retirement at age
65. Bad now but o.k. at 65! In the
meantime healthcare cost has reached
$3.5TN, an enormous burden. It
continues to escalate at a higher
rate than the average inflation.
Ms Warren's proposal should start
good debate , not knee jerk reaction
dismissing it as an ideological fixation.
3
I must be living in some sort of bubble, as I've never met anyone who seemed enamored with their health insurance or private insurers in general. My insurer has changed seemingly every two or three years. We've never even gotten around to a kiss, much less holding hands. If Elizabeth Warren can reasonably offer a better alternative backed by the federal government rather than the profiteers in the medical industrial complex, what exactly do I have to lose?
Of course, "centrist" Democrats of a certain age (plus "reasonable" conservatives like Mr. Douthat) convinced themselves long ago that it's important electorally to never offer a big idea. Never put yourself out there. Never let yourself get in a position where you have to defend your plans. Never allow anything of substance to enter the debate. The fact that these same milquetoast centrists were a major ingredient in the rise of Donald Trump seems not to have penetrated their skulls. Bill Clinton's wisest observation applies here: strong and wrong beats weak and right every time.
The squishy, low-information, apolitical voters that seem to be on the minds of the deep worriers aren't paying the least bit of attention to any of this yet. And most struggle to understand how health insurance works even when tuned in. Elizabeth Warren's gift is making complex policy understandable, without fear of naysayers. Underestimate her at your peril. I would bet that the Trumpies are already more than a little concerned.
5
Support for a failing system is better than any attempt to improve it according to Republicans. Despite numerous votes to kill the ACA, aka Obamacare, mostly because it was known as Obamacare, the Republicans made no effort to introduce their own version of healthcare reform. This was true despite Trump's promise of a beautiful, better, cheaper healthcare plan and despite Republican control of Congress. Conservatives always like the status quo--when it serves the needs of the 1%.
1
Couple this proposal with her other proposal of free college, student loan forgiveness, and free healthcare for people her illegally and the totality of the cost here would be north of 30 TRILLION. Plus breaking up large tech companies is unpopular in the flyover states.
The unknown and unintended consequences of these changes would be disastrous.
The more she reveals the more Republicans love her - she is guaranteeing Trump an easy victory.
7
It used to be the uninsured would go bankrupt because of medical care cost.
Increasingly, insured people go bankrupt, too.
And now people employed by companies who offer medical insurance are beginning to be unable to afford the cost they must pay for that insurance, because the company doesn't pay for all of it anymore, and the cost is becoming prohibitive, and the way costs continue to increase, 99% of the country will have to do without care soon.
That's the real issue. Don't deflect from it by muddling through politicking and a long list of suspect or disproven we-can'ts.
If the wealthy and powerful don't accept that we all need affordable care, and that they must help pay for it, the wealthy and powerful will re-learn why France, in their quest to fix an income inequality issue, turned to the guillotine.
5
The willingness of voters to radically overhaul the nation's health care system depends on how many have experienced it at its worst: bankruptcy, or lack of care or insurance. In a way, it's like gun control: in spite of all the violence and mass shootings, not enough people have been affected to demand change. More need to suffer directly before change is possible.
The fact is, too many voters now either have employer-based insurance or are on medicare. Young people have cheap insurance or have not yet had a crushing hospital bill. So only a small portion of voters have a real incentive to radically change the system. Employer-based insurance has, in effect, trapped us into an expensive system with poor results, and as long as a minimum number of voters have it, no one will want medicare for all.
If you don't believe me, just go to a local optometrist in December, when people with optical insurance have to spend their insurance dollars for the year or lose them. The warped system "forces" them to buy the most expensive eyeglass possible (even if they don't need them at all) in order to use those dollars, while driving up the cost of glasses and insurance for everyone else. No wonder health costs of all kinds are spiraling upwards.
2
Now is NOT the time to jump in with Medicare for All. Now is the time to beat Trump and Pence.
Our health insurance system obviously needs fixing - but that will take time. Medicare for All is not an honest offer to the American people. And it surely cannot be done overnight. The American people want some reality from our candidates as we come up to the 2020 election. Something related to now and the near future that we can support with enthusiasm. To all candidates: PLEASE, PLEASE talk to us about issues we really care about!
1
@kbw: Why are Trump and Pence so awful? Isn't their repulsiveness rooted in their smarmy fake theocracy?'
Oh, please. Why do U.S. conservatives keep pretending that any attempt at universal health care coverage is a pipe dream? Virtually all other countries in the developed world have some form of universal health care. None have the U.S. system. For tips on how to get there, please speak to Canada, Australia, New Zealand, all the Scandinavian countries and most of Europe.
4
@Angie.B: Trumpism is revanchism, not conservatism. Trumpists believe in restoration of a golden age that never was.
2
With regard to healthcare, Elizabeth Warren needs to reassure voters by saying her goal is improving coverage and lowering costs for Americans either by Medicare for All or improvements to Obamacare. This acknowledges the reality of Congressional compromise that shapes whatever a President ultimately achieves.
4
My new nickname for Mr. Douthat is Mr. Doubt That.
Whether it's Medicare for All or Medicare for Those Who Want It, this is the will of most of our citizens.
Just ask anyone who is uninsured or uninsurable.
2
@David: I got news for you: I've been calling him that for some time, now.
Proof positive creative minds think alike.
Admittedly, I am far from the deepest bucket in the well of solutions as to how to wrest the presidency from a further four years of disaster.
But, I'll offer this - Warren has singular opportunity to do so, save her candidacy and quite possibly America by slipping off that extreme healthcare albatross dragging her down and modifying it mightily - pandering, if you will, to the polls and Americans' insistence that the health care they have - or hope to have - or think they have - (such as it may or may not be) must not be "taken" from them. Then we can move on from there. Otherwise, we all fall and fail.
1
Now is the season of confusion as everyone in Medicare has to decide what supplemental insurance plans to buy, since these are constantly changing, especially the formularies of drug plans. No other country hoses its citizens this way.
2
Medicare doesn't even collectively bargain drug prices. It is a half measure at best.
@Steve Bolger That can be changed and some of the Democrats have called for the government to set such prices.
1
Considering the effect of the GOP proposal to end "Obamacare" on last year's mid-term elections, you'd think that the Democrats couldn't possibly lose on the issue of health care. Of course Bernie Sanders, a self-proclaimed Socialist (of sorts), predictably came out in favor of Medicare for All- a position he's advocated for years. Unfortunately, Elizabeth Warren seems to be so anxious about being overtaken on the left that she's fallen victim to the mantra of "Me, Too"- despite the fact that this particular concept does not hold appeal in America's heartland (where the election will be determined a year from now) and despite the fact that champions of the Far Left like AOC and Ilhan Omar have already endorsed the senator from Vermont. What Democrats really need to advocate is the idea of universal affordable health care, with Medicare existing as a public option for those who are able to pay the standard premium (and Medicaid enlarged to encompass all of those who cannot). And those who are comfortable with private insurance should not feel compelled to give it up. That's a winning agenda for the Democrats and for a nation that remains nervous about the sorts of changes still being pursued by Trump and the Republicans. Joe Biden's aware of this- as are Pete Buttigieg and Amy Klobucher. As with so many other things, moderation is key.
1
No question, nationalized health coverage is correct purely as a matter of policy, but it doesn't necessarily pave your way into office. And, we all know that the opposite .. bad policy, con jobs .. and/or just plan hate mongering can get you elected.
Recall what the GOP did with "death panels", et al, the last time the Dems tried to enact sweeping changes to health care. And, how tenuously success has been. Just imagine what the Trump GOP will do this time, combined with taxes .... "they're coming after your health care with a hammer and a sickle, and the're gonna grab your wallet while they're at it" ...
Dems better be careful what they ask for ...
2
Well, this is a tough issue, isn't it? According to OECD statistics, in 2016 the US spent an average of $9892 per person on health care costs, and Germany spent $5551 per person. Recent infant mortality rates per 1000 live births (often used as a bellwether for overall quality of health care) for the US were 6.6 and for Germany 4.9. The US competes in a world economy, where costs and outcomes matter. True, Mexico has an advantage in some manufacturing because their wages are lower. But also true, Germany has some advantage because the waste less money on a bloated, inefficient private health care insurance industry. Some might even say that the current healthcare system is an albatross around the neck of the US. Turns out that costs and results in a sector representing 20% of our GDP do matter....
3
@Larry H
Maybe Germany does't have over 50% of its population consisting of obese people with diabetes, heart issues, as well as the myriad of other issues that come with it. It's never an individual's responsibility to be healthy, it's always the insurance companies or the drug companies or fill in the blank's fault that the US' costs are so high. Medicare for all won't fix the underlying cost issue which is that a majority of Americans are overweight and unhealthy, a sad and inconvenient truth.
2
Ah, the sweet smell of victory in 2020; and the blues will only have to look in the mirror to identify the root cause.
But, let's look beyond Trump's second term: "In the year 2525, if man is still alive.." what will American politics look like?
I pray that - chastised by the spoiled fruit of our cynical dismissal of the common good - we will have magically blended into some wise and centered shade of purple.
Please, don't try to wake me up.
Mr. Douthat cites “the potent fear of insurance disruption” as a liability for M4A. My health insurance coverage has already been disrupted many times over the years. Each and every time I changed jobs, was laid off, or my employer changed insurers, my coverage was altered or disrupted in ways over which I had no control. My only option was (and still is) to pay the prices demanded or go without insurance. I have no fears about disrupting the current system.
Medicare For All is a far more attractive proposal than the true Republican plan which is to eliminate Social Security and provide Medicare for None!
6
Why not start with expanding Medicare to completely pick up the bill for all cancer treatment for those diagnosed before age 50, Type 1 Diabetic treatment, and sickle cell anemia treatment, etc...otherwise known as those who got the short end of the genetic stick. Right now these patients are on their own, as the rest of humanity turns their back, and their bills are increased to support seniors on Medicare until their own assets are depleted and they go on Medicaid. Absolutely inhumane to stick them with the eldercare bill, especially since so many of the elders have substantial assets.
1
@ARL,
You seem to be confusing Medicare with Medicaid.
Medicare eligibility is simply a function of age, whereas Medicaid is means-tested: i.e. eligibility depends on your income and assets, so it is possible to be eligible for both programs.
I don't know what you mean by "eldercare" but if you are referring to long-term care only Medicaid covers long-term care and is means-tested just like the healthcare portion.
@Louis OK Boomer
"But being a progressive candidate in a leftward-marching party required her to sign on to Medicare for all". The entire Western democratic world (NOT western Republican world) socializes the costs of health care of it's citizens. USA rich boys claim too bad, so sad for the leading capitalist nation in the world that does NOT socialize health care costs--EXCEPT for all Senators for free for their lives after public service. The hypocrisy of conservatives and republicans can be no clearer. Socialism for the rich, not the 99 percent of citizens. Health is not a requirement, just a privilege the rich can thumb their noses at for claims of decency.
3
It’s interesting that the Catholic Douthat sees healthcare as an ideological issue rather than a moral one. Hypocrisy? Irony? Well, let’s just chalk it up to the conservative mind’s ability to condemn government on principle, no matter how good it is for everyone.
It is also interesting that Douthat’s cherished liberal democracy holds that humans have self-evident, inalienable rights – but healthcare apparently isn’t one of them. The right for an individual to decline insurance and to use the emergency room as their health provider and pass the cost along to everyone else is apparently fine with Douthat. For conservatives, the principle of individual choice supersedes the well-being of the collective.
And finally, it’s interesting that Douthat, in the name of the holy free-market, is ok with drug companies and private insurance companies making vast fortunes of blood money off of the unfortunate health of individuals.
Now…having said all that - and as a die-hard progressive – I think Democrats have to be very careful with how they present universal healthcare. It is necessary that we attain it eventually, or a hybrid version of it, but in what time frame? We can’t just flip a switch and make it happen. As a matter of practical campaign strategy, Democrats need to not scare the bejesus out of the undecideds. They also need to promote issues like jobs, infrastructure, election reform, taxes, and education in their platform. Healthcare can’t outshine everything else.
8
It's the "FOR ALL" part that will give us 4 more years of Trump. Why not a government plan for those that want it, as an alternative to the private plans?
4
Warren is brilliant, but not street smart to win in the general election. Her message on Medicare for All will be a great fodder for propaganda by Trump fake machine to scare the voters on the tax implications. It may help her to win the primary since very few participate in the primary and often by the so-called progressives. It is a grave mistake Warren is making. She could easily stay in the middle touting affordable care act, current gaps and the ways to fix it. Warren knows very well that it is a pipe dream and the feasibility of implementation is zero because of our corrupt Congress, special interest groups and Judicial system. General voters are anxious and fearful of the future. They need hope and pragmatic ideas which are feasible to implement. Alas, the current democratic candidates are failing to do so. 2020 election is easy to win with a pragmatic solid candidate. It is unfortunate that we have none.
3
It isn't the math it's the logic. The major costs of healthcare happen in the last two years of life and invariably fall on those whose wellbeing are most seriously affected. I have almost 50 years of single payer healthcare and the societal benefits of using math not ideology to discuss reality are one of the reasons Canada is now far ahead of the USA in quality of life.
We live longer healthier lives. We are better educated, we eat better, sleep better and it is we not the USA that most sorely needs a wall of protection from a neighbour whose problems are most probably beyond repair.
There is nothing I can imagine worse for a country's belief in the future than medicare for people like myself (S.S. and Medicare) and not providing healthcare for those who will be actively providing the brain power and the innovation needed in the future.
When the large corporations and the Big Money left Quebec during our quiet revolution we had a major gnashing of teeth and alarm over our future, but even as we had the worst economy north of Mexico we were told our future would be perilous without the job creators and those who understood how economies function. In 2019 it is obvious the conservatives who benefited most from the status quo and our ultraconservative partnership between church, state and big business lied to us.
Our economy is booming and our people are optimistic and our biggest problem is providing workers for the next generation of jobs our dynamic private sector provides.
6
@Montreal Moe
I don't think it's either the math nor the logic. It's the conservative propaganda that has very successfully permeated the country in the last 20 years thanks to Rush and other Infotainers, and the rabid anti-taxers behind them like Grover Norquist. People simply refuse any kind of new taxes, even if it's in their interest, and even when those taxes are on the wealthy and not them. It's why our state universities have been defunded.
Conservative America is perfectly willing to pay for absurdities like the Wall, or bazillion-buck missile systems, or even all those rallies that our president has flown to. As long as it's not framed as a tax that will benefit other people. As long as "they" might be taking something from "me."
Conservatism is doing just what it's name suggests: convincing people that any kind of change (except going backwards) is risky and bad. This is why they have no plans except to lower interest rates or deregulate. It's true that novel liberal policies fail--so we try something different.
Conservatism, by it's nature, is afraid to try.
3
@Scott Cole
Thank you Scott.
In 1775 Dr Samuel Johnson wrote a letter to the American Congress titled Taxation No Tyranny. Johnson who gave us a common language to communicate was a conservative and helped translate a social contract into English even as Rousseau was still breathing and the English speaking world had an unwritten Social Contract.
The word conservative has a specific meaning and America's "conservatives" are not conservative they are what we call neoliberal fiscally and authoritarian hierarchical socially. Look to William F. Buckley Jr's Wikipedia entry.
We know the Douthats, they ruled over their flock here in Quebec from the foundinding until the 1970s. There was virtually no contact with France from the French Revolution until DeGaulle's 1967 visit to Montreal.
I try to make clear when given opportunity that there is a difference between being afraid to try and needing to try and I am afraid Reagan was elected when the change Carter said was needed was needed. Carter was a conservative or at least when Carter received the Democratic nomination it was because he was a conservative.
Trump supporters and the GOP are committed to the destruction of the USA or the destruction of the country that had evolved from the revolution to the Civil Rights Act. America was committed to evolution and unfortunately the media acquiesced in calling reactionaries conservatives.
1
@Montreal Moe
There may be only one thing worse than saying we have no future than Medicare for those over 65 and that is lowering the age to 50. What it says is we reject the future than we will put all the expenses of the healthcare of those over 50 at the foot of the taxpayers and will not invest in health, education and welfare of our young and we make sure our CEOs and shareholders have all the money they will ever need in their afterlives.
1
The problem with Warren isn't the tax aspect, which no one really understands, anyway. The problem is "Warren is gong to take away your existing health care plan.” That's all some people have to hear. If she's 20 points ahead, it won't matter, but is she?
2
This Medicare for All proposal is simple financially unsustainable. Especially with the open borders policy of the left. What will happen after all of the money from everyone has been taken? No one seems to want to answer that question. Those on the left seem to think that there is a never-ending supply of money that just multiplies in the dark without any effort. If you take everything from the producers and do not allow extra reward for extra effort, they will stop producing and we will ALL be much worse off. When we are all living in the mud, what will we fight over then? Oh..I know...it will become who has more mud.
3
Speaking of math, do you have any? Or maybe some of the numbers on current costs, about which your boy Trump has done precisely jack?
Or is it all just rants about immygrants, without numbers there either?
Actually, I’m being unfair to say that your boy Trump ain’t done jack. By chopping away at Medicaid and the PPACA, he’s made things worse. Just as he’s made deficits and debts worse.
Numbers, numbers, numbers. Pesky things, numbers. Ranting’s far easier.
Ms Warren ruled herself out of serious contention with her plan. if she were serious she would propose Medicaid for all, not Medicare. Making the federal government pay for shortfalls suffered by States. The difference in costs would have made her plan viable. Instead she declared war on nearly everyone. Or she could have guaranteed Medicaid for all uninsured, and set up a government insurance plan to cover high deductibles for those on Obamacare and those on employer sponsored healthcare. She effectively shifted her initial appeal to Biden or even Buttigieg.
2
@woody3691,
Medicaid for All?
So difficulty finding providers due to low reimbursement rates and having the government come after your estate if you need long-term care is your plan?
1
Warren is not an "ideological" candidate; she is proposing ordinary, common sense things that we should have been doing for ourselves for years (as does the rest of the industrialized world). I agree though that the "Medicare for All" is a step too far, too fast, and I hope she pivots to the more centrist plan of expanding on Obamacare for now, Medicare for All later.
2
Just from a political point of view on the campaign trail. Warren in running on M4all and de facto the elimination of obamacare. She is already struggling with african american voters (and the most valuable trump-obama voters). She also appears to have minimal support from Obama himself (the most popular figure in the US) and Pelosi. Simple fact: Obama supports Obamacare!
The progressive component cannot win the national election without african american and moderate support, especially MI, WI, and PA. Dems are playing a losing strategy, similar to FL governor election, etc.
They get overenthusiastic that everyone in the US believes the same as they do, get overconfident in polls, lose the election, question how it happened, and double down on the losing strategy on the next election.
4
Warren has not explained the details of her MFA. Is it like present Medicare, expanded to all? In which case it will cover only up to 80% of costs, leaving the rest to the patient, who may opt for some gap insurance, as is done now by most retirees. Will this insurance be an option in MFA or rely on private insurance? If MFA covers only 80%, in severe health crises, the 20% cost share could still bankrupt most people if they don't have gap insurance. And what will happen to the Medicare funds workers have contributed to, will they be credited to them or confiscated? Another aspect of Warren's plan is to negotiate low fees with healthcare providers and hospitals. Many may opt not to participate and seek the establishment of a shadow healthcare system that caters to the affluent. An obvious example is elective cosmetic surgery not covered by MFA, but could easily be expanded to other types of surgery. There is nothing unconstitutional in such private ventures to be disallowed by new laws. There will also be a severe bottleneck in access to healthcare as millions more seek access over a period that is short relative to that needed to train additional physicians and specialists. Most medical schools do not have the capacity to accept vast new numbers of students.
The political problem is that these issues will not be resolvable until they are tried after the elections, yet they will generate fear in many voters of uncertainty that will be exploited by the Republicans.
7
Mmm, yes, but it is Warren's health care "albatross" that attracts all those younger voters. More importantly, we now unfortunately live in an age when most Americans seem to assume that the executive IS the legislative, and that we are in a kind of democratically elected presidential dictatorship. The consequence for a presidential candidate (as opposed to, say, a candidate for Congress) is that you must avoid admitting to the electorate that new policy provisions you favor cannot possibly become law, even if you are elected, unless Congress makes that law.
If Warren were even smarter, I think she might admit that her health care proposal—and almost all her other smart policy proposals—would not go into effect on her election. Even President Trump has had to get used to the quaint old small-r republican notion that in the U.S.A. one cannot make law by fiat or ukase or Executive Order (although Trump is certainly making hay with the executive's somewhat greater authority to make foreign policy).
4
Are we sure american worker actually likes the current employment-based health insurance? After the non-stop premium hikes and coverage reduction year after year, I believe we have reached a point that most people don't like what they get from their employer-sponsored health insurance.
Let's get Warren and M4A as the democratic banner in the 2020 election. It's totally worth the try.
What else can we lose?
4
I am a registered Democrat but actually agree with Ross Douthat here.
Elizabeth Warren's plan relies on a "trust us mentality" that requires those with private insurance to take a leap of faith that what they will end up with will be better--both in terms of quality and cost--than what they have now. Needless to say this isn't going to go over real well with a lot of voters, for reasons that should be quite obvious.
If you look at the scope of Warren's plan and what she is proposing be covered--she is proposing to cover both vastly more people and more services than Medicare in its current form--her claim that it could be paid for without raising taxes on the middle-class relies on some assumptions that are rather optimistic about revenue and expenses, at best. At worst they are outright falsehoods.
4
How is Elizabeth Warren's health insurance plan an albatross? It is a joke. Warren will never get elected our president and will never come close to ever mucking up our health care system which by and large is the best health care system in the world. Yes there are millions of Americans who need affordable health care who do not currently have it. A public option will be worth looking into where government can manage clinics and hospitals and employ doctors and nurses to deliver free health care to the sick and needy.
We have an albatross of 24T national debt. We do not need the Warren albatross on top of the one we already have.
3
@Girish Kotwal Yes, we have the best health care system in the world but only for those who can afford to access it.
@Girish Kotwal Unfortunately, the U.S. health care system is not even close to the best in the world. According to the World Health Organization, the U.S. ranks 37th. Our system costs more than other nations and delivers poorer results including reduced lifespan.
https://www.usatoday.com/story/money/2019/04/11/countries-that-spend-the-most-on-public-health/39307147/
Democrats, unlike Republicans, agree that everyone should have healthcare as a right, not a perk. We don't understand why Republicans aren’t on board with this because ultimately it is better for society to have healthy citizens. Showing up at the emergency room w/o insurance is not cost effective. It is yet another sign that the Republicans have been bought off by corporate interests.
So many of these signs now.
The question is how to get there, fast or slow. Medicare For All will not sell well in the swing-states we need win. The Republicans will use it to make hay, painting us all as Socialists. The fact that most of them don't even know what the term means doesn't really matter - it will scare people. And that's just what they want. It's the only way they know how to win elections now.
I am for the slower path.
4
Sorry Ross. The argument that a more moderate candidate would be a better candidate because McCain and Romney were pushed to the right and lost, makes no sense whatsoever. Obama won on a liberal agenda. Trump won on an agenda of redistribution to the whites and nostalgia for the good old past. Taxes and redistribution (including through the form of M4A) is the issue of our time. Why going out of your way to protect billionaires?
4
Over ten years on after the 2008 Great Recession, the quality of life for most people is bad. Inflation grows, while salaries are stagnant and jobs are not secure. The Healthcare system is crazy and expensive. Costs keep growing, but personal income doesn’t. There’s no real excuse for medications costing cents in Canada and hundreds of dollars in the US. This is where Senator Warren can begin to tackle the system. Medicare can be expanded; we know some people won’t give up their private insurance and that’s OK. Medicare expansion is not an ideological movement, but a reaction to a badly broken system.
When McCain and Romney ran, there was still hope that the system would readjust to bring back opportunity. It hasn’t and isn’t. Hedge fund fraudster. Leon Cooperman’s five-page letter, released a few days ago, challenging Senator Warren is what the status quo looks like. Leon is quite happy to continue as is. He’s made billions speculating the market, not manufacturing anything. He probably wants war with Iran as well.
1
The barbed, vindictive part of Warren's 15,000+ word health care plan, from her website:
.."every candidate who opposes my long-term goal of Medicare for All should put forward their own plan to make sure every single person in America can get high-quality health care and won't go broke - and fully explain how they intend to pay for it. Or, if they are unwilling to do that, concede that their half-measures will leave millions behind...Serious candidates for president should speak plainly..."
Warren is judging who is a "serious candidate" now? Who is not one? On criteria she alone sets?
Who is she to claim she can "make sure every single person in America can get high-quality health care" (whether they go broke or not)? Will the best doctors drop out of Medicare for All low payment levels? Will our shortage of primary care doctors create delays, bottlenecks and rationing? Can "every single person" get high quality health care when many don't show up for appointments, which being free for everyone, will have no penalty for patient non-compliance? Who does she think she is?
Elizabeth Warren's albatross may already be sticky enough that she'll have trouble removing it without damage to how voters see her judgment. She has made a serious tactical error and has repeatedly compounded it by insisting that going big is the only way to go. This will work to the advantage of the centrist candidates who are much more in tune with ordinary American voters and give the Democrat campaign a chance to breathe.
3
Candidates can't afford to be too specific. Warren has a good plan that should fly, but can't, because of the past. Too many people above the income median are still satisfied with the current health system. They are afraid of losing what they've got. As a Democrat, I'll take Biden myself, much as I admire Warren.
1
Why does the supposedly liberal “Main Stream Media” require Democrats to explain how to pay for every proposal while giving Trump and his party a pass on the $2.5 trillion cost of the 2017 (largely corporate) tax cut? It must be same reason that Trump’s profiteering children get less ink than Hunter Biden.
21
@Annette Woodcourt What made you think that Ross Douthat is a member of the "Main Stream Media" when in fact he is a Republican Conservative.
Universal healthcare could easily be paid for with what the defense works spill; don't you think? So let's not talk about the cost.
5
Pretty simple... Republican's have been promising a competing plan to Obamacare for 6 years and nothing! Democratic opponents have offered basically nothing but words... She's got the guts to put forward a plan as a starting point for developing a transition to a reasonable plan that covers all Americans! No brainer...
7
Father Douhat is very pleased that 50 million people do not have health insurance.
12
Ideological party? We have in office a wicked ideology that is ruining our country, and it has been nurtured by the Republcan
party for too long a time for any Republican to throw this
cliched charge at anyone. We are in the most crucial crossroads
this country has ever faced, and this writer is worried that a
health plan is out of hand. It almost seems like a dodge. Readers
may wish that this columnist himself be "adjunct media."
2
If millennials and generation Z’s in the swing states come out and vote then Elizabeth Warren will be our first female president.
6
If Warren can't afford to credibly bend without breaking her promises on everything she proposes, she's toast and she still doesn't know it. 'Anyone But Trump' is a campaign mantra, yet it won't be enough to stop the juggernaut of greed, corruption, treason and hypocrisy that Trump and his slavish stooges have connived to support the first American president who's beholden to our most formidable sworn enemies. His leadership philosophy is fear and lies, hers must be provable benefits to all Americans and the bridled passion to provide them. While that choice should appear to be a no-brainer, it's far from it as the last 3 years have shown us. Hopefully, this charade will not last another term and destroy what's left of our democracy.
1
Elizabeth Warren has no chance to be President.
The Democrats will cry sexism as the reason Warren will lose in a landslide.
Warren couldn’t win even if people were convinced she really used to be a man and that she is not just a fake Indian.
I suspect she will have some kind of unfortunate accident and Hillary will be required to step in and save the day.
2
Here is what I don't understand about the health care debate...maybe I am just dumb. Every civilized country in the world, many with far less resources than the US, has a universal health care system for it's citizens and manages to pay for it, we don't. Are our representatives just that much dumber than the other democracies? How can we argue that it is not possible when so many have done it?
13
What’s YOUR plan, Ross ? Let the Churches and other
“Charities” provide care for those that can’t afford private Medical Insurance ? Workhouses, for those unable to function independently? You do realize the current system is culling the Herd, don’t you ? Please, give us some new, improved ideas, not a rehash of old GOP talking points and excuses.
I’ll wait.
17
Medicare for All "has enough political vulnerabilities, in terms of costs and disruption both, that no sane Democrat should want it as the centerpiece of their national campaign."
More advice from a right winger who hides ideological opposition to M4A under the pretense that, 'Hey, I'm your friend, remember? I'm 'only tryin'na help ya' not lose.'
You're not afraid M4A will fail Democrats, Douthat. You're afraid it will succeed.
[https://fair.org/home/the-return-of-the-inexplicable-republican-best-friend/]
6
Douthat is correct about the dangerous direction Democrats are now taking. Zooming ahead based on ideology is like being energized by amphetamines. Exciting, it turns out bad. Ms. Warren is not insane and she is not stupid but if she adamantly clings to MFA, on grounds of doing something really big is the only way to win, she will resemble those who are.
1
Let me see if I have this straight: Ross Douthat writes that Hillary Clinton lost in 2016 because she was not a centrist. Uh huh.
7
Mr. Douthat and his fellow right wing scribes at the Times have spent much of this years ink offering their opinions as to how the Democrats need to foil four more years of Trump.
Never a word about how they themselves enabled his election in the first place.
For Mr. Douthat it was his religion. He chose Trump over a woman's individual reproductive rights.
5
Appealing to the intellect will not cut it.
2
The trouble with Warren's Medicare for All is that it's presented as an either/or proposition. Since Medicare, as we have known it, is immensely popular (not even Trump will touch it), why not re-frame the plan as an expansion of what now exists, lowering the eligible age to, say, 50 and to those under 50 with serious pre-existing issues. Give it a 10-year "tryout." Let people who want to keep their private insurance keep it (as they do in the U.K., for example). Obamacare was scary enough and the political fallout for Democrats was immense. Substantial but not sweeping is the sensible way to go.
4
And there you have it, folks. First it was, “show me the plan/how you are going to pay for it.” And now that Ms. Warren has, it is described by Mr. Douthat as “a folly, a case study in ideology’s exacting costs.” The US needs a healthcare system that is not only adequate but also affordable. It does not need one that is just affordable to people like me, who because of his job, is “lucky” enough to see to it that his spouse, who happens to be an asthma patient gets, the best asthma medication available on the market, on time, and uninterrupted. By contrast, other asthma patients, often to no fault of their own, take just one dose every other day—as opposed to my spouse who takes it twice a day—or have to share the medication with a family member who also happens to be an asthma patient. Efficient and adequate healthcare should be inherent to the right to life, liberty, and the pursuit of happiness. Supporters of the Democratic Party, I implore you to stop the hand wringing and not to engage in fear mongering; leave the later to the Republicans, who have proven time and again to be quite capable of it. No, don’t be blind to the facts either. Let us first ensure that a Democrat—Mrs. Warren?—is elected POTUS. There will be plenty of time afterwards to hold her/his feet to the fire with regard to Medicare. Before that, all the discussion about “Medicare for all” is just that.
1
Senator Warren has a winning way about her.
Smart, a top debater, pleasant but she can't win .
So now, for the rest of the story.
Because half of all american workers are pleased with their current employer paid health care, they aren't going to risk
some other idea that may or may not work out as described
by well meaning Elizabeth Warren.
We need another candidate who can beat Trump.
2
I think the statistics show that a majority like their doctors but few like their health plan aka insurance. So we need to convince people there is a way to preserve this personal connection while phasing out the for profit delivery.
3
@Brassrat
Employers are paying an average of $1,160.00
every month for employees with families.
That's a large sum to refuse just because a senator wants to win an election by proposing a plan that might not work and "others" will pay for.
$13,927.00 is a lot of money to be willing to give up for something that is not a sure thing.
Ross, I rarely agree with you, but, you hit the bullseye on this. This election is the Democrats to lose--the general public dislikes Trump---he really has never been a real likeable person---Now add to this a entire basketful of tweets and policies that make his Casino bankruptcies look brilliant. So, all you need to beat Trump is a likeable candidate, one who promises to fix Obamacare, promises to get rid of corruption, address income inequality---yes, a more progressive tax system, and throw in an infrastructure project---bingo---you are now President. It is that simple. I am a Warren supporter--she would make a great President, but, fear she has backed herself and maybe the party into a losing corner.
187
@Amanda Jones
As a moderate Democrat, I’m no fan of Elizabeth Warren’s policies. But, Trump has been so destructive to the fiber of this country that I’ll vote for Warren if she wins the nomination.
That said, I hope she knows something I don’t about the popularity of reparations for the descendants of slavery, decriminalization of border crossings, giving complete free healthcare to anyone crossing the border illegally, and forcing all Americans into an untested Medicare for all plan with little transition.
29
@Amanda Jones You hit it right on the head. I was a Rockerfeller, Javits, Warren (Earl), Republican for most of my life or until Bush 41 ended my dreams of a greater Union and my disillusion with GOP nominees has gone downhill since. Elizabeth Warren cannot win with her health care plans. Even the remaining Trade Unionists will stay home or move to Trump who will do away with all public health care. She had two strikes against her going into the primary campaign; she comes across as an angry older woman whose smile and demeanor mirror the angry old man from Vermont and has never understood the middle class mind set just like the grade school teacher that she is who thinks the country needs to learn right from wrong "by the book". The only Dem who fits the moderate, intelligent, and likable is Amy who, by the way, is from a moderate Midwestern state and has always been a winner.
19
@Amanda Jones: Medicare doesn't even work as well as public health funding systems in other first world nations, and it is way more open to fraud.
4
The self-interest of the American electorate isn't as evolved as the its German counterpart in 1880. In order to maintain a viable working class and prevent true socialism, Otto von Bismark began to implement a series of social welfare programs in 1881, foreshadowing Franklin Roosevelt's rescue of capitalism from the jaws of both socialism and corporatism. Roosevelt was nonetheless branded as a socialist by the forebears of today's corporatists who have clearly succeeded in getting the working class consistently to vote against its own interests.
Bismark responded practically to the needs of the working class to maintain a healthy body politic without being motivated by an economic crisis. His policies fell far short of collectivism, and were tepid compared to true socialism, but kept the working class docile. Roosevelt responded practically to an economic cataclysm with only 1 program that benefitted all Americans. Social Security stands alone as the single program that did not discriminate on the basis of race. His alphabetized programs were mere palliatives that minimally reduced the effects of the Great Depression. WW2 ended the Depression and begat the military industrial complex that is today more powerful than ever. The richest country the world has ever known is currently in the midst of a political cataclysm and still debating issues that other 1st world countries resolved long ago.
2
It feels as if a candidate’s stance on health care is what distinguishes a moderate (center-left Democrat) from a far left Democrat. The hyper focus on the previously niche issue of health care has left a lot of other ideological tensions between the candidates unexplored.
Also, the release of an extremely specific, extremely thorough policy proposal at this stage of the campaign where polling is generally quite volatile, is a colossal blunder. I think the ‘moderate’ stance of ‘yes, universal healthcare is the dream, but given our political climate, its immediate realization is somewhat of a pipe dream - we will pass the legislation that we can, in the name of progress’ is not a moderate capitulation, it’s a realist perspective.
Elizabeth Warren, typically shrewd and sharp on most points, has given over an essay replete with opposition talking points. She should’ve remained vague on the details to give herself more wiggle room in the actual drafting of policy that could feasibly pass through the senate.
2
I prefer Biden's and Butigig's proposals to improve Obama Care. While the Warren and Sanders democrats may love the sound of Medicare for All, so does Trump and the republicans: they will savage it into a monstrous threat to middle-class solvency. Democrats are forgetting that we did not win the House of Reps on medicare for all.
3
Many of the Comments here appear to defend the virtues of a single-payer system and bypass Mr. Douthat's point, which was not about the merits of such a system per se but rather how making it an election issue could backfire.
1
It is difficult to foresee what could backfire in the election. Trump's fierce rhetoric was supposed to backfire in the general election, it didn't. Hillary was supposed to win considering that she was much more traditional and, therefore, (contrary to the author's claim) more moderate candidate than Trump. None worked out as supposed
If history is any guide, non of the cost projections of politicians is correct.
Here is the one of President Obama
""If you like your doctor, you can keep your doctor. ... The only change you'll see are falling costs as our reforms take hold"
Instead health care costs increased. The winner were the 5 largest US insurance companies whose pre tax earnings increased from $ 15 Billion in 2009 to $ 25 Billion in 2015
Data
https://www.economist.com/sites/default/files/imagecache/640-width/images/print-edition/20151205_FNC666_0.png
You should spend more of your time talking about Trump's corruption - way more relevant!
3
Can we find a conservative somewhere, anywhere, who can grasp that private, for-profit health insurance is the real albatross? GOP, the party of masochists. MAGAland, island of fools.
6
USA is a country of individualists. Insurance for yourself is ok, but caring for others not. That is why USA never gets "healtcare for all". I was apalled when I saw the democatric debate. Someone was yelling to mrs Warren: "Are you going to raise taxes, are you going to raise taxes, are you going to raise taxes." And no one mentions anymore that no 45 first act was to steal some trillions from the treasury. Your are unbelievebly gullible to say "He is going to give it back". Being social is nessecary in a modern society.
Remember the words of Martin Niemöller:
First they came for the socialists, and I did not speak out—because I was not a socialist.
Then they came for the trade unionists, and I did not speak out— because I was not a trade unionist.
Then they came for the Jews, and I did not speak out—because I was not a Jew.
Then they came for me—and there was no one left to speak for me.
5
Obama was a fool not to invite directors of successful public health plans in other nations to testify to Congress how they do it.
1
@Steve Bolger
American Exceptionalism strikes again!
So healthcare humanism threatens your holy Capitalism, Ross? written like s true shaerholder in a vicious and very profitable monopoly
5
Mr. Douthat, yourself and anyone who thinks believing that health care is a human right is an albatross is free to vote for the racist, sexist, pathological liar. It's your choice.
4
You conservatives who hate the incompetent, corrupt bigot in the White House and the way he's destroyed the GOP should start a third party. It would give voters a choice and end stupid articles saying that a Democrat can't win unless they lead like a moderate Republican. FYI, Hillary was definitely a centrist.
5
Ironic that Cardinal Douthat is so opposed to something that would help the least among us, going to far as to equate it with a plan (the flat tax) that would benefit only his billionaire patrons. He appears far more aligned with Paula White than Pope Francis. I've spent the last 30 years with health insurance provided through corporate employers. I've picked my insurer a grand total of 0 times (since my employers choose not me), and had no clear knowledge of what these plans covered and what they didn't until the time came to use them. My nightmare is knowing my family's lives depend on some accountant at UHC/Aetna/Cigna/BCBS deciding whether or not to cover something. I'd rather have every American know exactly what is covered and what isn't, and actually have a say in that through their vote. Healthcare should be considered like police and fire protection - something we all pay for and all use as needed, without fear of bankruptcy. Imagine having to call your fire insurance company to ask which fire department to call when your house is on fire.
4
I fully agree with this article. And now that Warren has described her plan with specificity, I think it's too late for her to backtrack for the general election. While I think she would make a great president, certainly among the best of those running for the nomination, I'm worried that she will lose to Trump. So I no longer support her.
7
In a book I wrote, published in 2016, I proposed that Medicare for All should be phased in gradually. I suggested that each year the eligible age for Medicare be reduced by 1 year. Next year it would be 64; next year after that it would 63, next year 62, etc. Taxes could gradually be increased to pay for it.
Now, let’s take Warren’s idea of how to pay for it. Just take the taxes she suggests weighted by only the 64-year-old cohort’s contribution for the first year, and start there. Each year increase by that ages’ cohort new contribution. It gets phased in so nobody is overwhelmed.
My guess it that within a few years, everybody would love the system. In fact, I would predict that people would be clamoring to increase the age reduction per year to more rapidly phase it in.
4
Wouldn't it cost more for the general public? Just because in such mechanism there is no much control for raising cost and the cover pool is consists from mostly sick people and more expensive than general population. I am not so sure how popular will be idea for yearly tax increase for next 65 years
@Martin Moran
At the rate that life expectancy is declining in the U.S., there won't be any cohort left. It's nice that you approve so heartily of your own slo-mo plan, though.
For once I agree with you Mr. Douthat. I think Elizabeth Warren is intelligent, knowledgeable, and has the exuberance and charisma needed to appeal to voters. I ardently wish she had talked more about shoring up the ACA and fixing its shortcomings, rather than taking a page from Bernie Sanders book to appeal to the far left. It isn't about compromising your ideals, it is about being realistic about what can be accomplished. Medicare for All right now is not a realistic goal. I wish that were not the case, but unfortunately it is. Insurance companies will put their power and money behind defeating it. However, it is a hoped for future goal for a younger generation of voters and politicians to pursue.
At this point I would settle for controlling both Houses of Congress as a start in getting us back to where we were when President Obama left office. We have lost so much ground, that it will take years to repair the damage that has been wrought by this scorched earth policy dangerous President. If the damage is not permanent....
All that said, if Elizabeth Warren is the Democratic candidate chosen to run in 2020, I will most certainly vote for her. I still have hope that somehow good will triumph over evil. We have to have keep that "audacity of hope" alive no matter the odds nor obstacles.
193
@Diana If what Elizabeth Warren is proposing is what you want - why run up the white flag and surrender to the oligarchs and kleptocrats? Why not fight for what you believe is right - especially since, "We have lost so much ground..."?
56
O.K., Diana , can you please tell me how many people have to unnecessarily die or go bankrupt, and how many TRILLIONS do we have to waste before we can push for an efficient universal government run healthcare system as all other developed countries enjoy?
I really would like to know.
85
@Diana
I think the reason Warren isn't talking about shoring up the ACA is because the ACA can't solve our problem of getting affordable insurance for all. The ACA, even with a public option added to the exchanges, still leaves most Americans under employer-sponsored coverage or a government plan. And the costs to the insured for those plans are also becoming unsustainable. The ACA exchange plans are also not cheap and even if the public option is a bit less expensive, it's still going to require the buy-in premium and probably deductibles, copayments and coinsurance similar to what Medicare for seniors requires. (There's also another problem—the ACA has been declared unconstitutional by a federal court and there's no guarantee the conservative Supreme Court won't uphold the ruling; and Trump's DOJ is supporting the challenge to the ACA as they want to see it deemed unconstitutional.)
There simply aren't easy solutions to the American healthcare coverage problems. Americans are afraid of big change, so they gravitate toward solutions that are presented as easy, like adding a public option or shoring up the ACA. But the reality is that these won't solve the problem. They are distractions—politically palatable but near worthless as real solutions.
24
When a third of our medical care is already covered by Medicare and the other 2/3rds is twice as expensive as the international average for similar coverage, what is radical is the idea of sustaining the status quo with some ACA patchwork.
I agree that Warren will probably need to modify her message with at least the caveat that she will not push Americans into any system that they are not ready to embrace, even if is the logical path in her mind.
Then, when she's elected and we sweep the incompetent GOP majority in the senate out of power, she can take on the multi-trillion $ medical industrial complex and maybe get the trojan horse of the medicare option passed so all Americans that opt for it can have it.
The idea that this issue is completely in the hands of voter opinion is naive. In the U.S., corporate interests pull multiple strings and in the case of health care there are billions to invest in such strings.
But our health care system represents the kind of wanton inefficiency that sinks empires so we desperately need a leader willing to go to war against its' profiteers.
422
@alan haigh Great comment, though instead of "incompetent GOP majority," I think that the adjectives "venal" or "corrupt" would have been more appropriate.
34
@alan haigh You write "at least the caveat that she will not push Americans into any system that they are not ready to embrace"
How about "at least the caveat that the President cannot make law in the American republic—only the Congress can."?
4
@alan haigh So when you say the medical system is a mess, but it's 66% run by the government already, perhaps completing the dismal takeover of liberty isn't the answer, but to get government back down to 10%, or 5%, where an actual safety net is needed.
3
Ross Douthat calls Medicare for All "ideological" and too far too the left. I call it practical and economical. We will not rein in healthcare costs as long as private, for-profit insurance companies rake off billions of dollars annually.
5
Ross equates Vermont's attempt at universal health care to Kansas' flat tax. It would be a valid comparison - if a flat tax had been successful in every other educated country on the planet.
4
@Robert
Also, trying to do some of these things at a state level is impossible because states still have to comply with federal law and because our economy is still more national than it is state-based. Health care reform must be done at a national level.
4
So providing healthcare for all is a fools dream but spending 760 billion in a year to make planes at 150 million a piece to fight a 1500 drone is a great idea.
Warren ma not get the exact plan she is talking about. Other countries have plans that cover everyone and they are not broke. Nor do they have heathcare billionaires and Medicaid fraudsters like Rick Scott being championed by one of their partys.
Keep on dismissing the crimes of the right and being alarmist about When Progressives actually caring for our citizens rather than asking , What can you do for me today.
5
M4A "polls O.K. if you don’t tell people about the trade-offs."
False, Douthat: polls show support rises when you "tell people about the trade-offs" - including on giving up private insurance.
For example:
"Majority Backs ‘Medicare for All’ Replacing Private Plans, if Preferred Providers Stay"
[https://morningconsult.com/2019/07/02/majority-backs-medicare-for-all-replacing-private-plans-if-preferred-providers-stay/]
It was the same at the April Fox Town Hall where the host "asked audience members how many had private health insurance. A large majority raised their hands. He then followed up by asking how many would like to see Medicare-for-all enacted. Almost all the same hands went up — remember, this was on Fox News! — with wild cheers to boot."
[https://www.washingtonpost.com/opinions/2019/04/16/how-fox-news-accidentally-revealed-truth-about-support-medicare-for-all/]
8
As a Democrat, I see Warren’s Medicare for all albatross, Biden’s fade, and the failure of most of the other candidates to catch fire as requiring a second, more open attitude toward Buttigieg as the best alternative. His more moderate center-left policies make him more acceptable to the broad mass of Americans, particularly independents—and more likely to defeat Trump. He has proven himself to be an intelligent, articulate candidate. His lack of experience seems less of a concern. He has many months to build on his positive attributes and show he is fully capable of being president.
Of course, in order to win the nomination, he has to overcome his deficit among blacks, The first test of his political skills! I urge black Democrats to consider: there is no perfect Democratic candidate, and the re-election of Trump will be a disaster for you and the rest of us. Who is more likely to defeat him?
4
America has a health care albatross, not Warren.
6
Ross (RD) has convinced himself that Jesus would like our current system. RD willfully forgets how J treated the moneychangers in the temple. What is it about the self-professed professional religious and their Xtian selectivity? The current system requires a fix that covers more people more intelligently.
2
Ross, Republicans have no policies to support your assertion of their strong ideology.
That's the problem. There ARE important issues that need addressing. Race, Climate, Healthcare, Immigration, Guns.
But your party denies all of them. There is no racism in America that is out of the ordinary. Climate change ain't happening. Healthcare is fine. Immigrants are bad and need to be locked up. Guns are good.
Has Warren overreached? Probably. But at least she's out there in the arena as Teddy Roosevelt said. Trying to right wrongs.
9
Dr. Douthat,
I find the amount of the hand-wringing and the outrage about an amount of money for a healthcare program quite strange...., and also the usual question: "Who and how will we pay for this???"
And yet, nobody, especially the GOP, will bat an eye, or ask the same question when trillion dollar tax cuts are passed (99% of which benefiting the GOP fat cat donors, the politicians themselves who pass the laws and the rich top 1%), or for a 15+ billion dollar for a SINGLE aircraft carrier or for a trillion defence budget that goes up every year??
Perhaps you can shed a light on this conservative hypocrisy??
9
Douthat has no problem supporting the massive military that takes 52% of our tax dollars, however.
8
The difficulty stems from 40 years of anti-citizen hypercapitalism that Republicans have just opposed any logical reforms. Health care in the US is ridiculous and in desperate straits, one of the principal reasons citizens like me prefer working and living abroad - yes Mexico has universal health care and free to highly subsidised higher education and yes young Mexicans in urban areas are beating the pants off of their 20-30 something millenial counterparts in tech and medical fields because of this.
So Warren is stuck contemplating a drastic change, Obamacare if McConnell et al had not blocked every adjustment was a suggested way in to semi-gradual change.
There are many ways to structure universal health care that USA needs. Medicare for all is one way and its quite stupid to resist at this crisis point. Anyone is welcome to buy private insurance at any time, and companies are welcome to offer employees additional plans - this is a basis. Corporations and companies will be thoroughly relieved once this shakes out and will be out of the business of insurance and medicine. Workers will be better. Life will be better. We need to catch up from 40 years of destruction to US quality of life - sure there will be some shakeout but its better than continuing being extorted by non-medical profiteers, having health care tied to jobs is dumb and disfunctional for all, we have a terrible level of health care for the priciest in the world.
4
Of course it's a risk trying to explain something intelligent to the American people who love to repeatedly shoot themselves in the feet with their irrational fears of government, taxes, 'others' and doing the right thing.
But voters should remember that the Canadians, the English, the French, the Japanese, the Australians, the Tiawanese and citizens of other rich countries are NOT out in the streets clamoring for the great American healthcare rip-off....they're home relaxing and going about their lives with no fears of medical bankruptcy because their single-payer or universal healthcare systems work great and have been working great for decades.
Are there anecdotal problems with their systems ?
Of course, but there are not huge swaths of their populations afraid to go the doctor because of sticker shock and there are not 500,000 medical bankruptcies each year like there are in the United States of Greed Over People.
And let's not forget that the Republican Party's long-running healthcare plan remains on the table:
A giant 'Drop Dead, America !' sign.
Whatever healthcare plan is proposed, it will make its way through the House and the Senate before signature by the next President, so there will plenty of opportunity to produce a compromise plan.
We know that Republicans will deliver nothing but a 'free-market' healthcare fiasco that ultimately kills people, similar to their misanthropic environmental, gun and economic policies.
D to go forward; R for reverse.
118
Hillary “abjured” centrism? When was that? Hillary embodies conservative Democrat policies. And her stale, obsolete approach did her in. Douthat can’t accept the fact that the people not in Douthat’s charmed circle want meaningful change. I guess he plans to be on the wrong side of the ramparts next year.
2
Here is a statistic everyone who opposes supporting M4A now should know. It is called "amenable mortality to healthcare". It is mortality, deaths per 100,000 population, that result from medical conditions for which there are recognized health care interventions that would be expected to prevent death. It is a measure of how well healthcare is delivered in that country.
The latest figures I could find are for 2014, but here are some
US - 112
UK - 85
Germany - 83
The Netherlands - 72
Canada - 78
Sweden - 69
Australia - 62
France - 61
So when I ask people how many people must die before we should push for an efficient government run system of healthcare such as enjoyed by other wealthy countries, I am not just making a rhetorical point.
https://www.healthsystemtracker.org/chart-collection/mortality-rates-u-s-compare-countries/#item-amenable-mortality-2004-and-2014
7
NYT please write these health care pieces with an eye on what Republicans promise. Here’s Trump on his plan: “We have to come up, and we can come up with many different plans. In fact, plans you don't even know about will be devised because we’re going to come up with plans—health care plans—that will be so good. And so much less expensive both for the country and for the people. And so much better.” — Interview with Dr. Mehmet Oz, September 15, 2016
6
I haven't got all day here but this barrel is full of fish needing to be shot.
According to Wikipedia, conservatism is a political and social philosophy promoting traditional social institutions in the context of culture and civilization. The central tenets of conservatism include tradition, organic society, hierarchy, authority, and property rights.
Start with Michelle Bachman. If that's your benchmark for modern day conservatism let's remember that her primary currency was homophobia. You're not still riding that horse are you Ross?
Not to mention racism. Ok, I just did, and it's another hallmark of today's brand of conservative. Add to that misogyny, islamophobia, xenophobia, lack of respect for the environment, and denial of science. If this represents the tradition, organic society, heirarchy, authority, and property rights you're hoping to preserve then count me out.
Warren won't be talking that much about health care. This campaign will have every bit of oxygen consumed by Trump's impeachment and malfeasance. Trump, I'm sorry to say is the standard bearer for today's conservative. Show me a Trump voter in Ohio who has ever heard of Edmund Burke and I'll eat these words.
2
"Hillary Clinton lost in 2016 in part because she abjured her husband’s popular legacy of centrism, enabling Donald Trump to appear to many swing voters as the more moderate candidate in the race."
Are you kidding me? Did you sleep throughout the race. All HRC talked about was not changing much from what BO has done. Clinton was the moderate candidate, it's just no one trusted her.
8
In Douthat's mind, ideological means having new ideas about politics. God bless America!
1
“But it would still be a folly...for Democrats to take the chance.” Why, Mr. Douthat? If you explained, you lost me.
What you really mean is “She’s (Elizabeth Warren) after the billionaire class and the CEO’s; welfare for the rich is acceptable but wealth distribution to the peons is un-American.”
Senator Warren’s M4A is a continuation of the national healthcare debate. She knows that we won’t get to single payer anytime soon but someone has to jumpstart this discussion. She’ll not find any red state converts to “socialized medicine,” but where’s the Republican alternative? Answer: they don’t have one and don’t want one. If they can continue to pass on the exorbitant costs of the administrative wing of the industry that hemorrhages our money as well as our severed femoral artery, they will. It doesn’t cost them anything.
President Obama’s ACA barely passed Congress because Republicans made it a racial issue, not a medical one, and under Donald Trump, the racial animus has only intensified. M4A is going to cost a lot less than the military’s annual budget outlay, another unnecessary boondoggle that benefits another wealthy industry—not the general public.
This is another exercise in your party’s usual false equivalence, Mr. Douthat; aren’t you weary of beating the same dead horse?
5
Oh, please. For seventy-five years Americans have had to deal with a defense-spending "albatross." I know where I want MY tax $$ to go.
8
The main albatross here is the inadequate and expensive healthcare services provided by our employer based system. The analogy made on SNL equating our current healthcare provider with a bad boyfriend is spot on. You know it's rotten but you're terrified of breaking up. Mr. Douthat is probably right in thinking that American workers will be too scared to leave their cruddy current health insurance provider but that doesn't mean Senator Warren isn't absolutely correct in suggesting a way out of this distinctly unhealthy relationship.
176
@jonr
You have described the perfect analogy!
Let’s take it a step further to where unhealthy Americans are right now: let’s think of this not as a bad boyfriend but as an abusive partner. How often do people stay in abuse relationships because of fear? They’re afraid they will be killed if they try to leave, so they die slow deaths as their abusers take little physical or emotional or sexual or psychological chunks out of them over years and decades. Sometimes they do leave and are killed.
Damned if you do; damned if you don’t.
A percentage of our population is at that point. How many diabetics or cancer patients or young fathers with ALS have to die before we agree that not only is this system not working, but that we’re also keeping it to enrich a minuscule portion of the population?
Why isn’t anyone reminding us that every day we maintain this system, it makes Senators and Representatives who accept campaign money from the healthcare industry richer? Choosing to support a healthcare system that really serves everyone would not make them poorer; it would simply prevent millionaires from making American wealth inequality worse.
Finally, please help me understand why patients would lose access to their current providers. In what part of a “For All” system does it state that even though all doctors are now working in the same system, patients cannot see them? If that were a valid concern, couldn’t it be addressed as the program was being built?
16
The insurance companies demand higher premiums every time my union negotiates a better contract. If we eke out a well deserved pay raise, they step in and demand a large chunk for themselves, in the form of higher premiums for our hard pressed families. Our weak state regulators are under constant pressure from armies of insurance lobbyists and will not stand up to this extortion. Corporate spokesmen, well represented in this paper, demanding to keep the old awful system are usually highly paid functionaries of this corrupt system.
157
@Kent Hancock No, the more you get government involved, prices will go up and service quality will go down. Free markets work. There is no other form of insurance you can buy that pays your day to day expenses and upkeep. Government ruins healthcare.
2
@David Turn down Medicare when and if it's offered.
7
As always, why is the media so obsessed with the Democrats' plans and there are NO questions about a Republican plan for ... anything? Why is the bar set below ground for Republicans - even in office? Warren gets savaged for trying to come up with a way to make life better for Americans. Republicans don't even try. Go ahead, voters, pick your party.
610
The online based smear campaigns of Hillary and DNC establishment types by Donald Trump and his highly coordinated networks of misinformation and conspiracy capitalized on the creeping, intrinsic hatred of Democrats. People are more wont to criticize a Democrat, because they have actual ideas and plans, instead of Republicans who operate in some shadow capacity maintaining the supremacy of the American dollar and the dominance of major corporations - which is admittedly more difficult to unpack and understand than a clear-cut, singular piece of Democrat-originated legislation.
29
@CarolSon Bravo!
18
@CarolSon Because we are practical and smart and want to win.
Tired. So very tired of the media and pundits framing healthcare for all as some sort of wacky dream. Other countries do it. So can we. Those who believe in American exceptionalism — are we so exceptional that we can’t provide to all citizens the dignity and security of knowing that you and your loved ones will have access to healthcare, regardless of where you sit in the “percent”?
316
@Tammy
Some of us understand foreign, government-sponsored medical care systems, and we've discovered, unsurprisingly, that most "have risen to the dizzying heights of mediocrity." When patients in these countries become critically ill, their preferred choice of treatment location is typically a center of excellence in the United States which specializes in their particular disease / condition. And, that says it all.
Almost every economist agrees that a "free good" is considered to be worthless by consumers. And so it will be with "Medicare For All." Protect the elderly with Medicare, fix and enforce the Patient Protection and Affordable Care Act, and move on.
10
@Tammy it is not media pundits framing it this way. Many american people do not understand the complexities of this broken system and many of us have in health care have seen this ignorance play out time and time again. There are also enormously powerful lobbies and groups that will protect private healthcare. It will be a very very difficult fight. That's the issue of this article...that she is riding on such a decisive, complicated issue which many americans are not ready to sign on for...(I am in health care, I support single payer). I think what she is doing is unwise strategically
3
How dare you say only citizens will get free healthcare? And this question is the problem Democrats will have to address. Are we welcome to everyone who arrives and wants to stay? Do they get full free healthcare? If not, do we informally acknowledge them as second class by denying them healthcare? How do we pay for it? Why can’t I move to my social democracy of choice and sign up for their plan?
3
We're in this together, Russ. Warren is advocating what President Truman proposed in 1945 until the AMA coined socialized medicine at the beginning of the McCarthy era. California Republican governor Earl Warren took up the cause after Truman's defeat, only to lose his California Medicare proposal by one vote. American insurance companies can play a role in future Medicare for All, but they'll kick and scream all the way to the bank they can't segregate us into small insurance pools that benefit their shareholders instead of patients, as though that's our choice. Vermont failed to enact Medicare because they allowed large companies that are self-insured to opt out instead of funding their health insurance through payroll taxes as we do with Medicare and what almost every other industrialized country does. We're better off creating a single, public insurance pool that provides protection for every citizen and legal resident. They payment side can be single like Medicare parts A and B or multipayer like France, Germany, Japan and other countries provide, something like Medicare Advantage with significant differences. Americans want to see any doctor taking new patients and be admitted to any medical facility our doctors recommend without copays and deductibles. Medicare for All could include the medical portion of workers compensation that can runs over 50% of payroll. Imagine the savings in home and auto insurance without medical? We still have time to get it right.
3
"Hillary Clinton lost in 2016 in part because she abjured her husband’s popular legacy of centrism, enabling Donald Trump to appear to many swing voters as the more moderate candidate in the race."
What universe do you live in? Clinton lost because she held progressive policy issues in contempt and disdain. Even in a heavily biased primary, she was competitively challenged by an outsider who brought popular policy ideas to the debate. Clinton didn't have any policy ideas. She was the "My turn" candidate. That's why she lost. Bill Clinton's primary negative influence on her campaign, aside from bad memories, was approaching Loretta Lynch on the tarmac. Not "abjured centerism." Give me a break.
Douthat is projecting. He doesn't like the idea that Warren has a good chance of securing the nomination when anti-Trump conservatives would prefer a more centrist candidate. What Douthat fails to understand is Warren's message isn't about any specific program, whether health care or child care. It doesn't matter what program we ultimately spend the money on. We could go back to infrastructure for all I care. She's promoting progressive tax policy to finance large public service projects.
Conservatives obviously cringe at this suggestion. However, what do they have to offer? These, the people who brought you Sarah Palin and now Donald Trump. Sit down children. The 80s are over.
4
Before going into MFA it should be pointed out that the in "debacle" of Hillary Clinton's loss to Donald Trump in 2016 for the presidency, she defeated Trump by almost 3 million votes or 30 times as much that JFK defeated Richard Nixon by in 1960. Clinton was a victim of the real "debacle", in which our artificial state boundaries and the Electoral College those boundaries gave birth to gave voters in Wyoming, for example, much greater weight in a national election than voters in California or New York. The Electoral College needs to be abolished and the state boundaries and the organization of the US and its political jurisdictions needs to be reconfigured
Our country has debated health care and the system to deliver it for over 100 hundred years without a satisfactory outcome. Obamacare was a good first step but unless we as a nation believe and understand that it is in the national interest and particularly in the national security interest that all of our citizens be healthy with access to excellent health care and a system to deliver it, we will see the continuous decline in our longevity and the decline in our physical and spiritual infrastructure. I am not against Medicare for All as long as I know it can be implemented and administered as efficiently and as successfully as the current Medicare is. What is important and what is needed is whatever works to produce a healthier national population both physically and financially.
2
This is a hundred percent spot on. Poor Elizabeth Warren, she's fallen into a trap of her own making. Releasing plans makes you subject to criticism, that's why the rest of the more political candidates have stayed away from this. Now even people like me are nervous. I live off investment income and the idea that she might tax unrealized capital gains to pay for Medicare for all is scary. I believe it's targeted at the top 1 percent, which I'm not, but still - it makes me steer to Pete. Now if only he could secure the black vote.
15
@Anjali
Equally spot on. What is so blatantly missing from Warren's, Sanders' et al "Medicare for All" (MfA) proposals, let alone the fallacy in their revenue assumptions, is the notion of choice — fundamental to the American experience. Do patient's and providers have the option to choose whether to participate in MfA? Aren't the Dems supposed to be the party of choice?
You must get provider buy-in if you are to accomplish universal healthcare that is affordable. The fundamental problem with our healthcare system is that it is unaffordable and unavailable to too many Americans. Expanding hc thru MfA will be unaffordable to America and likely will not make us any healthier.
6
@Daniel N Ovadia, MD, MPH You seem to be asking Americans to make medical care choices the way a fully educated thoughtful patient/client, with time to spare—like you—would. I know Americans in general like choice, but this is the sort of choice most Americans are really not equipped to make and private enterprise will take more advantage of this ignorance than government would.
I agree. Even though I know single payer works - I am from Canada and my friends and living living there are VERY happy with their health care - it won’t happen here. Certainly not in one presidential term.
To people who ask ‘why’, I point to the metric system and paper $1 bills. Canada moved to metric and coin dollars and they are MUCH, MUCH easier and less disruptive than dismantling health insurance.
Canada adopted single payer in the 1970’s. There was grumbling - some doctors relocated to the US. But it was done, the wrinkles were ironed, new generations of medical personnel graduated into the system. The Canadians I know appreciate not having to worry about cost when making health decisions. My brother owns a small business; he appreciates not being responsible for providing health insurance for his employees.
I wish Warren had spent the last few weeks studying the issue and coming out with the declaration that strengthening Obamacare and providing a public option was the best way forward. If she is the nominee I’ll vote for her but I know this will make beating Trump harder.
I hope folks take a careful look at Michael Bennett. He is still in the race, has a great background and is an intelligent man who could beat Trump and be a fine President. There will be a mess to clean up after Trump leaves - Bennett could do it. And isn’t it time to get the Baby Boomer generation off the stage (I am a Baby Boomer).
11
Ross, get back to us after you've read the 9300 page program to pay for Elizabeth Warren's Medicare For All program. Then explain with all you "Christian" ardor why 30 million or so citizens should be denied decent healthcare because we cannot disrupt the current system which misses them.
This is a campaign, it's supposed to be aspirational. And yet for the first time in my lifetime (I'm 72) there is a candidate who is providing details not only of her goals, but of how to get there and pay for them. Until such time as any other candidate can show us their roadmap, don't get caught up in critiquing the details and debate the vision.
Whose is better, Biden's return to yesterday when Moscow Mitch stole a SCOTUS seat, Mayor Petey's with glib phrases and a vaporware healthcare plan (and how, by the way, do we pay for Medicare for Those who May Want It)?
Thanks, but I'll take the person who conceived and midwifed the CFPB BEFORE she was even in the government. Nobody believes there is a magic wand to achieve this goal, but to even begin to move that way we need a real fighter who has our best interest at heart and her name is Elizabeth Warren, our 46th President.
10
Medicare for all is mostly a change in the direction that revenue flows rather than a shift in total cost. The increase in tax is offset by a decrease in the premiums paid to private corporations.
The side effects would also reduce profit taking and price gouging, and disentangle employers from healthcare. Corporations and employees favor it for obvious reasons.
What are the upsides of the current system? Conservatives fear that it will stifle innovation because they presume innovation derives from competition and bot another incentive structure. Conservatives will have to retool restrictions on the availability of procedures they oppose - like abortion - because the power structure will shift from corporate control of decisions which are not subject to popular vote to a government that is. And they know that in a popular vote they will lose.
2
I hear this argument a lot these days - don't be too radical democrats. Keep it simple and move to the center. I don't buy it. The mid west swing voters that gave Trump his technical win in 2016 believe in magic. Many of them voted for Obama. They want a transformative president.
8
From a progressive point of view, the pure folly is for working class Americans to support a President's re-election based on tax cuts to the tune of 1.5 billion in lost revenue which will expire for all but Corporation in 2025. Supposedly with fuzzy math these same tax cuts were going to magically create millions of good paying cuts. Just like the idea that a magical wall would stop illegal immigrants from entering the country even though there are airplanes & tools for cutting same wall in the 21st century.
Folly is also believing the Trump doctrine of bringing back the troops while simultaneously increasing the military budget by billions of dollars (over 7.5% per year) when the USA already wastes over twice as much spending on the military as China and Russia combined. There appears to be no oversight on the military as high priced items like a $220 million surveillance drone are wasted by veering into Iranian airspace. Meanwhile the folly of decimating the State Dept. and never filling diplomatic posts in strategic countries while relying on aggressive military posturing creates cognitive dissonance in the idea of wanting America to suddenly become a pacifist.
Lastly, the party of Trump who lied about having a great health insurance plan while really seeking to overturn the ACA leaving millions uninsured while giving away billions in tax cuts to Corporations that pay minimal taxes is inhumane & antithetical to the notion that they are the party of Christians.
7
This Medicare-for-all issue is way out of hand. It is a timely and noble goal in need of further definition and a transition roadmap, not a premature cost estimate.
We who are currently covered by Medicare are wildly grateful for the coverage, especially when we hear our adult children and friends complain about denied payments for medical procedures, and provider networks that restrict their choice of doctors and hospitals. We also see how people rejoice when they reach Medical age so they can dump their current exploitive health care insurance.
We Medicare patients pay monthly Medicare premiums. Will Medicare-for-all provide premium-free coverage for all? Why not continue to charge patients reasonable monthly premiums, and use the Obamacare exchanges to subsidize the premiums of low-income recipients?
Presently, the Medicare administrative functions of eligibility verification and claims processing are performed by the federal Medicare agency and contractors. Will Medicare-for-all require expanding the federal agency by a half million more government employees to handle the additional administrative load? Why not contract the administrative work to private insurers who already participate in the Medicare Advantage program?
We need answers, not cost-estimates and tax plans, for Medicare-for-all. Are you listening, Senator Warren?
6
@AynRant
Everyone should read her plan:
https://elizabethwarren.com/plans/paying-for-m4a
Many of the answers you are asking for are in it.
1
The insurance companies have increased rates year-over-year for as long as I can remember. That has forced employers to revamp their employee plans with alarming frequency. The effect is that I can't even keep the insurance I like with a job that provides insurance because they have already pushed me into less-appealing care. Similarly, the private plan I once purchased is no longer affordable. If there is a public option, why would I opt to stay in a system that keeps ratcheting up costs and doesn't provide any more care? And secondly, why would employers choose to keep paying to administer health care when they could leave it to the state? I don't understand the argument about wanting to keep the insurance one has, mainly because, when given the option, I don't believe employers will keep offering those plans anyway. Why would they?
6
@suzrush Think of all the company resources wasted in being health care providers vs. say IT developers, car builders, cement contractors. It is just insane.
Two questions for the M4all crowd:
1. In Warren's plan, employer taxes for employees skyrockets. Corporate taxes would rise precipitously. Wouldn't it be in employers best interests to automate or layoff large amounts of employees and make a few do all the work?
2. What would be the status of the 2 million or so health insurance employees? How about the millions in the tech, finance, and energy industry which are also under threat of being broken up/banned?
4
@Satishk
1. The increase in taxes (actually a fee, so I assume it can be counted as a tax-deductible business expense) will be offset by the fact that employers no longer pay insurance premiums. Overall, the cost for employers should be similar. (Of course employers still won't like losing control, but that's a different matter.)
2. Warren has promised a second plan shortly to deal with that. The transition to her plan is a crucial component, so I'm looking forward to hearing what she proposes.
3
@Satishk - Corporations already pay minimal taxes thanks to Trump's only legislative accomplishment, the Tax Cuts & Jobs Act of 2017. Corporations already push down wages and lay off workers without concern about same workers to squeeze quarterly earnings. Same Corporations will incorporate robotics or automate without concern for the workers depending on analysis of cost/benefit figures.
Regarding the reintegration of health insurance employees - there will no doubt be plenty of opportunities to apply their skills to running M4A or to switch into other types insurance like disaster relief which will certainly be big business in the decades to come. Also, if we could prevent premature deaths with new drugs or cure cancer, would we as a nation say no because we don't want funeral homes to go out of business? Likewise, would be want to keep pharmaceutical prices inflated in order to prevent the loss of jobs at biotech or pharmaceutical companies when the same drugs cost a fraction when sold to other countries? Or would we rejoice as consumers that we are no longer being fleeced & treated like patsies while stockholders reap the financial gains of dying seniors or infants bodies who can't afford prescription drugs.
3
@Satishk
1. "Wouldn't it be in employers best interests to automate or layoff large amounts of employees and make a few do all the work?"
It's always in the interest of corporations to automate,layoff, outsource, go offshore, and generally pay workers as little as possible. It's happening now, and M4A doesn't change that.
2. "What would be the status of the 2 million or so health insurance employees? "
What about the status of 28 million or so that are currently uninsured, who will gain healthcare?
1
Eventually, although probably not in our lifetimes, one of two outcomes will emerge:
(1) Politicians will be called out for pretending that a "moderate" position on healthcare is anything more than a lie to get elected, as all experts know that a moderate position will just cost more money and not produce the desired results. Then the US will finally become like the rest of the developed world and have universal healthcare for its people.
(2) The polarization will continue, and in spite of mounting preventable deaths and bankruptcies, there is no change. The "blue states" will become unwilling to continue paying for the "red states". Blue states will develop their own healthcare plans prompting people to move from red states to blue states for healthcare (a non-sustainable condition). Then the US will split into two, or more likely four, countries - West Coast, Central plus Southeast, Texas, and the Atlantic-Northeast.
May the future come quickly. Meanwhile my patients die, or go bankrupt, or both.
3
Looking at things realistically, what are the chances that we would ever have medicare-for-all? Practically zero. Even if Warren won the presidency, she would still need a filibuster proof Senate and a majority in the House in order to think about passing medicare-for-all.
I think republicans see medicare for all as a handy tool to use again her. The republicans don't know squat about governing but they are past masters at spreading smear and division, sowing confusion and chaos. A favorite lie is to brand democrats as socialist. And of course the republicans have Fox, Rush, Coulter, Hannity, and company running smears 24/7. So a lot of democrats get nervous and frightened.
Like they did in 2016. Ms. Clinton had her own problems as a politician - but she was hurt tremendously by the 20 years of investigations and the accompanying bad publicity conducted by Fox and the republicans. Many democrats bought into that and said they could see no difference between The Donald and Ms. Clinton.
Ross is like many democrats in that he(they) have one standard for The Donald and another standard for the democratic candidates.
We have a situation where the most shameless, brazen, and ignorant con man in history is president. I would think that any democrat would be preferable to him.
But democrats like Ross are busy thinking of nitpicky reasons to not support democrats. I can hear them now -- Warren is a socialist, etc.
2
@concerned citizen I agree.
In my comment I was writing in regard to Warren and the up coming election. She is being tagged as supporting something that is not going to happen in 2020. If Warren was elected in 2020 I doubt that she could bring in medicare for all during her first term in office.
But long term it would make a lot of sense for individuals and employers (businesses) if we had health care for all. Health coverage and it's quality would not depend on where you work and employers would not need to be in the health insurance business. We could have a healthier population and it could be less expensive than the current wasteful system.
Best wishes.
1
The author should take the time to "do the math" and recognize that the status quo US health financing structure is untenable in the long term because it relies on massive subsidization by private insurance (meaning employer provided coverage). According to a recent Rand study, employer based insurance pays providers on average 240% of Medicare and in some markets 400%. With more Americans aging into Medicare and with expanding Medicaid coverage under the ACA (which pays providers even less than Medicare), this massive cross subsidy will soon reach a breaking point.
In the absence of a robust competitive market for health insurance and health care, a Medicare imposed fee schedule is one of the few effective ways to address the exorbitant cost of US health care.
A 58% reduction in prices paid to providers (due to using Medicare fee schedule rather than the employer-based, 240% of Medicare average today), will result in a lot of cost savings for health consumers---- and necessary belt tightening by non-competitive health system cartels that dictates (in the absence of robust provider competition) exorbitant prices for those who are privately insured.
Does the author really think the status quo which results in average family health care premiums and out of pocket costs for US family coverage in excess of $20,000 per year sustainable? Give Sen Warren credit for recognizing and addressing the total dysfunction of our deeply flawed healthfinancing and delivery system.
6
There is a middle of the road on healthcare, but no candidate has suggested anything similar. First, expand Obamacare. Second, let people who want to keep their current private policies keep them. THIRD AND MOST IMPORTANT, lower the age at which a person can get Medicare to 63 (or 64 if we want to be cautious). To be paid for by taxes on the wealthy. It's an affordable experiment and in two years we'll know whether we can afford it or not, whether people like it or not and whether or not the quality of medical care remains high. If it works, expand it, if not, abandon it. By the way, providing Medicare to 63-65 year olds should be less expensive than providing it to 65-67 year olds and, if expanded to the 61-63 cohort would be even cheaper still.
7
@Anthony Gribin Wrong. Michael Bennet has suggested something similar, in fact pretty much the same. As someone else has pointed out, he's still in the race, he has ambitious plans that could actually be delivered and that independents would actually vote for, he's a popular senator from a purple midwestern/western state, and he'd beat Trump by 10 points in the general and roll up 32 states in the electoral college, sending Trump's white nationalist base back under the rock from under which they crawled. Wake up Democrats, we have a house on fire and only we can put the fire out.
1
Trump doesn't run on policies and their details. He runs and feelings with a slogan, vague promises and mostly on attacking his opponents personally and their policy proposals. In 2016 it was "Make America Great Again" which meant winning and great deals and railing against other countries taking our jobs. His big promises were a big beautiful tax cut, of course jobs taken back from other countries and repealing obamacare and replacing it with a better plan even though he provided no details. For Hillary the slogan was "lock her up", releasing the DNC/Hillary e-mails while he attacked her support for obamacare but offered nothing but the vague promise of a beautiful plan of his own; someday.
That's what Trump plans to do again for the 2020 election while especially focusing on attacking his opponent personally and their policy proposals. Like slow Joe and Pocahontas. He will want to avoid discussing his record except regarding the economy. It will all be about cheap shots and slogans attacking medicare for all while really offering nothing in return.
1
This column is spot on. Hillary also ran as a wonk, and definitely to the left of her husband - despite the urban myth now that had her losing because she was too centrist (thanks, Bernie). Trump has always just made vague promises about everything, except tax cuts for himself and his rich friends. Those particular promises he kept. The rest was and is blarney. Just as the article says, even Warren knows that her medicare for all plan will never become law. So we appear to be running a primary campaign largely based on various views of the number of angels that will fit on the head of a pin. Biden, along with Klubuchar and Mayor Pete may be the only adults in the room.
7
@Joe Runciter Amen.
2
“But it would still be a folly, a case study in ideology’s exacting costs, for the Democrats to take the chance.”
Well Mr. Douthet, despite your hyperbole I do agree that Republican folly has burdened our nation unjustly over decades in so many ways. And I don’t believe Medicare for All if passed or not will cause most Americans to look upon Democrats with the utter contempt held for today’s Republicans the overseers of unlawfulness, immorality & untrustworthiness not witnessed since the Confederacy or Robber Barons.
4
This column is decent until you suggest that Senator Warren's "adjuncts in the media" are going to give her math the benefit of the doubt.
The media wasn't just asleep at the switch with Donald Trump. It was in a coma. Among his promises:
1. A middle class tax cut that would more than pay for itself via 3 to 6% GDP growth.
2. Eliminating in its entirety the national debt held by the public, which was $19 billion in 2016. Now it's $22 billion.
3 A health care program that would provide universal coverage. There was no plan, there was a page on a web site with some vague principles.
Too many conservative pundits punted and would say things like "well he's new to this," or "if he put out the plan he'd alienate the base." It was all a sham enabled by an unconscientious, even lazy, media.
13
@Glenn Thanks, I read this piece, decided to comment. Your comment, the first I saw, said just about everything I wanted to say. I would add these points.
During the first two years of the Trump administration, Paul Ryan's predictions were treated seriously without any mention of his magic asterisks.
Fox and Sinclair, with their profit margins, are now setting the standards for journalism.
2
Is there a chance that if instead of a single payer system, universal health care is achieved through a different financing system, which is a likely final outcome, the albatross disappears?
2
I do not concede that Senator Warren is the de facto leader - another national poll came out today and has VP Biden up 5 and holding his support . Senator Warren is clearly gathering votes as other seems to fall, but I still think Mr. Biden is doing well. I also think after her 20 trillion dollar Medicare for all plan, which requires cutting the military by 800 billion and raise taxes only on the rich and in ways that makes all her plans seem completely unfundable, may stop her rise in the polls. Selling universal healthcare that includes a public option is very sellable and a big improvement upon upon Obamacare. Mr. Biden is planing to do that , he just needs to stop saying Obama’s name so much and sell his ideas - the same way Senator Warren is selling hers. But yes - Medicare for all is an albatross
5
@Kevin Jordan Not to mention that one of her assumptions is passing a major immigration overhaul to legalize undocumented immigrants--she projects 20 million of them--and decriminalize illegal border crossings, and that she will cut medicine costs by 70 percent, among other fantasies.
This is we Democrats losing the 2020 election right now.
2
Sadly, so, so sadly, I have to agree the Democrats--my lifelong party--have fallen into the trap of ideology over facts, sanity, and winning elections.
It appears a slim plurality, if not majority, want to ignore the lessons of the 2018 election and how we brought more voters into the party and won in formerly entrenched Republican suburbs, as but one example, with a message of providing elegant, left of center solutions to real problems that push the country closer to our position and direction we want to go.
Even Paul Krugman is lending support to a deeply dishonest funding plan for mandated Medicare.
And when confronted by facts, the true nature of the electorate in 2020, and reality, the left argues the validity of the policy as if it is the only answer, then accuse anyone who doesn't support it is a corporatist Republican-lite.
They fail to understand the key point that we other Democrats are making--and that has every scintilla of fact behind us--no matter the merits, mandated Medicare will cause us to loose this election up and down the ballot, will never be enacted even if the impossible happens and Democrats eke out a win, and will make addressing every other issue--including global warming and economic inequality--all but impossible.
Right now, we are handing Trump and Republicans what will be an epic victory to fight and die on the hill of mandated Medicare knowing it will never become law in the next five years no matter the outcome of the election.
10
@OrchardWriting While I respect your view, it is not the "ideology" of the Democratic Party that will cause the Democrats to hand DJT an "epic victory", as you put it, it are the naysayers who will. If you truly believe that "mandated Medicare .. . will never become law in the next five years no matter the outcome of the election", then why the lament? I see 2016 happening all over again when, for instance, members of the Black Lives Matter movement lamented the policy of Mr. Clinton in the 90s, probably causing a number of Black people refraining from casting their ballots, votes that could have made a difference (not that BLMdidn't have a point; the timing, I think, was unfortunate). We, Democrats, should stop the hand wringing and leave the fear mongering to the Republicans; believe me, they have proven time and again to be quite capable of that. What the Democrats now need more than ever is a united front. I'm not arguing that we should be blind to the facts. Rather, let's keep those at the back of our heads for now. Let us, first and foremost, see to it that a Democrat is elected POTUS (personally I hope it will be Mrs. Warren). There will be ample time afterwards to debate whether or not we should have a "mandated Medicare (for all)". To repeat what you have stated, "mandated Medicare .. . will never become law in the next five years no matter the outcome of the election".
@steffie Again, I'm not debating the merits of the plan--though Warren's is highly dishonest in cost and other factors. I am saying is this plan will cause us to lose the election. Period. Simple argument.
Nominate Warren, we lose because of this one issue.
And being attuned to reality is not a naysayer. It is simple truth.
1
@OrchardWriting
Maybe he's "lending support to it's soundness" because it actually is sound. Douthat is not an economist but Krugman is. Why should we believe Douthat?
Krugman is honest enough to say explain where economists differ with her plan. Douthat is not honest enough to explain why economists would agree with it for a non-partisan reason.
1
Can you imagine a nation with health care, better education, highly-paid teachers, less military spending, Mr. Bezos and his friends paying taxes, fair choices in judges, planning for an environmentally safer future, considerate gun laws, and having a president who cares about her fellow Americans? I'll take it.
Better health care?...better attendance in school, better adults on the job, better for those who have mental health issues, better for seniors who need meds.
9
@Nancie: The cognitive dissonance of the US can drive practically anyone nuts.
@Nancie Sure, if we win the lection. With mandated Medicare we can't. It's that simple.
@concerned citizen: The US even dopes the media with prescription drug advertising, which about equals the research budget of the US pharmaceutical industry.
One third of all voters will vote for Trump in 2020, even if he is filmed running naked down 5th Avenue firing an AK-47 at small white children as he runs, even if he is running with his buddy Vlad carrying his extra firepower.
Forty percent of voters didn't bother to go to the polls in 2016.
MFA, free college tuition, subsidized child care are all morally and economically right to some degree. However they all cost money. Money I agree should be spent on citizens other than the military/industrial complex and subsidies for the wealthy.
But anyone who thinks that insurance companies, munitions companies, banks and the wealthy with all the assets and power they have at their disposal are suddenly going to surrender their power to mold public policy and opinion are sadly mistaken.
Ross is on the wrong side of the moral question, but probably is right about the electorate. Warren needs to figure out a way to modify her plan to allow choice and let the insurance companies go the way of other industries that no longer serve the needs of their customers.
16
@Maureen Steffek: Almost three million votes were discarded to install Trump as president, by a system designed to make voting a waste of time for most who vote. This system wasn't invented by any God, it is rooted in state optional slavery.
Dear Ross,
And your point here is?
A) Do nothing – It's all too hard and winning is enough
B) Run as GOP-lite - with a few tweaks but not to touch the broken healthcare system
C) Run on a platform the offers policies that have solution.
The "Do Nothing Democrats" as Trump calls us, need something to VOTE for. That "something" includes fixing the mess called Obomacare (revamped GOP proposal and a good example of Dems going GOP-lite)
8
@Clive
Dear Clive,
You can’t do anything if you don’t win. You can scoff at Obamacare but millions of people now have health insurance because of it.
Obama knew it needed to be modified and made better but he, Nancy Pelosi and the brave Democrats who passed it started the journey. Another Trump term will completely destroy it and millions will probably die without health care.
It is unusual for me to agree with Ross but on Warren’s plan I agree that she is taking a risk. Warren is my candidate. Health care is a human right and all Americans should have affordable access to it. But climate change is a threat to human existence and if Trump is re-elected , it’s game over for life as we know it. I worry about the bleak future we are leaving our grandkids. Her healthcare plan is going to dominate the political campaign and probably not to her benefit. What is wrong with extending Medicare down to those 55and older and adding a public option to Obamacare? Why can’t Medicare be extended in increments this way? It is less threatening to the few people left in America who really truly like their private coverage. Warren would win with this idea. Too much is at stake to in this election. I fear this issue is going to sink her.
13
The presidential election is one year away and let’s compare what we’re talking about on each side.
Democrats: what is the right way for Americans to manage the high cost of health insurance so they can be free to live their lives fully?
Republicans: how many Ukrainian mobsters does it take to keep Trump in office?
I’ve read Warren’s plan and I think it’s worth pursuing along with improving access to post-secondary education and infrastructure. These are the kinds of big national goals we need right now.
I don’t know what will happens over the next year, no one does, but right now Warren is talking about the future while Trump and his Republicans are way in the past.
12
@M I like your analysis of the difference between Democrats and Republicans and glad to see you agree there is a difference as most on the left do not.
However, we have to win the election. We will lose, and lose badly on this one issue alone. We are witnessing the loss of 2020 right now.
1
Healthcare as it exists now is an albatross for our nation.
7% increases a year for 40+ years. Doubling every 10 years.
Highest costs in the world, 17% of GDP vs about 12% for the rest of the OECD world. The cost to our country because so much of our population just cannot afford healthcare is a waste.
Do Conservatives think this is sustainable? Do moderates think we can tinker our way to significantly lower costs?
This issue is like climate change. Just do nothing until it overwhelms us.
6
Ross wants Democrats to be more like Republicans. In his NY Times columns he along with David Brooks and Bret Stephens relentlessly harp on the idea that Democrats are too bold for their own good. Ideologically, Democrats are dangerously straying too, too far from the status quo. Medicare for All is an albatross, they caution. Which for timid status quo lovers, aka, those with solid health insurance, translates into; the rest of us must learn to love our insurance companies.
12
I happen to agree with Ross this time. I was an original Warren supporter, donating small amounts over a period of 3 to 4 months this summer.
And then it it me: any Democratic candidate is de facto called a Socialist or Communist by the Republicans, so it's absolutely necessary that the candidate be a centrist.
Far right liberals claim the coasts, but the vast middle of the country, with all it's electoral college numbers, are far more conservative than Democrats in general. I'm not saying that Dems bend to be GOP lite: I'm saying their focus should be on pocket book issues reasonably implemented in a first term.
Medicare for All is decidedly not that! It will dominate Trump's tweets, retweets, memes, and conspiracy theories.
Don't Dems realize how hard it was to pass the ACA? For Lord's sake, fix that and cut drug costs, focus on gun safety, reinstate anti-pollution regs for clean air and safe water.
On those issues alone, Dems can give the country a clear choice.
19
@ChristineMcM,
Thanks for your comment, a voice of reason in what is sometimes a shrill echo chamber for the far left.
I'm an independent, so my vote is up for grabs. Warren's policies scare me. Although, as a commenter above points out, she is focused on the future, the radical nature of the economic reforms she suggests would likely produce unintended consequences.
Devaluing the dollar would be unlikely to increase American manufacturing sector jobs, but it would devastate seniors' savings. Outlawing private insurance would likely mean large turnover in physician ranks (i.e. early retirement) and long waiting times for hip replacement and other non emergent surgeries. The wealth tax - abandoned by most of the European countries that have tried it - would likely lead to change of citizenship for enough billionaires that our potential tax base would be further eroded.
I'd really like to vote for someone who would enact practical and incremental changes - a Klobuchar or a Mayor Pete of a Tulsi Gabbard - but I fear that I won't have the chance. Warren has placed a lot of emphasis on plans that radically change the way of conducing routine life activities in the US. "I have a plan for that," seems to satisfy many democrats (and unquestioning journalists); it doesn't satisfy me. Her website's college-essay style write ups on the financing of the green new deal, the wealth tax and devaluing the dollar all seem extremely naive to this independent.
2
Progressive health care policies will affect billions of dollars currently earned by hospitals. Hospitals s owned by religious institutions, including the Catholic Church could be a major concern for Mr. Ross. Albatross? What do you call the present health care programs?
2
@DJ Again, you fail to address the core issue. It is not the merits of the policy, but that it will cause Democrats to be devastated in the election for a proposal that has no chance of being enacted.
3
Excellent article.
As a practicing physician of 20 years, the complexities of health care are immense, and slogans of "medicare for all" by Warren and everyone will be covered with a great plan by Trump are naive carnival barker promises.
Specifically, medicare for all will fail on many fronts, but largely on supply/demand. There is no conceivable way hospitals/doctors can handle these volumes. There is already a shortage of physicians. Hospitals work on tight margins, often sub 5%, and many, especially rural, will go bankrupt with medicare rates, which would require nationalization of the hospital industry.
Moreover, the costs are being underrepresented by the M4all candidates. If all care is free (no premiums or deductibles), people will elect more expensive options. For example, I am currently on a statin for 10 dollars for 90 day supply. Under the new plan, since I pay nothing, I would go on a PCSK9 inhibitor, which costs 1000 month to the government. Moreover, medical tourism would get out of hand. There would be seemingly no downside of bringing one's relatives from overseas and getting MRI's, surgery, etc for free.
A public option makes a lot of sense and is practical. Healthcare should be the major component of the 2020 dems campaign, as many are worried about costs and coverage of pre existing conditions, similar to 2018 election. Making Trumpian false promises of medicare for all and stripping millions of people of their private care will lose the election.
17
@Satishk
You wrote, "Hospitals work on tight margins, often sub 5%", yet, as of Aug. 2, 2019, 85 publicly traded health care companies amassed $47 billion of global profit on $545 billion of global revenue in the second quarter, according to company documents (Axios). As far as private health care insurance companies (octopi): Take Humana,(also August 2019 per WaPo) said it made more than $1 billion in profits in the second quarter and raised its earnings and revenue forecast for the rest of the year thanks to growth of seniors signing up to Medicare Advantage plans.Cigna, too, which said it made more than $1 billion in the second-quarter, also increased its earnings forecast last week for the rest of the year. And the week before, Anthem, which operates Blue Cross and Blue Shield plans in 14 states, also reported more than $1 billion in profits in its second quarter and said its profits are ahead of expectations for the year due in part to the money its making off of government contracts with Medicare and Medicaid programs. Meanwhile, UnitedHealth Group's UnitedHealthcare health insurance unit reported last month $2.6 billion in earnings from operations in the second quarter and the parent company boosted its earnings forecast for 2019. Maybe you should get out of the hospital business into a greater remunerative field!
11
@Charles
Democrats are good at such refutations to their detriment. However you miss the point of the doctor's and Douthat's writing.
7
@Charles
Complete misrepresentation. I am talking about hospitals, not insurance companies. Hospitals work on tight margins, as we have to treat all patients, regardless of insurance and much of our care is not reimbursed. Most hospitals are not part of the publicly traded complex.
Rural and inner city urban hospitals are already struggling. Take a look at Detroit Medical Center in downtown Detroit, which is bordering on failure. Even if all of those patients became insured, the loss of private patients would be a net negative, and they would go under.
You may be able to cut and paste your animosity towards insurance companies but it demonstrates a lack of understanding of the the many components of healthcare.
9
Ross is right on one thing: the best thing any health-care system can have going for it is incumbency. Change is disruptive; very few people think about health in non-emotional ways; the few who do think of it in economic terms that most people can't understand. Commentary on the matter is so driven by policy preferences that it is nearly impossible, even for educated citizens who understand numbers and know something about the cost structures of medical care, to evaluate comparisons between our system and those in other developed countries.
What I hope: Warren's plan will be read neither as a piñata to be whacked nor as a reality to be accepted or rejected whole, but rather as evidence of a candidate's willingness to engage with realities, crunch numbers, clarify objectives, and get to work. Her plan, as it stands, is not going to be adopted. The question is: who do we trust to sit at the table where the next cluster of decisions are going to be made?
9
@Seraficus If it will not be adopted and there are other proposals that solve the same problems that are popular and will win the election, why lose the election on this issue?
It's idiocy. The rest of the world and this country is praying that we Democrats win this election, so why sign up for a noble, but massive loss?
2
Single-payer was put on the ballot in Colorado in 2016 and failed with 80% of the voters against it when confronted with the practicalities. Single-payer in practice will have to address all kinds of things that I have not heard politicians discuss, such as:
1) Are abortions/birth control covered? If yes, you’ve just mobilized millions of voters on the other side who don’t want their tax dollars funding what they see as murder. If not, you’ve just kicked millions of women off of private plans that may cover such services in favor of a government plan that doesn’t.
2) What about immigrants? Trump just passed a rule saying that immigrants won’t be allowed in if they get Obamacare subsidies. If Medicare for All passes, there’s a good chance the next conservative President will ban all immigrants who might use it (which means all immigrants period, since there would be no private insurance for immigrants to buy instead).
Medicare for All might work in a country without a huge number of conservatives who would use it to harm reproductive rights and immigration, but that’s not the country we live in.
It is much better to keep a system of private insurance to avoid the problems inherent in having the government decide what healthcare everyone in the country gets. Notably, even Medicare itself includes many private healthcare plans in the form of Medicare Advantage, Medigap, private prescription drug coverage, etc.
12
The world must be spinning the wrong way since I actually agree with a Ross Douthat column. I am not a fan of Medicare for all, but personally, I'm gonna be on it in 2.5 years anyway. Still a single payer option sounds better to me.
1
@Maloyo56
Warren's proposal is probably better described as single payer. "Medicare for All" has become a convenient catch-phrase for single payer. Unfortunately, that phrase leads to people confusing more comprehensive single payer solutions like Warren's with the actual current Medicare program. With Warren's plan, there would be no premiums, no deductibles, no copayments, and no coinsurance charges. Plus more would be covered than is covered by current Medicare. It's very similar to Canadian single payer, except it covers even more than Canadian single payer currently does. But like Canadian single payer (or more accurately the Ontario version of Canadian single payer), there is no fee to purchase coverage and everything covered is paid at 100% of cost so there are no out-of-pocket costs for covered services.
3
What I don't understand -- although it's probably a sign of the leftist MSM not wanting to ruffle the feathers of any dem candidate -- is why doesn't someone say what is true -- medicare ain't free. I pay much more for medicare than what I paid for insurance when I was working. And in addition to medicare I have to pay a whopping sum for supplemental insurance because medicare doesn't pay for everything. And then you have to have insurance for drugs. And medicare doesn't cover dental.
So -- after years of working and paying into medicare -- I'm essentially paying what I would pay for private insurance as a contractor -- and much more than when I worked in corp America where the employer picked up a major portion of the bill.
So, let's say the dems win (awful thought) and they pass medicare for all. Do you think that all those people who worked for corporations are going to suddenly get the insurance benefit they were getting (about 80% of their insurance cost, part of their total comp package) back? I doubt it. So most working Americans are going to take a huge hit on this. Or the corporations they work for, or both. But I don't see how this is a winner.
But ultimately insurance isn't the problem -- it's that healthcare is ridiculously expensive -- and the cost grows at a rate that is faster than inflation. So simply sprinkling medicare for all magic dust on the healthcare won't cut costs -- and they'll keep increasing.
9
@Ralphie I have Medicare and I pay about the same as I did when I had for-profit health insurance and it covers more. Yes, you don't get dental but I have never had a plan that did. Sounds like you had a Cadillac plan before and your employer was shielding you from most of the costs. Image all the extra money companies could put aside for their employees if they didn't have to pay for their employees' health insurance. I am for leaving for-profit healh insurance as an option but the rest of us would benefit hightly from medicare for all option.@Ralphie I have Medicare and I pay about the same as I did when I had for-profit health insurance and it covers more. Yes, you don't get dental but I have never had a plan that did. Sounds like you had a Cadillac plan before and your employer was shielding you from most of the costs. Image all the extra money companies could put aside for their employees if they didn't have to pay for their employees' health insurance. I am for leaving for-profit health insurance as an option but the rest of us would benefit highly from medicare for all option.
6
Sir, one of the most incisive comments I've read on this issue. Several of your points bear repeating:
"why doesn't someone say what is true -- medicare ain't free"
Most seniors don't notice what Medicare costs because the monthly premium for Medicare is deducted before Social Security is deposited into our accounts.
"insurance isn't the problem -- it's that healthcare is ridiculously expensive -- and the cost grows at a rate that is faster than inflation. So simply sprinkling medicare for all magic dust on the healthcare won't cut costs"
It is the unregulated, noncompetitive costs of healthcare that are the problem. Do any of the candidates "have a plan" for controlling health costs? An example: for one procedure, I was told if I paid for it upfront, it would cost $800. If I filed for Medicare to cover the cost and denied, then I would be charged $3,000. So what was the actual cost of the procedure? And by the time I was told this, it was too late for me to "shop around" for a cheaper provider, even if patients in need of care get to "shop around."
Why aren't hospital systems covered by antitrust laws? In most communities, they operate as monopolies.
5
@Ralphie Yeah, I find that difficult to believe. We pay quite a bit of money for our plan and it isn't something a senior living on social security could.
Most people on Medicare love it, particularly if the get the supplemental insurance. Also to your point about costs, medicare is very good at negotiating down costs.
I applaud her for working harder, thinking harder, watching less tv, tweeting less, planning more, acting thoughtfully, and - most importantly - caring more about her fellow Americans than mr. trump. She is amazing! She cares.
9
Oh, please. Every major country can afford Medicare For All and we can't? We're spending three times more on health-care in our nation than they are. Look it up.
60
@JFP This is an over-simplification of a complex issue. It is not true that all major countries (especially European) have single-payer coverage. Germany has a reputation of being one of the best, and it's an insurance-based system. Also, many countries employ measures to limit costs that some in the U.S. would consider draconian.
10
@JFP No they cannot afford what Sanders and Warren propose. Their plan is massive compared to those of Europe and Canada.
Most industrialized countries use a mix of public and private insurance, have made critical choices with regard to what is and is not covered to control costs, include higher taxes on all as well as out of pocket costs.
If you want a plan that mirrors what Europe does, then vote Biden, Buttigieg, or Klobuchar.
7
@JFP Actually the US spends about 18% of its GDP or about 2 times more than other western industrialized countries who have single payer government run health care systems. But I agree with what you are saying. Medicare for All would provide good coverage to all citizens at a lower cost than our current system where many are uninsured or have inadequate coverage. Yes rearranging the payment flows; for example taxes instead of premiums, co-pays and deductibles; is a challenge but can be overcome.
2
I strongly support Warren but I think this was a mistake. You must first get elected, and Trump and the Republicans have a national propaganda machine powerful enough to twist any truth and promote any lie. Despite the need for the plan and the serious detail work behind it, the Medicare For All policy will become "taking away your health insurance", "raising you taxes" and "socialized medicine". This is a sad state of affairs but it's true that Fox and Talk Radio have about 45% of the country under their spell - why play into their hands? Especially when it's extremely unlikely such a plan would get through the Senate.
Running on a public option would have been a better strategy.
13
Dear Mr. DOUBT THAT--Yeah, I'm not going to vote for anyone who wants me to have the best health care in the world. Corporate welfare, price gouging, political bribery, investor profit...oh, and a military that's 12 times larger than the next 10 countries, should be our very first concern. Rich people, and corporations, shouldn't have to pay any taxes--we'll do it, since we are the little cogs in the wheel. My health and welfare does not come first, nor does yours. I want the insurance companies, drug & device companies, hospital chains, et al to prosper at my expense. That's okay, I'll just wait, and maybe die. Completely fair and fine. I'm here to serve.
32
@ChesBay well-siad. the Capitalist Maw is wide and insatiable.an feeding it is Ross's' constant concern. Have we we ever heard him propose that his Vatican liquidate its immence wealth holdings to benefit human beings? i he did he would insstantlylose his republican constituency and financial support
3
Healthcare needs another reform than just slapping current culture with medicare-for-all, we need: curbing cost of drug prices, limit wages for medical doctors; limit cost of per night hospital stay etc etc.
Only in US, anesthesiologist - one of the least paid specialties elsewhere - may earn at a hospital wages between $500k-$1million - we do not even pay attention who might be our anesthesiologist, while having a surgery, and he/she might be the highest paid doctor on our bill. Hospital bed for one night at a hospital may run $10k-$20k. A drug that costs in Europe $20 - full price - the same drug is in US $800. What is the culture of accepting healthcare relates that are unheard of anywhere outside of the US? To add medicare -or-all without bringing healthcare expensive to what they are really worth - we will end up supporting with our taxes army of faceless $500-$1 million a year anesthesiologists.
Can we demand from politicians a real healthcare reform?
7
@Ellen
Anesthesiologists are the people who keep you alive during surgery. They may be faceless but you want a good one! That said, the costs of American healthcare are unsustainable and if we don't do something to reduce them, there aren't going to be many anesthesiologists around because no one but multi-millionaires and billionaires will be able to pay for them.
3
@Ellen,
Thanks for this comment. Inability to control costs is, I believe, the real problem in our health care.
Trump continues to refuse to negotiate Medicare volume discounts with Pharma. No one's plan addresses the overcompensation to proceduralists (esp. radiologists and anesthesiologists). Our physician shortage is exacerbated by a system that promotes well compensated procedures over patient contact.
1
@617to416
Yes, I agree, that without having a plan how to reduce costs of healthcare here, only "a few" would be able to afford it. Still introducing in such an unchanged cost-ineffective healthcare system just a medicare-for-all would not contribute to lowering the costs, only bring a great confusion to most. Running her campaign on medicare-for-all, Warren makes a grave mistake.
She is the best candidate to win, then why she is doing everything not to win?
1
Republicans were beaten like a mule in the last election because they not only don't support Universal health care, they are against wage earners and the poor having any right at all to it if their employers, benevolent wonderful supporters of all that is good in America, don't give it to them.
The time to debate Universal health care is over. The public is Universally on board. Sadly the Republicans have decided to opt out. This debate has to be carried out in the Democratic party. I predict Warren and Sanders will lose but Universal coverage will win.
The public option and Universal mandated coverage has broad support because the ACA which Republicans universally opposed would have actually worked with a public option and a stronger mandate and everyone knows it because the Democrats passed it in spite of massive Republican obstruction.
5
One by one, week by week, Ross picks off the potential Democratic nominees. He doesn't really like Trump, but all of the alternatives seem to have fatal flaws, are unelectable. It's a page from an old playbook.
16
Even if Warren gets elected, for medicare for all to become law, it must pass the House and Senate. I can't imagine it ever getting into law because the Replicans would never sign on due to welll... every part they would object. Many Democrats would not sign on because it kills the insurance industry which are major employers in their state. Also, the size of tax increases needed would jeoporadize their own extence in the House or Senate.
7
Warren represents 'change', a conservative's nightmare. My God, how can that be happening?
We, the 'people' represented in the US Constitution, understand that things like happiness, and the General Welfare of all of us, is basically guaranteed by this document.
That goes against the grain for those who lead greedy and grasping lives, and who happen to rule today. Conservatives believe that it is 'every man for himself', and only the strong and ruthless are entitled, a very libertarian philosophy.
Recent signs worldwide though show that citizens everywhere are rebelling against the narrow vision of conservatives who accept corruption as their entitlement.
9
@Harold So, you say bring on the noble loss in 2020 for a proposal with no chance of becoming law.
For those of us who want to win the election, your adherence to losing on a single issue is deeply disturbing.
2
@OrchardWriting Staying on topic Orchard but not ignoring the big one, corruption with climate and health care right up there. Who has a plan for all?
Oh how I wish she would just embrace a "public option" instead of trying to take on the entire health care industry. A well run "public option" plan that anyone could sign on to would most likely morph into a medicare for all plan at some point
13
@DonS
People say that a public option will morph into single payer. No one, however, has shown how that will actually happen. Nor has anyone shown how a public option (which you need to buy into and which still does not cover 100% of costs) will do anything more than marginally help with our main challenges of insuring the millions of uninsured Americans and reducing excessive premiums and out-of-pocket costs.
The "public option" is a way to pretend we are doing something significant while in fact doing next to nothing. There is no way to solve the US's massive healthcare problem without significant disruption. There are no easy solutions. The public option creates the illusion that there is an easy and effective solution, but it's merely an illusion.
4
@617to416 - If it doesn't morph into a single payer system, it means Americans have Universal health care and competition that's actually working.
That would be an even better outcome than medicare for all.
3
@HL
How pray tell does it morph into universal coverage? The great thing about the public option is that no one has explained it in any depth, so it's easy to deceive people into thinking it's anything they want to think it is.
No. The actual way the public option will likely work is to add one more option to the exchanges. You will still need to pay for it to get it—unless it's completely taxpayer funded so that it's free for anyone who wants it (in which case everyone will want it and it will morph very quickly into single payer).
2
Bret argues that it is politically risky for Elizabeth Warren to run on single-payer health care. He could be right: many popular policies such as gun control can become an albatross around a candidate's neck when the opposition controls the narrative. With the mixed experience many people have of Obamacare, liberals are especially vulnerable on the health care issue in the red-leaning states they have to win.
Unfortunately, the merits of single-payer health are rarely presented or debated in a rational way. Almost every independent study that has been done indicates that the overall cost to society of a single-payer system will be about the same, or possibly lower, than our present system. With single-payer, the administrative costs go down, while coverage is extended to people who presently have none. The end result is close to a wash.
What is not so simple to grasp is that there would be a massive movement in jobs from private insurance to an expanded Medicare-like public institution. There would also be a massive shift in costs from partly-employer-paid insurance plans to corporate and public taxation (aka "your taxes will go up"). I think these changes could be managed, but they evoke fear, and do not make for a compelling policy narrative.
The US health system is the most costly, confusing, and unfair in the developed world. I wish the Democrats good luck with single-payer. But like Bret, I'm not sure they will win on it.
3
This analysis is spot on, historical analogies and all. Well done.
4
Mr. Douthat doesn't seem to realize that American health care is broken. At this point there is no tweaking of incentives/disincentives, malpractice and tort law to get it right. It is that bad as its cost rapidly approaches (if not already surpassing) 18% of GDP. I think very high-cost Switzerland is at 13%! We are so broken, there is no normal. There is no trend line to which we may return. So, Mr. Douthat, I think yours is a misunderstanding of Burkean conservatism. Doing nothing is not a Conservative response, and that is an exact description of your proposal.
31
This is somehow right. The part about flat tax and single payer. We are doomed and it will be the case that the most pertinent word to describe health care reform will be incremental. We will deal with outrages as they occur and the two sides of the impossible debate will rail and we will muddle through. That's America for you. And I would not have it any other way. Sides have razor edges.
1
We should have one of the smaller states try out this idea first before it goes nationwide, the way it is meant to be. Well, guess what, it was already tried, in the small state of Vermont and the lawmakers concluded it would bankrupt the state. Remember this is the home of Bernie, the Socialist, who's home state rejected the cornerstone proposal of his platform. If you want to run the country into the ground this is what you want. For every one else, this is a non starter.
10
@sob States have to run balanced budgets. The feds do not. How come every other civilized country can manage this and we cannot?
4
@sob This drives me nuts. States cannot support something like single payer. It is the kind of plan that must be national. Maybe, maybe CA could do it but for the most part there can be no jumping ship of companies. No entering into the state for insurance.
1
Your headline, 'Elizabeth Warren's Health Care Albatross', is a reminder that our existing health care system is an albatross that we, and our employers, and our governments, lug around every day. Our existing system works fine for well-off people such as media pundits, and the medical establishment, and young people think they'll never get sick, so Warren is walking into a hurricane-strength headwind. But the system does not work for the sick and not-well-off, and it makes the US economy an impossible place to employ people who make actual things, or do actual things, that don't involve buying or selling cheap stuff from China.
It's a fair criticism that Medicare for All is too ambitious for a country that can't do anything anymore. I tend to agree. Making Obama's patched-together health insurance reforms actually work for everybody, including employers, might be a more attainable goal for us at this stage.
7
I recently turned 65 and I am now in Medicare. I have two observations.
One: Medicare is in fact mostly administered at least from a beneficiary perspective by private health insurance companies through advantage and supplement plans.
Two: It is great! It is far more affordable for me than anything I ever received from my employer. That is saying something. I had/have blue chip benefits I am sure were more generous than 90 percent or more of the population receives.
31
@Joe Under Warren's plan there will no more private health insurance companies. Warren's plan does not allow for profit or efficiencies generated by profit. Consequently, no private sector participation in managing Medicare for all.
The Medicare for all plan will be administered directly by the Federal Government.
3
@John Quinn The only "efficiency" generated by for profit insurance is that they constrict your access to healthcare (that you are paying them to provide).
8
@John Quinn: there would still be ‘private’ insurance companies,as there are in Europe, but they would provide only SUPPLEMENTAL insurance. This makes sense for the wealthy, so they can still have it both ways. Also, when you have M4A, you don’t need 50 state (captured) regulators, who ensure monopoly (rentier) control.
7
Medicare for all will suffer the same fate as the ACA.
Screeching from the conservatives included the "death panels" which did galvanize the masses into their opposition to a plan that would have helped them.
Now, we have the conservatives lined up stating that Medicare for all, in part, will lead us down the road of communism or toxic socialism that third world countries suffer from.
Many will state that socialized medicine does not work in this country as they seek charitable medical care due to lack of insurance-socialism in practice-the seeking of charitable care.
Many of us are on Medicare, military healthcare, Veteran's healthcare, all socialized medicine. Yet many enrolled in those programs gasp when a liberal politician suggests universal healthcare and bleat that will lead us to socialism.
Well, readers, now that late fall is upon us and we have seen snowfall on our roads and streets please be aware of the socialist snow removal equipment removing snow from the socialist streets and roads.
17
Its funny how all of these right wing pundits criticize Warrens healthcare plan without presenting an alternative that will provide healthcare for everyone. and get some control over costs. They don't do this, because they can't. They always tout America as the greatest country on earth, just not capable of doing what every other modern country does!
47
@Cary Clark ACA didn't do anything to control costs. Healthcare inflation has continued to be greater than overall inflation. None of my doctor's automate anything --- they don't talk to each other, at least electronically. There is no incentive to cut costs in the healthcare industry. There is little real competition.
And do you have any evidence that people now have more access to healthcare than before ACA. They may have more insurance -- but before there was ACA most places had public hospitals where anyone could go for treatment. You can't equate insurance with access to healthcare.
1
@Ralphie Warrens healthcare plan Is not equivalent to the ACA! One of its main focuses is to control costs. The ACA was not intended to do so, just to subsidize the paying of those costs.
3
@Cary Clark wrong...obama said aca would
Drive down costs
1
Ahh, Conservatives. Everything might be too hard, so let us do nothing.
Which is 7% increase in HC prices over the last 40 years, doubling every 10 years. One of the few blips was Obamacare, which had increases of only 5%.
So, what is the conservative answer? Free market? We just have to wait a little longer than 40 years to have it work "correctly"?
No plan is perfect. Nothing man made ever is. What is the conservative plan, besides only the rich get healthcare?
29
@gratis gratis -- that blip was because we had a recession -- remember that -- and overall inflation declined -- but healthcare costs still grew at a greater rate than overall inflation -- at about the same relative rate as before ACA.
@Ralphie
Recessions do not do anything to slow healthcare costs. The GOP has done all it could to weaken Obamacare, and that increased costs over the last 8 years.
4
"Hillary Clinton lost in 2016 in part because she abjured her husband’s popular legacy of centrism, enabling Donald Trump to appear to many swing voters as the more moderate candidate in the race."Moderate???? I am 74 and Ross would probably give one argument about how I look 39 and another about how I look 139. And he would believe both at the same time.
13
@Gunmudder I agree. She lost many dems because they viewed her as two moderate. Most of the people who voted for Donald Trump who did not do so for outright racist/sexist reasons did so to "shake things up" which is hardly the stance of a moderate voter.
1
@Gunmudder She lost because she was Hillary Clinton. Another woman with another name would have won. Many do not understand the absolute dislike for that woman.
The larger point in the Medicare for all issues, that nobody discusses, is that commercial insurance is now fully embedded in the Medicare system in the form of Medicare Advantage. Medicare and commercial insurance are conjoined twins that will take years of work to separate.
Likely, the reason this point is neglected is that so few can compare and contrast the two programs. Even those over 65 who must choose between the two usually don't know the difference. I'd wager the candidates don't either.
My advice to Medicare for all advocates (including candidates), is to propel the discussion, but underscore that no actual policy change is likely unless and until a national consensus develops.
7
Mr. Douthat, how does Warren's Health Care Plan compare with the Trump/Republican Health Care Plan?
How much will the GOP Health Care Plan (sic) cost
and who will be covered?
Where can Americans learn the details of this long promised Conservative Health Care Plan which the President has promised will be far better and less expensive?
Comparing Warren's detailed plans with those from your side of the aisle is like comparing apples to air.
76
Douthat dreams again hoping despite his faults that are too many to count that Trump will win again.
What other president will defund Planned Parenthood, reduce access to not only abortion but contraception, pack the Federal court with reactionary dullards move us to a theocracy and have the blessing of Evangelicals? The answer of course is Trump.
Krugman whose economic judgement I trust more than Douthat says Warren's plan will work.
I venture most people who doubt the need for some form of affordable and comprehensive health insurance and see the supposed folly of proposing policies that do that do not live where fund raisers are seen in every small town, donation cups on the cash register counters all for local people whose families have been struck with a medical tragedy that they have no means of paying the bills for.
It is time to be bold. Playing it safe with HRC gave us Trump.
6
Elizabeth Warren has lofty goals, and some are worth pursuing, including universal health care. She should stick with the vision, and drop the "plans". Take a lesson from Trump. His "build the wall" and "Mexico will pay for it" were instrumental in his success, not so much for the message, but for the simplicity and lack of detail. Democrats are overthinking these issues, the mainstream voters are not.
8
Medicare for all might not be feasible. But it would be nice if conservatives could come up with some solutions to the very real problems in our healthcare system. (And dear conservative voters, when you lose your job in the next recession and find yourself over 45 years old, that health insurance you're so happy with will go away too.)
21
How is "healthcare for all" an ideological issue? How is it that almost every other relatively affluent nation manages to have some version of it regardless of the political ideology of its leaders? Stripped of the fear-evoking buzz words , what this piece seems to saying is that we can't have the type of system that works in other countries because our current mess of of system is too big and entrenched to change. I don't buy it. Is "potent fear of health-insurance disruption" some new psychological disorder?
19
@Katie
Just call it the new American "can't-do" attitude.
1
@617to416 Thanks for my much-needed laugh of the day. It fits!
Medicare For All is a grand idea but shouldn't be forced on anyone. It will be impossible to do all at once, anyway, given the current political climate (even if Dems keep the House and take the Senate) and Warren should be up front about that.
If "MFA Who Want It" is phased in, and is as good as promised, all citizens will be covered and those with private insurance would be transitioned over slowly. Forcing the healthcare industry out of business, and forcing people to give up some outstanding coverage all at once is a mistake and EW needs to be honest about the time frame, and probability of its succeeding.
3
If our current system is so great,why are insurance deductibles so high and going higher and why so many bankruptcies? Why are medications taking such a large piece of some personal budgets? why are private insurance premiums so high? Name me one country with national insurance that wants to go back to a private system. All this criticism of Warren’s plan and yet no real alternative from republicans.The costs of her plan too high? Not if we modernize delivery and reduce excessive profiteering.
16
The current American healthcare system is a disaster. We are now spending $3.5 trillion per year—about $11,000 per person—for healthcare. That's nearly 18% of our GDP. Most advanced nations spend about half that on a per capita basis—and get better health outcomes.
Worse, the American system, pushes these costs on individuals so that a typical working American family of four pays about $8,000 out of pocket. (Their employer pays another $12,000 or so). The median salary for a family of four is about $60,000, so the typical median family is now spending 13% of their income on healthcare. Naturally, millions of Americans can't afford to buy insurance or to cover their costs even if they have insurance.
Single payer is the only proposed solution that actually solves this cost problem for average and lower income Americans. The public option may help a little, but mostly all it does is add one more too-expensive policy option to the mix (remember the proposed public options all require a buy-in, which means they still require premiums, and current Medicare still only covers 80% of costs).
There are other solutions that could solve the problem. Many European systems use highly regulated and highly subsidized private (but often not-for-profit) compulsory insurance to provide universal coverage. We could do this too, though no one has proposed such a solution for the US. Like it or not, single payer is the only proposed solution that actually solves the real problem.
37
Trump will feast on this proposal if she gets to the general election. If you do a little checking you will find very little support for her grand schemes. Americans don't want to give up their private insurance to jump into the vast unknown of government run healthcare. Who will trust the government with 20% of the economy. Will you doctor take a 50% pay cut? Will people wait for months for an operation, when they are in constant pain. Single payer is a pipe dream. that will sink the economy. Only people without current coverage are in favor this, while sending the bill to someone else.
9
@617to416 agree 100%, but, I (for once) agree with Ross on this...her proposal should be for a single payer system to be worked out in a bipartisan way with (as you say) private insurance companies involved (a system that would reduce overall costs)...she should, also, advocate for "affordable" child care and college, and stop the talk of "free" child care and college (that just opens the door to attacks from the right, and more likely to see the light of day at some point...also, forget the idea of forgiving all student or medical debt (lowering interest rates , yes, but not eliminating them)...
3
@sob I think you’ve summed it up nicely in a nutshell. Despite its flaws, this country has the highest quality health care in the world. A government run/Medicare type coverage should only be offered to those who are in need and without private coverage. But unlike Obamacare, it should not be imposed on everyone.
I'm always confused about why Republicans think being anti-health-care is ultimately a winning theosophy. Laissez faire capitalism doesn't deliver health-care-for all. Yet everybody needs access to health care. It is the Republican Party that puts itself in an ideologically unsustainable position. The general thrust of the Democratic Party is ultimately a winner.
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@Ghost Dansing
The GOP thinks it because it sells to the base. Their base keeps voting for less and less health care.
1
You have no idea what you're talking about, which I'm afraid is usually the case.
Many people were trying to decide between Trump and Sanders. The election was about Clinton being too centrist for our working class who have finally figured out that the Clinton Globalism Initiative, as I like to call it, wasn't working for them whatsoever.
So, go ahead, live in your made-up la-la land universe while our working class are listening with interest to what Warren has to say, whether it's about universal health care or putting an end to corporate welfare and unfettered billionaire-ism.
The thing she has going for her? She makes waaaay more sense than you.
11
@CF The Democratic Party working class vote is largely made up of people of color, and Warren is not doing well with that group. She mainly appeals to white college educated voters. Unlike the Republican party, the Democratic party is highly diverse and represents a wide range of interests. That is one of the things that really worries me about her - that she won't be able to build the necessary coalition of diverse voters that will be needed to win against Trump.
First of all, disruption. Yes. If you want something you never had, you have to do something you never did. Any single payer plan will be disruptive. That is the point.
Secondly, cost. The focus on cost and taxes is misleading. The USA pays for it now, and more than necessary. There are cost savings all over the place. It is just an accounting matter, how money is moved around. And that is done legislatively, if it is done at all. Done correctly, which is a low probability, the total cost will be less than we pay now.
Thirdly, every other OECD country in the world does this. The idea that we cannot is absurd.
Fourthly, Ross mentions a liberal "dream" of single payer health care and a conservative "dream" of flat taxes. Scandinavian countries have achieved both, along with another conservative dream of balanced budgets. The tax rate is approximately flat at about 50%, but everyone is paid a living wage so they can both live and pay the taxes.
Norway, in fact, usually runs an annual budget surplus. But, sadly, Norway is the most socialist, having nationalized their oil. So, having achieved a couple major conservative "dreams", why are the Nordic countries never mentioned as desirable models for these movement Conservatives? It is like they want to achieve the same goals by doing the total opposite.
11
Here is my idea of a "centrist solution". Your 16 year old daughter comes home one evening and announces that her 24 year old boyfriend will be moving in. Debate immediately ensues. "Moving in" is not allowed. Debate continues. A "centrist" solution emerges. The boyfriend will be allowed to stay three nights a week.
Sixty plus years of health policy debate and analysis has rendered one, absolutely solid conclusion. You must change the incentives (unique to the US system) where hospitals and physicians receive more payment when they do more services. There is no "centrist" solution to that problem.
5
I think it probably is a folly for Democrats to take that chance, but the policy is sound.
But what is best often doesn't seem so.
Pete Buttigieg, who is astonishingly articulate, is proving to be a wily and opportunistic contender. His pivot to the center seems to be working. It sure was fast, even a bit shameless, but not quite ruthless. More power to him. FDR would have been impressed.
Warren has painted herself into a corner, and Mayor Pete is going to do his best to keep her there. In the primaries, that is.
They are the smartest, and are my two favorite candidates.
I'll vote for one of them in the California primary, but I'm not sure who it will be yet.
14
I'm saddened pivoting is accepted/expected from a candidate. Can we not have an honest public servant that does what s/he says they'll do?
What a charade we are.
1
@Matt Elizabeth is already out of that corner standing on 9300 pages of detail. Now the ball is in Pete's court and he can no longer just criticize the M4A concept. He will have to explain how is Medicare if you Want it plan will be paid for. How will it extend coverage to include what is now private Medicare supplemental insurance? WIll he re-introduce the hated mandate? Will the cost of his plan be higher per person?
WHen the game is simply My Big Idea versus Your Big Idea anything goes. But once it's down to brass tacks only one side is in the game, it ain't Mayor Pete.
Republican presidents get to bury the needle but Democratic ones should be seat warmers without much ambition, or else they’re not even electable?
No thanks. If Elizabeth Warren is rejected in favor of Trump, the country is already lost. I’ll take my chances.
9
Health care is not a political issue. Health care has nothing to do with whether a person is a Democrat, Independent, or Republican, or whether someone is conservative, liberal, or progressive. Disease and Disability plays no favor. The U.S. health care system is broken and needs to be fixed, from top down. Bright minds putting forth possible health plans that may or may not come to fruition is a positive thing. Identifying the problems and then trying to find solutions is a positive thing. Providing health insurance to all, mitigating disease and curing disease is a positive thing. Much more positive than Trump and his sycophants name calling thinking individuals as "socialists".
13
@SLF --your premise is failed. While disease and injury are nonpartisan, the delivery of healthcare is. It is truly a matter of how costs and benefits are distributed.
9
This issue is another of the reasons I strongly support Pete Buttigieg. On health care, he wants to give everyone the option to be covered by Medicare, if they need/want it. At the same time, everyone could keep their private health insurance, if they have that and would prefer that.
What Buttigieg has proposed is simple, straightforward and sensible; achieves the goal of everyone ultimately having health coverage; preserves the choices that people currently have; and will be significantly less costly than what Warren has proposed.
In the general election, I'll strongly support whomever is the Democratic nominee. But, in the primary, I'm all in for Pete Buttigieg.
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Buttigieg’s proposal is Not simple. It incorporates all the complexities of today’s broken private insurance with the creation of a government sponsored healthcare system. Private insurers can’t compete with the government because the privates need to create profits. The insurers will either undermine the public option or leave the market. I bet they will use their vast political and economic power to make the public option into a sham that doesn’t deliver the promise of affordable health care. Also, the system will become more complex. Businesses will still have to devote resources to the annual pick a plan game. Consumers will still have to pour over data and be forced to predict their next year’s health crisis. Doctors and hospitals will still be burdened with entire departments devoted to figuring out who pays what and how much. Medicare for All brings relief from all that and once in place can’t be undermined by Humana and all the other health care middlemen and extortionists. The public option won’t reduce costs and won’t deliver the better health Americans deserve. Dive deeper, my friend. Don’t be fooled.
22
Buttigieg's plan has the the backing of Aetna Health Insurance, CVS Health, Astex Pharmaceuticals, Anthem Insurance Inc. and Ironwood Pharmaceuticals.
These donors to Pete's campaign have thoroughly researched his / their plan, and concluded it would very beneficial.
12
@Ray B Lay indeed your cynicism about the for-profit system and its bought politicins and i is well-jusified..
2
How many plans have been proffered that will be funded on a tax on the rich?
Americans understand what this means--when the wealth tax fails, the middle class tax is the fallback.
If people want healthcare, free college and student loan forgiveness, they should cast their vote with the clear expectation that they will have to pay for it.
21
@Sendero Caribe
How? Right now, only the rich have money. Taxing the middle class is really squeeing blood from a stone.
Statements like this seem to be born of fear, little to do with reality.
2
@Sendero Caribe
how about:If pople want to transfer all their wealh an also that of their children to the already-wealthy 10%and to predatory corporations "they should cast their vote with the clear expectation that they will have to pay for it.
iOW; vote Republican
How many ways can the Democrats just give the 2020 election to Trump? I stopped counting after Warren announced her stupefying $50 trillion price tag for health care for all. It's mind blowing how out of touch she and others who continue to push this on an electorate that wants no part of it. And they call Trump extreme? Not once have I heard a Dem candidate talk about the Supreme Court, or poverty, or job creation. It's just one plan after another that requires higher taxes. As they sink into the quicksand, perhaps the only hope is someone who hasn't announced yet, but may now have an opening to run - Michael Bloomberg.
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@Mattbk
I think many of us are hoping for a reasonable third party candidate like Bloomberg but it's becoming unlikely. 2020 seems lost for the democrats, and possibly also the house secondary to contagion on higher taxes, open borders, and losing private health insurance by topline candidate.
2
I disagree. Unambiguously insisting on health care for all is extremely popular and long overdue. The candidate who runs on that will have massive support. Like Bernie Sanders does.
12
It's so bizarre that democrats to the right of FDR, one of the most popular presidents in history, are called ideologically extreme. We have fallen so far as a country.
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@Connor
The Green New Deal is very much like FDR's New Deal. But, FDR's New Deal would never pass in today's Congress. Results do not seem to be important to the GOP Congress.
4
Taking over health care by the government is a losing proposition foe getting elected and to govern. It has been the fuel the current GOP has digested to become the ideological monster it is. 1994, 2010, 2022.
First and foremost boost the economy for the general population and fast and you’ll gain trust.
8
@Wayne
Sigle-payer universal health insurance is just that, heal insurance. It is not a "talking over [of] health care by the government. Under a Canadian or French style system , for example, physicians still work on a fee-for-service basis. They are private practitioners. Only the insurance is administered by a government agency.
12
@Wayne
One big reason for single payer system is that our current system is actually hurting our economy. Too much money is going into healthcare in the form of waste, excess profits and fraud, which denies money that could actually help the economy grow.
7
@David Zimmerman
I may be wrong, but it's my understanding that Canadians are happy with their health insurance system.
Advocating a multi-trillion dollar plan to completely overhaul the U.S. health care system could be seen as ambitious. It could also be seen as madness verging on political suicide.
Democrats seem timid of achieving success in spite of the mind-numbing list of ways Trump has demonstrated that he is unfit for office. It is beyond perplexing to me.
15
Not sure why Warren's $20.5T plan is so scary when by our current system we're projected to spend $30.5T in the same time period. Seems like a simple question to pose: do you want to pay $30.5T or do you want to pay $20.5T?
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@Harry Finch
This is exactly correct, we already spend $ 3.3 T per year on health care, so none of the Democrats' plans will cost us any more. The money is already being spent, with individuals, families, employers and government providing the funds - Bernie is is already saying this, but he's not doing it effectively.
The discussion should be about how to restructure and rationalize how the funds are provided, not "new" taxes.
If company x now pays $ 100,000 per year for employee health care to Health Net, and next year is required to pay $100,000 to Treasury as a heath care "tax" for the very same coverage, there is no impact on the company or the employees.
Warren and the Democrats need to understand this and develop a short and simple explanation for the voters.
12
@Harry Finch It isn't scary, and I don't for a minute believe that Elizabeth Warren is afraid of her own proposals. It's Mr. Douthat and the GOP who are afraid, and so the they resort to the old bogeyman of "you'll lose voters if you do it your way." But there is a lot of time between now and the elections to educate voters, and I don't know even one person of any political persuasion who is happy with our current healthcare system.
12
Ross, you said it perfectly. Best column ever. I hope Elizabeth is listening. I am an independent who is surrounded by Democratic friends. No one likes this health plan. Warren might gain more support by using a “ Rick Perry, whoops” and withdrawing this proposal.
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Gosh, Ross, maybe I just don't read enough newspapers, but so far I haven't seen that "she has many more media adjuncts willing to give her math the benefit of the doubt...."
What I have read is a lot of tut-tutting about how irresponsible she's being, by promising to knock everyone off the private insurance every pundit insists is just luuuuuuuved by the American people.
Not to even mention how she's going to bankrupt the country while forcing every hospital and most doctor's offices to close in despair.
Some genuine analysis of her plan and, if it were to become the law, the most reasonable way it should implemented would be an actual breath of fresh air.
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@Stephen Beard Even just a mention of what the current health care set-up actually costs -in comparison to her plan-would open some eyes.
4
It's not that what Elizabeth Warren proposes is wrong; it's that we would have to turn the Senate, along with the White House, Democratic for any of her platform to stand a fighting chance. She has to know the power of Congress as well as anyone could. And the last thing anyone would want for their presidency is to be written off as just another politician who rode into office on empty promises.
6
@NM 'But the right will block M4A, so it go down as an another politician's "empty promise"?
Oh, come on - Sanders or Warren will be elected not on the promise to pass M4A but the promise to fight for it.
Everyone who votes for Sanders or Warren knows the right will block it - the assumptions are that, if elected, it will be seen as a mandate, and that bully pulpit will further increase rising support for it, further galvanizing movement support and, ultimately, making opposition a liability.
At his Fox News-sponsored meeting, after Sanders explained M4A trade-offs, a majority of a Fox News audience in a conservative state kept their hands raised in support of it. A pro-M4A candidate in office will make that a national conversation.
7
It is wrong. The problem with Warren isn’t that she isn’t thoughtful enough and not just that she has a selection bias of the ideas she absorbs, it’s that she has no instinct about the future economics. Her response to the financial crisis in 2008ff was to make mortgages 40 yrs and greatly increase the FDIC insurance, both ideas that were based upon fear and not what people need. Give the banks more insurance!!!?
Sorry but I will vote for Warren before Trump because of the judges and Trumps total disregard for the country, his poisoning if anyone close to him, his lawlessness among others but I fear what the Dems may lose in 2022 with this craziness.
Don’t come back at me that other countries do better. Perhaps they do but it’s not a reason to go off the rails.
1
Interesting to read Douthat's criticisms of Warren. Where are his criticisms of what the GOP has done to make the ACA as unworkable as possible? What about how the GOP, courtesy of McConnell, refused to allow any tweaks to the ACA? What about how they are allowing Trump to make a laughingstock of the country? I haven't seen a single GOP plan that doesn't hurt the middle and working classes when it comes to health care, tax overhauls, and so on down the line.
I think that Douthat and the other conservatives should start to examine what their party is proposing (more of the same or nothing at all) rather than condemning what Warren and others are putting forth in an effort to improve things for Americans.
11/2/2019 11:08pm first submit
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@hen3ry
Thanks for joining us with your late evening concerns.
With more voices of clarity like this in our nation, more of us will be able to be in dreamland by 11:08pm, rather than sitting awake in a GOP/Trump bad dream...
1
The discouraging thing about the 2020 outlook is that Elizabeth Warren in her personal demeanor and temperament comes across
as being a radical on the verge of a nervous breakdown. For voters
who pay their own way through college and/or who diligently pay their college debts, Warren's proposal of forgiving college debt is a turn off obviously. For the average voter with some capital gains, increasing the capital gains tax rate is not something that they would vote for. For hard working Americans who have medical insurance at work and/or who have paid medicare taxes for many years, "medicare for all" is not attractive.
27
@David: I paid off my college debt. Just finished paying it, in fact. And I'm fine with her forgiveness proposal.
There are two ways you can respond to the idea of making life better for the next generation. One is to enthusiastically embrace it ... the other is to harrumph indignantly and say "Well, if I had to suffer, so should they!"
I choose the former.
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@Erik
Agree. The U.S. economy will improve if the next generation is not saddled with crushing debt the minute they receive their diplomas. They will be able to buy houses and invest more of their earnings. They will have more room to be innovators. This can only be good for the job market and the stock market.
12
@Erik
why should anybody make any effort at all to earn any money, if I can get others to pay off my debt and expenses
8
"But it would still be a folly, a case study in ideology’s exacting costs, for the Democrats to take the chance."
Healthcare should be a slam dunk issue for the democrats since Trump is widely understood as having accomplished nothing on the issue. But Warren and Sanders are turning it into a losing issue. Americans like Obamacare and believe it can be reformed to improve it. This approach will garner votes from the far left to the center right in the general election.
23
@LewisPG yes and no one better demonstrates "ideology’s exacting costs', than Mr. Doubt That. especially so long as the "costss" are financial and threaten his Oligharch- patrons' cash-flow.
2
Here's what you and others who think losing private insurance is so horrible are missing: Medicare for all would cover us no matter where we were when we needed treatment and we wouldn't have to meet deductibles each year, select from narrow networks or worry about a provider being out of network. Complain all you like about what Warren and Sanders are proposing but don't forget this: having health insurance is not the same as being covered, not under the present system.
110
@hen3ry there are deductibles and networks with the supplemental insurance one needs in addition to Medicare...so many people do not know how Medicare works...
7
@Jim However, the Warren and Sanders proposals expand Medicare to complete coverage with at most a minimal co-pay so no need to meet deductibles or purchase a supplemental plan.
6
@Jim then people need to be educated rather than being told that our present wealth care system is the best or the worst. I rarely see any articles where that is done. Do you?
3
Warren sincerely thinks that a sound and well intentioned message can prevail when it has not popular support, that it would make one by being expressed, and that explains why she would be an ineffective President.
12
Elizabeth is my first choice among the candidates but I will not vote for her to be the nominee unless she drops her enforced Medicare for all.
This one issue will lose the Presidency and that is not acceptable.
In one of the early debates Warren stated 'We are Democrats, we don't take things away from people", then she turns around and wants to take away their private insurance.
This issue also shows a fatal flaw in Warren, an inability to listen to constituents. There is a fine line between determination and obstinancy.
If Medicare is better, allow people the choice. If it is better people, and their employers, will quickly migrate.
51
@JMC - There are several reason that giving people the choice between public and private health care will not work.
The 1st one is obvious. It is much, much cheaper to administer a program where everyone is treated the same than one that has Medicare, Medicaid, VA, Indian health, TriCare, etc, AND 1,500 different private insurance policies (not counting Part D Medicare). Not only is there vastly higher overhead for the private insurers, but the compliance costs for physicians, hospitals, & patients are enormous, at least $600 Billion every year. Choice leaves that on the table.
The 2nd one is that a public option has to cover everybody the same while private plans can develop plans that cater to the young, the healthy, & the wealthy. They can give bribes to companies to get them to buy their coverage, This would leave the old, the sick, & the poor to the public option or Medicare itself. All this would raise the cost of the public option & negate any administrative savings.
The 3rd reason is that the universal gov run plan of other countries ALL have one entity that can gather data, analyze it, & make recommendations based on medicine, not profit. If a lot of people are covered by private companies which keep their data secret, we could not do this. See https://www.nytimes.com/interactive/2014/health/paying-till-it-hurts.html
How many people have to die or go bankrupt, how many TRILLIONS have to be wasted before we can push for an efficient universal system?
105
JMC I completely agree with you. Klobuchar is looking better every day.
16
@JMC Once Sen. Warren is elected president, she will have to work with a H of R and, hopefully, a Senate controlled by moderate Democrats. Any health care agreements negotiated will not lie at either of the extremes but will track somewhere in between, which to me sounds like a Medicare option. Over time, people will vote with their dollars and their feet.
We are electing a president, not a king. We've seen how well electing a king works out.
15
The most awkward moment of the 2012 campaign came when Romney, a born moderate, tried to channel Ayn Rand and condemn 47 percent of the country as "takers" freeloading off the "makers." Libertarians cringed; Democrats pounced.
Joe Biden will provide more such moments over the next months, trying to sound populist enough to win the nomination. He sounds somewhat awkward even chatting about the weather, so it should be interesting.
Warren may not want to talk about her most extreme (and most costly) proposal for practical reasons, but she won't sound nearly as unnatural. Her desire for revenge on the evil rich is genuine.
3
Besides the 32 billion dollar tab (Warren says much of it will simply be transferred from employers' current health insurance contributions to a federal scheme; where's the law supporting that, and which 60 senators will vote it into being?), you also have reparations for slavery (do African immigrants have to pay? Do the owners of BET get a check?); free college for everyone (even Lori Laughlin's kid?), and decriminalized border crossings with free health care (that should reduce demand among people fleeing Latin America for the border.)
Warren is not yet the nominee. Once she is, the Republican sound machine will strip the bark off her, as Lee Atwater used to say.
42
@ed connor Maybe you don't know this but your employer is not giving you health insurance. That money is part of your compensation (your pay). Anyone who has been in the workplace for any period of time knows this because once a year the employees are presented with the bad news: your percentage of the payment is going up or your co-pays and co-insurance and deductibles are going up or your family coverages are going up. All of these come at the expense of raises if any.
8
More advice from the Right on how Democratic nominees should formulate policy. No thanks.
239
@Jordan And nary a mention - or care? - given to the benefit comprehensive health care brings to society.
Isn't conservatism comfortable when all that clutters your thinking is money?
14
It's ironic that you would characterize the Democratic Party as "a party that still fetishizes wonkery" but you don't think we're smart enough to know the difference between aspirational thinking and actual governing. We understand that Republicans will still be involved in that government and therefore we will be happy with incremental improvements in our lives in this frustrating form of government that defends against the tyranny of the majority but encourages a tyranny of the minority. If campaigns can be hurt by promising too much, how is Trump president? I believe it was Mario Cuomo, the Democratic Governor of New York who said "You campaign in poetry but you govern in prose." What a wonk .
37
If I had a dollar for every conservative that warned Democrats about the Democratic Party's "leftward march", I'd be able to fully fund Medicare for All.
444
@Republi-con
Thanks,very well said.
My own fear is that Democrats will, indeed, become lost in policy. Trump is trumping DEMOCRACY, while Democrats debate policy.
Trump threatens DEMOCRACY, daily, and Democrats are clueless. I suggest a new DEMOCRACY wave, with a Trump defeat in 2020.
Democrats might use the DEMOCRACY song:
"Democracy is coming to the USA" (Leonard Cohen)
-------------------------------------------
The NY Times might discuss the words of DEMOCRACY:
"Democracy is coming to the USA"
-------------------------------------------
3
@Republi-con You've had 30 trillion conservatives warning you about the Democrats leftward march? I believe your math is as fantastical as Senator Warren's and after Trump wins a second term I bet you'll be hearing a lot more "I told you sos".
1
@Republi-con
All the conservative pundits appearing in the Times have been pining for GOP-lite Biden. That one unstated goal informs everything they write, every argument they make, and tells you all you need to know about Joe Biden.
5
Thank you, Mr. Douthat, for the critique on Elizabeth Warren after she produced her plan to fund MFA. But I prefer and recommend reading Paul Krugman's reaction with analysis in yesterday's NYT.
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@mrarchiegoodwin
He’s not critiquing the plan Per se, he’s saying it’s a straitjacket and political loser.
Medicare For All is not a plan, it’s an aspirational campaign slogan whose appeal beyond a certain segment of the Democratic base is questionable.
It is unserious because no proponent has bothered to engage the professionals; doctors, institutions, and yes insurers not only affected, but whose buy in is necessary to make any plan work. And the millions of healthcare workers currently employed in the industry, and vast majority of people currently insured don’t even seem to be part of the equation.
Ross is right. The Democratic left flank is completely ignoring the lessons of the midterms and can’t seem to see beyond the primary. They spend more time criticizing fellow Democrats for than they do Trump.
And ironically, the left leaning candidates owe their visbility to Trump. If they were facing a traditional centrist blessing Republican, candidates like Warren and Sanders would be clear liabilities. The Democrats need to be flexible and responsive.
21
@mrarchiegoodwin That wasn't much of an analysis by Mr. Krugman. I can see why people could like it, though.
@mrarchiegoodwin - Yes, either provide a Rorschach test administered by a biased acolyte like Ross Douthat who advocates using religion as a tool in order to recruit new political devotees to the Republican cause or an objective analysis of Elizabeth Warren's plan by a Nobel Prize winner in economics, Dr. Krugman. One is writing as a GOP surrogate and the other as an unbiased expert in economics to inform the public about pros/cons of political proposals.
13
Excuse me, Ross, but Hillary Clinton lost in large part because she didn't "abjure centrism." She embraced it totally as an establishment Wall St. centrist to the point of picking a center-right candidate as running mate and thereby alienating the ascendant progressive wing of her party and ensuring the low turnout that doomed her in what should have been a blowout, James Comey and Vladimir Putin not withstanding. There is no discernible ideology at work with the progressives other than economic fairness that reduces the yawning gap in income inequality fostered by 40 years of Republican tax cuts for the wealthy. That's a policy not an ideology that won support for both a Republican, Theodore Roosevelt, and his Democratic cousin, Franklin. We are faced with most consequential election in our lifetimes to determine whether or not our Constitution remains the rule of law or is replaced by an authoritarian kleptocracy in "the rule of Trump." The country is completely out of balance to the point that it's on the very verge of becoming a Putin-style oligarchy. It will take a large, strong leftward push or pull to bring it back into balance. That's what we're witnessing in a very non-ideological battle between the progressive forces of democracy and the regressive forces of autocracy.
233
Long-shot candidates? According to the polls, among the Democrats they are now leaders and against Trump, for the general election, they are not at all long-shots, especially Bernie Sanders. Their positions are not hyper-partisan, but well regarded among the general electorate.
16
Dear America,
Thank you so much for paying for our universal healthcare with your Marshall Plan loans.
Now we get universal healthcare for the same tax burden as you! It's so sad to see how distorted the debate is in your country. I notice that as ever amorphous "costs" are quoted, but never detailed to you.
But there is a mystery, America, nearly the same slice I pay for healthcare, you waste on a massive army instead.
What an utter mystery that your press, not even your liberal press can make this connection. America, land of mystery.
We notice that once again in the article the middle class are mentioned, and yet, like everywhere else, most people in the US make less than the median wage, and are therefore not "in the middle" anyway, they are below the middle or average, and the vast majority of them.
You also have the most income inequality in the free world, and the loosest tax collection. How is more aspiration to be middle class, when most of you are not, and are working class, like on the rest of planet Earth ever going to get the thing you've paid for everyone else to have on that basis?
I don't know, but maybe if you were a little less... seemingly mistaken in a lot of obvious things, perhaps this debate might make more sense? I have friends that are journalists in the US, it's sad how certain blatantly obvious things cannot be said because of the fallacious "fairness" over there?
265
@Lucas
Well said, my friend.
The press itself is letting us down and enabling this to continue apace.
You can lead a horse to slaughter, but you can't make him think.
Land of Mystery.
23
@Lucas
ah, sage advice, (tho a bit snarky....)from Great Britain no less- which btw hasn't been "great" for a hundred years-with a reference to our needing sensible debate....you mean like Brexit?
11
@Lucas
You can't actually have a country (or any other group) where "most people make less than the median wage."
The median is the wage that exactly half of the people make less than. What you can, and actually do, have is a country where most people make less than the mean wage, figured by dividing the sum of everybody's income by the number of people.
The problem in America is that the income distribution is skewed; the mean income is much, much higher than the median income because of a relatively few filthy rich billionaires at the top. The problem is worse because real income for most people has become stagnant; most of us aren't seeing much improvement in our incomes year to year, while a few billionaires have so much that most of their worth has become play money to them-- "did I beat out Warren Buffet this quarter?" "Can I buy a bigger yacht than Putin's favorite oligarch?"
Sorry for the technical jargon, since your basic point is absolutely spot on.
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Bernie knows where we need to go and Liz knows how to get there, but all candidates need to beware of moderators and pundits that take control of the conversation. Health care for all is impossible without first cleaning up corruption and restoring more equitable wealth. Everyone should be asking about corruption first, before anything else, because that is the distinguishing feature of the Republican Party. I'm sure Warren is able and willing to explain how cleaning up corruption will require equitable taxation that will pay for health care for all. Since it is the American electorate she needs to convince her background as a special education teacher may be more relevant than her Harvard years.
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@mary bardmess I laughed out loud. by myself still in my bed early this morning when I read this line. "Since it is the American electorate she needs to convince her background as a special education teacher may be more relevant than her Harvard years." Thank you for starting my day. You nailed it.
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@mary bardmess
Excellent talking down! This is what people where I live resent more than anything.
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Health care should be a right, not an option. The goal isn't to find where to draw the line that excludes some people so that more "deserving" people aren't outraged by the cost.
Wealth is so unbalanced in this country that we've become a society of castes rather than a population of equally deserving people.
We've made such distinctions before. Working people were used and abused by wealthy industrialists. Women were beholden to their husbands wishes. Brown skinned people and immigrants were expected to make do with the minimum, or less.
The history of the 20th century was one of recognizing the rights of all workers, women, races and genders. Somehow economic equality has eluded us. Yet when Elizabeth Warren dares to suggest that there's enough money to take care of the old and the sick, she's met with columns like Mr. Douthat's.
We seem to accept the fact that the top 20 percent of people should own nearly 90 percent of the country's wealth. Maybe it's time to rebalance that equation.
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@gemli
What we've accepted through most of our history is property rights. Sounds quaint, I realize.
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@gemli Recent reports of the state of the Switzerland economy tells us that the issue of inequality has pretty much been resolved there. The people are reported to be happy with the current state of the union.
My own visit there seemed to confirm that those I encountered, young and old, were both happy and comfortable (and friendly). Stability helps. Intelligence seems to reign in politics and the economy. Something we are missing in the US.
Here in the US we are stuck in the 'greed is good' mode that become national policy in the Reagan regime. Will we accept anything else?
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@Michael Smith: Slavery was quaint? Women not given the right to vote until 1919; not allowed to open their own lines of credit until the 1960's and 70's; whose homes could be sold by husbands without the wifes' signatures until the 1970's in some states. All quaint, right? Please. Healthcare is a right. "Affordable" health insurance is a red herring.
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