Showing posts with label Medicare for all. Show all posts
Showing posts with label Medicare for all. Show all posts

Sunday, April 28, 2019

The Problem with a President Bernie Sanders


Senator Sanders is a good, intelligent, forthright man.  His heart is in the right place.  And he certainly believes strongly about what is right and what is wrong.

But there’s a problem with Sanders as President.  It lies in primarily two areas:  rhetoric and policy development.

When it comes to rhetorical style, Bernie Sanders and his fire-breathing progressive allies share much with Donald Trump.  It is confrontational in both tone and substance.  As Trump and many autocrats have shown, this is certainly the way to build a devoted, unwavering base.

But such a style and the unwavering … dare one say, unthinking … political support it engenders does not bode well for the future of our democracy.  If Sanders, or AOC (Ocasio-Cortez), or Trump say something, their followers take it as gospel truth and praise the speaker.  A healthy democracy depends on people thinking, sifting through competing ideas, not leaving it to leaders to think.

This style also exacerbates the us v them aspect of politics and social dynamic.  Before the recent extreme polarization of American politics, people were usually sorely disappointed when they lost an election, but the call by all was for unity, for forming a “loyal” opposition.  In Congress or elsewhere, there were political disagreements, people took their stands, but it was with the feeling that everyone had the country’s best interest at heart and so there was civility in the midst of disagreement.  People could agree to disagree.

Gone are those days.  While the problem started with Senator Dole's very negative relationship with President Clinton during his 2nd term, it became all -consuming when Obama was President and Republicans in Congress, led by Mitch McConnell and John Boehner, decided that they were just going to say, “no,” to anything floated by Obama; their only purpose in Congress was to defeat him.  It went so far as to not giving Obama’s 2016 Supreme Court nominee a hearing in order to keep the slot open should a Republican win the next election, even though that was almost 8 months away and the start of the new term 10 months away.

There is a danger in Sander’s campaign style as with the combative style of some of the newly-elected progressives in the House.  The danger is that you may win some battles, but you will ultimately lose the war. You will not change the culture/government in the ways you would like because you have alienated many rather than generated good will among your opponents.

The other problem with Sanders as President comes in the all-important area of policy development.  Let’s take as an example Sander’s Medicare-for-All.  A wonderful idea, but as I explained in my post, “Medicare for All or Some?” not the way to ultimately get to where he wants to be ... universal single-payer coverage.  But Sanders has no use for discussing all the problems, all the dislocation, inherent in implementing his health plan should it pass.  

I draw from this, in combination with his rhetorical style, that Sanders is not a reasonable man … meaning that one cannot reason with him and he can’t employ reason with those not on his team, convincing them to support him or finding a place for compromise where both sides win.  It’s like W saying, “Either you’re with us or against us.”  Like it’s impossible to imagine the reality of someone being on your side but having a difference of opinion on tactics.  What we very much need in a President is a reasonable man.

So I was not for Sanders in 2016 and I’m not for him now.  But not for the reasons of the Democratic Party establishment.  Not because he fights the larger ills of our culture and government.  Not because he sees the ills of capitalism.  Not because he thinks the super rich are richer than they need be.  I have no problem with any of those positions.

It is rather because his rhetorical style will leave us with a country which drifts even further apart.  Where the concept of an American social contract is even more distant.  Where the phrase “my fellow Americans” becomes an unimaginable anachronism.

Saturday, March 23, 2019

Medicare for All or Some?


Progressives are pushing the Democratic Party to embrace a universal single-payer health care system, what is being called Medicare For All.  But is that the best way to proceed for the American people?

I am in favor of a universal single-payer system in the United States.  Where every person is covered, where there are no deductibles, where there are only reasonable copays.  

But there are serious problems with the attempt to pass a Medicare For All plan now.  How would the transition be handled?  What happens to all the insurance companies and their employees?  

And there is the fact that many people do not want to be forced to change the insurance they have now.  Obamacare had major shortcomings, so many are not confident about the government’s ability to run a plan.  Even most people on Medicare do not experience a government run plan.  They have a Medicare Advantage plan run by a private insurance company that beefs up the coverage provided by “pure” Medicare.

So I don’t think the ground work is there for a Medicare For All plan now.  Instead, I would suggest going back to Obama’s idea and have Medicare For All as an option in the insurance marketplace.  Let people choose.

At the same time, improve Obamacare by finding ways to reduce the horrendous deductibles and co-insurance that people who buy the lower cost plans have to pay.  Even with the maximum out-of-pocket built into these plans, a serious illness would bankrupt many a family.

This approach would do two things.  It would enable people to compare and choose the Medicare For All option.  The ability to choose is critical.  The second is that it would give lower income Americans who do not have employer plans more affordable health care, whether through the private option or the public option.  And it would not disrupt the lives of all the people who work in the insurance industry.