"The Second Best Plan"

Paul Krugman:

By the way, defenders of the G.O.P. plan often assert that it resembles other, less unpopular programs. [. . .] Iíve been seeing claims that Vouchercare would be just like the system created for Americans under 65 by last yearís health care reform [. . .]

[. . .] First, Obamacare was very much a second-best plan, conditioned by perceived political realities. Most of the health reformers I know would have greatly preferred simply expanding Medicare to cover all Americans. Second, the Affordable Care Act is all about making health care, well, affordable, offering subsidies whose size is determined by the need to limit the share of their income that families spend on medical costs. Vouchercare, by contrast, would simply hand out vouchers of a fixed size, regardless of the actual cost of insurance. And these vouchers would be grossly inadequate.

(Emphasis supplied.) Let me make 2 points in response - (1) The exchange/subsidies reform created by ACA do not forward us towards the best plan - Medicare for All. They take us toward the path of VoucherCare. What's more realistic? That Medicare will be made to resemble the exchange/subsidy reform or that the exchange/subsidy reform will be made to look more like Medicare? I think the former. (2) The size of the subsidies under ACA will be much more dependent on defeating the "Austerity Now! crowd than on the affordability of insurance on the exchanges. The reality is ACA will likely end up looking like VoucherCare when it is all said and done. Krugman's critique of VoucherCare is spot on. But he has a blind spot on the weakness of the exchange/subsidy reform in ACA, which likely will become VoucherCare.

Speaking for me only

< Monday News and Open Thread | Sex and The Stupid >
  • The Online Magazine with Liberal coverage of crime-related political and injustice news

  • Contribute To TalkLeft

  • Display: Sort:
    Yep (5.00 / 1) (#1)
    by MO Blue on Mon Jun 06, 2011 at 02:18:57 PM EST
    The reality is ACA will likely end up looking like VoucherCare when it is all said and done.

    It will force people to purchase "junk insurance" that fills the industry's coffers and leaves individuals with less money and no way to afford actual health care.

    "First, Obamacare was (5.00 / 1) (#6)
    by KeysDan on Mon Jun 06, 2011 at 02:57:47 PM EST
    very much a second best plan, conditioned by perceived political realities."   True, the first and the last reason--molded or stipulated to by perceptions, not by attempts or efforts.  Indeed, the best model was not even taken out for a spin around the block before the "Edsel" was purchased, with the remaining considerations being undercoating, to be or not to be.

    Of course, even now, what should be perceived as being the politically unrealistic "Yugo", Vouchercare continues to be discussed as a starting point for Medicare reforms. And, these reforms are "urgent" in the sense of never miss a chance to exploit a crisis, real or not, to achieve reforms, substantive or ideologic.

    Is the thought here really (none / 0) (#15)
    by AngryBlackGuy on Mon Jun 06, 2011 at 05:43:01 PM EST
    that Obama and the dems didn't fight at all on ACA and healthcare.  That they just took whatever the GOP wanted and signed it.

    It's like we're living in a universe where 15 months of fights and battles and Xmas signings and negotiations and town halls and death panels and socialist calls and Hyde Amendment theatrics and destroyed political capital and Scott Brown and every other thing that happened during that period to stop the dream of single payer did not occur.

    Bottom line: If ACA is a conservative dream plan, they sure as hell didn't act like it was and still don't.

    In all of this rubbish about how ACA is simply a step towards a voucher system and a pay off for the GOPs constituency, we repeatedly lose the fact that the GOP fought the plan tooth and nail and would repeal it tomorrow if they could.

    So either the plan is net good or it's net bad.  If we decide that it's a net negative, then let's all join up with the republicans to repeal it because I think they'd welcome our votes.


    There (5.00 / 2) (#19)
    by Ga6thDem on Mon Jun 06, 2011 at 06:11:12 PM EST
    was no fight. It was Obama spending 15 months chasing after the GOP for votes and them constantly saying no and then him moving further to the right to please them and them still saying no until we got Bob Dole's healthcare plan.

    The only fight on the issue seemed to come from Pelosi.


    Style Points (none / 0) (#24)
    by AngryBlackGuy on Mon Jun 06, 2011 at 07:33:43 PM EST
    Don't count much for the actual legislation. I think that healthcare was a massive fight and even if you don't think Obama was throwing blows and taking hits, it's clear that Reid and Pelosi and the deems in congress were. Jobs were on the line.

    But I repeat the inherent question.  ACA gets bashed here about once or twice a week, and I just don't think I am clear on what the position is.

    Should ACA be repealed or not.  To read some of the comments it's as if the legislation was an evil creation of Rove and others with a few purposes:  helping insurance companies and hurting the poor and also frightening cute animals.

    So if it is that bad, go the repeal route 100 percent. Convince deems and the public that a tragic mistake was made, fewer people would be covered under the plan and it is far less preferrable than the status quo.


    Then maybe a better focus would be determining fixes that will strengthen the exchanges and their benefits. Or standing more firmly behind ACA so that we have the moral standing to delineate between it and what Ryan proposes.

    We are in a situation where the likely GOP nominee proposed a similar plan and that plan remains popular in the state years after it's implementation. We have the ability to absolutely slam home the idea that the incremental change of ACA was not only a GOP accepted compromise, but one that is only the first step.

    Instead we have a chorus of woe (oh if Obama had just fought harder, talked louder and farted magic fairy dust out of his butt we'd have a single payer system or a public option).  Instead of rallying around the incremental change, as conservatives do, we instead blast our own legislation because it is not perfect.

    If we are that stupid we deserve to relinquish control to the extremists on the right.  At least they have the common sense to understand the bigger picture and our long term objectives.  You didn't get your dream reform people. I get it. I also get that it's a year later and there are targets more fitting than Obama, Pelosi and others that busted their rumps to make the progress that they did.

    Or again, maybe you should join the republicans and demand repeal.  That would actually make more sense.


    Someone (5.00 / 1) (#26)
    by Ga6thDem on Mon Jun 06, 2011 at 08:03:55 PM EST
    who throws blows usually don't give away the store in the end or do back room deals with the pharmaceutical companies or the insurance companies.

    The fact of the matter is that we probably would have been better off not passing it. Obama would have been better off working on the economy or maybe not since he hasn't put forth the best policies regarding that either. He could have just passed a few things like preexisting conditions and been better off and he may not be in office when the ACA goes into effect if it even lasts that long.

    The ACA doesn't even have to be "repealed"/. As it is, Obama has been handing out a ton of waivers to people so they don't have to comply pretty much undercutting the legislation himself and then you have the GOP which is probably going to defund it so what do you have in the end?

    At the end of all this, it's really hard to argue against Ryancare when Obamacare is essentially the same thing.


    The Republicans would oppose (none / 0) (#18)
    by observed on Mon Jun 06, 2011 at 06:04:49 PM EST
    school prayer, if the Democrats supported it.

    Thank (none / 0) (#20)
    by Ga6thDem on Mon Jun 06, 2011 at 06:12:07 PM EST
    you. I keep telling people that the GOP is just a bunch of knee jerkers but you put it very succinctly.

    Hmm.. (none / 0) (#31)
    by Left of the Left on Mon Jun 06, 2011 at 09:32:39 PM EST

    Bottom line: If ACA is a conservative dream plan, they sure as hell didn't act like it was and still don't.

    maybe they just know how to negotiate better.

    In all of this rubbish about how ACA is simply a step towards a voucher system and a pay off for the GOPs constituency, we repeatedly lose the fact that the GOP fought the plan tooth and nail and would repeal it tomorrow if they could.

    its entirely possible, crazy as it may sound, that politicians may act a certain way because it was in their best interest.

    But lets say they were 100% honest, is Republican outrage a guaranteed sign of a good bill? Republican displeasure is evidence of nothing.


    Fair Points (none / 0) (#34)
    by AngryBlackGuy on Tue Jun 07, 2011 at 09:23:55 AM EST
    I concede that that wasn't my strongest argument. But I do think that GOP opposition to a democratic healthcare proposal is a pretty good indication that it isn't the preferred GOP outcome.

    Democrats 2012 campaign slogan (none / 0) (#2)
    by jbindc on Mon Jun 06, 2011 at 02:40:35 PM EST
    h/t Avis Rent a Car

    "We Try Harder"

    "Try harder" (none / 0) (#7)
    by Zorba on Mon Jun 06, 2011 at 02:58:50 PM EST
    at what, though?  I was thinking their slogan would be "Vote for us- we suck less than the other guys."   ;-)

    Your slogan might be (5.00 / 1) (#8)
    by MO Blue on Mon Jun 06, 2011 at 03:01:24 PM EST
    more accurate.

    Of course, more accurate still is "Vote for us-we can pass conservative legislation better than the Republicans."


    True (none / 0) (#9)
    by jbindc on Mon Jun 06, 2011 at 03:03:13 PM EST
    But ya gotta think positive spin!

    Very true (none / 0) (#3)
    by Ga6thDem on Mon Jun 06, 2011 at 02:48:35 PM EST
    and it was the inherent flaw in the ACA that it relied on subsidies and not having some sort of public option for people to choose from.

    If we just went with Medicare for All i'm wondering how much money it would save? We could get rid of Medicaid, SCHIP and probably lots of other programs that the states run.

    The next best plan that was out there was the one that allowed a Medicare buy in along with subsidies for health insurance.

    if you look at the federal law (none / 0) (#4)
    by CST on Mon Jun 06, 2011 at 02:53:20 PM EST
    in a vacuum, I'd say this is a reasonable assumption:

    "What's more realistic? That Medicare will be made to resemble the exchange/subsidy reform or that the exchange/subsidy reform will be made to look more like Medicare? I think the former. "

    But, one thing that you are not taking into account is the continuous shift on this issue.  Right now we have VT implementing single payer for their state, CT is considering it, MA is looking hard at their existing plan to see how to cut costs (I don't see a shift to single payer, but I don't see inaction happening here either).

    These states are taking the lead, and in a few years there will be more data and more headway on this issue to coalesce around nationally.

    Hmmm (none / 0) (#5)
    by Big Tent Democrat on Mon Jun 06, 2011 at 02:56:23 PM EST
    ACA enabled this in what way? Made Medicaid and subsidies available for it?

    And what happens if those funds are cut?


    ACA is not an enabler so much as a baseline (none / 0) (#10)
    by CST on Mon Jun 06, 2011 at 03:10:35 PM EST
    it forces every state to deal with the issue on some level.  Either they go with the federal plan, or they attempt something else.  But it will become the baseline to compare all the other plans that are in place.  And I think VT, etc... will come out looking better.

    "what happens if those funds are cut?"

    Than you are right, and I am wrong about which direction we are headed on this.


    It's the same sad story, and I don't know (5.00 / 2) (#12)
    by Anne on Mon Jun 06, 2011 at 03:50:18 PM EST
    why it's still acceptable, that where one lives is more of a determinant of what kind of care one is likely to be covered for.

    That's not going to change under ACA; sure, there will be some sort of minimum guidelines, but we don't even know what they are - and you can be sure that at every step of the way, there will be fighting and attempts to undermine those requirements, to get waivers out of those guidelines.  And on the front lines of those attempts to undermine coverage will be - guess who? - the insurance companies.  Do you think that after four years of hosing those of us who do have insurance, and even with the possibility of millions more victims to suck the lifeblood out of, they're not going to be working to get the minimum coverage requirements lowered - and without a corresponding lowering of cost?

    I just don't understand why people don't see this, and I'm really tired of the essential and entrenched unfairness in a balkanized coverage system that the insurance companies have gamed so well.

    It just makes me want to scream.


    If we passed (none / 0) (#25)
    by AngryBlackGuy on Mon Jun 06, 2011 at 07:39:42 PM EST
    Medicare for all, funds could be cut and that program destroyed too. There is mo magic anti repeal juice that would have been sprinkled on Medicare for all to prevent a GOP led government from gutting everything.  

    If your argument is that the GOP might repeal ACA, you can't argue that they couldn't repeal your plan either.

    You argue from the position of what the structure is right now. Arguing that a law is bad because it might be repealed isn't fair.


    Cut Medicare??? (none / 0) (#37)
    by Big Tent Democrat on Tue Jun 07, 2011 at 10:48:23 AM EST
    Not so easy as the GOP is learning.

    That is called thinking politically.


    Bellow you posted that (none / 0) (#38)
    by Warren Terrer on Tue Jun 07, 2011 at 10:59:00 AM EST
    you see ACA as a slippery slope toward single payer and better cost savings. Now you say that expanding Medicare for all, which is a single payer system, would lead to the destruction of the program.

    These arguments are contradictory. All you are really saying is you support ACA (because it's what Obama wants) and you will defend it by whatever argument seems to work at any particular time, even if those arguments contradict each other in the very same diary.


    I am sick of this back and forth argument (none / 0) (#11)
    by loveed on Mon Jun 06, 2011 at 03:21:38 PM EST
    it's all political.
     The argument you will never hear.
     Separate soc.security.& medicare totally from the budget. These two programs are funded by the citizens, why are we paying twice.
     Allow those over 50yrs. to use medicare as there insurance carrier if they choose(all other insurance programs are available). It would probably be cheaper,also a huge influx of revenue(instead of the employee paying the insurance company, the money will go to medicare).It also would give the insurance companies some competition.
     The funds from soc.security.& medicare should be totally separate from the budget. Soc. secur. is solvent at this time.The extra money would shore up both programs. I would love to have medicare as my insurer(there probably million who feel the sameway). My employer pays about 11,000 a year for my health benefit).
      Not many jobs offer health care when you retire anymore. Medicare is now the official health care carrier for a large amount of retiring seniors. We might as well pay into now and strength it,instead of letting it just collapsed.
      Also the government owes soc.secur. 3trill.dollars. No one every talks about a repayment plan.
      Why can't they try and make it better,instead of trying to destroy it?

    Krugman v. BTD (none / 0) (#13)
    by AngryBlackGuy on Mon Jun 06, 2011 at 05:36:23 PM EST
    Let's not sugar coat what Krugman says and what BTD's response is. Fundamentally, Krugman believes that ACA will do what it purports to do and is a path towards cost reduction and greater coverage.
    BTD assumes the exact opposite.  Where I see ACA a a slippery slope towards single payer and better saings measures (and I think Krugman sees that as well), BTD sees a conservative scheme designed only to help the insurance companies. We often talk here about the credibility to pundits and others and when convenient, Krugman is given a lot of credit.  But on this point, because ACA isn't popular here, he is ignored.

    BTDs point in (1) is speculation. I would argue that the slipper slope moves in the opposite direction.  When exchanges do no prove adequate to  solve all of the issues, a public option will become more appealing. No one is in a real position to predict how that will turn out IMHO.  It's all just speculation.

    So (2) is the only real debatable point: BTD uses "when all is said and done" and other speculation about changes to existing law.  But the law today is clear and the difference between Vouchers and ACA are clear as day.  Krugman puts it best in another post:

    "Well, the answer is that the ACA is specifically designed to ensure that insurance is affordable, whereas Ryancare just hands out vouchers and washes its hands. Specifically, the ACA subsidy system  sets a maximum percentage of income that families are expected to pay for insurance, on a sliding scale that rises with income. To the extent that the actual cost of a minimum acceptable policy exceeds that percentage of income, subsidies make up the difference."

    People can speculate about what might happen or what will happen, but Krugman is talking about what did happen and what the law is.  Today. Right now. The only way the structure changes is that Obama refuses to veto amendments to his own plan.  Highly unlikely.

    Speculating is all we can do (5.00 / 1) (#23)
    by Big Tent Democrat on Mon Jun 06, 2011 at 07:33:33 PM EST
    unless of course your middle name is Nostradamus.

    Mine is Cassandra.


    Fair Point (none / 0) (#29)
    by AngryBlackGuy on Mon Jun 06, 2011 at 09:23:45 PM EST
    Interestingly, my middle name is "win one to silence the haters lebron".

    My mom had skills.


    If you'd bothered to do the math (5.00 / 1) (#27)
    by Anne on Mon Jun 06, 2011 at 08:12:29 PM EST
    on what constitutes "affordable" under the ACA, you'd know that Krugman's statement doesn't hold water; he's right about RyanCare, but he's wrong about ACA being all about affordability.  It's named "Affordable" Care Act in much the same way that Bush gave us the "Clean Air" Act and the "Healthy Forests" Initiative.

    And just so you know, given that the bulk of the Act has yet to be implemented, that the exchanges have not been set up, that we haven't seen what the baseline coverages will be, and we don't know how the insurance companies are planning - and you know they have people whose sole mission is to plan - to get around and weaken whatever is required of them, Krugman absolutely IS speculating about the ACA.

    As I said, he's right about RyanCare, but that RyanCare sucks doesn't mean Obamacare doesn't also suck, in a different way.


    I didn't realize (none / 0) (#28)
    by AngryBlackGuy on Mon Jun 06, 2011 at 09:20:34 PM EST
    That "the nobel prize winning economist didn't do the math" was an acceptable answer.

    Between Krugman and Obama's nominee that didn't make the GOP cut, Nobel prizes in economics are apparently being handed out in Happy Meals.


    You do the math, ABG; (none / 0) (#32)
    by Anne on Mon Jun 06, 2011 at 09:40:39 PM EST
    see if you can conjure "affordable" out of the numbers.  Go on - just this once, see what happens when you take the information out there and think for yourself.  

    This is not a new argument, you know; this whole issue of what's "affordable" has been out there since this whole craptastic legislation was being put together.

    Here - this is from BTD's post RyanCare v. ObamaCare:

    Moreover, Krugman is all too sanguine about the efficacy of ACA's ability to make sure "insurance is affordable." A perusal of the article Krugman links to, written by Jon Gruber, demonstrates this:

    Through the insurance exchanges, employers and individuals will be able to choose among plans that have a federally determined essential-benefits package. While the exact details of this benefits package have yet to be specified, health plans in the insurance exchanges must have an "actuarial value" of at least 60 percent; that is, for the typical population, the insurance plan must cover, on average, 60 percent of the cost of insurance..

    In addition, the out-of-pocket limit for enrollee spending cannot exceed the regulated level for health savings accounts (roughly $6,000). [. . .]

    Consider this "affordability" argument. If you qualify for the minimum subsidy under ACA, you have to cover 40% of the cost of insurance premiums PLUS $6,000 in out of pocket costs. What is 400% of FPL (the level at which subsidies are permitted)? For an individual it is around $53,000.00. Do the math. This is affordable?

    Gruber continues:

    A major feature of the Affordable Care Act is assistance for low-income individuals purchasing insurance through the exchanges. Those with incomes from 133 percent to 399 percent of FPL are eligible for income-based tax credits to help defray the cost of purchasing insurance in the state exchanges. These families will pay the percentage of income specified in Exhibit 1 for the second-lowest-cost silver plan available in their area, and the government will pay any remaining costs above that level. [. . .]

    Do.  The.  Math.

    The way you cling to the premise that Krugman's Nobel Prize means he can never be wrong is just sad.


    The exchange does not have to made more like (none / 0) (#14)
    by steviez314 on Mon Jun 06, 2011 at 05:42:13 PM EST

    Medicare can (technically, if not politically (yet)) be just added to the exchange as another insurance option.

    This is a separate issue from #2-level of subsidies.  You can buy insurance from an exchange plan even if you don't qualify for a subsidy.  No reason why Medicare can't eventually become just another plan available in the exchange.

    VoucherCare (5.00 / 1) (#21)
    by Big Tent Democrat on Mon Jun 06, 2011 at 07:31:49 PM EST
    with subsidies that address affordability is on the table via ACA.

    Maybe 20 years from now everything can change. But adding Medicare to the exchanges seems politically unrealistic for the foreseeable future.

    The problem with ACA is we're pretending it is a historic achievement. It isn't.


    Good point (none / 0) (#16)
    by AngryBlackGuy on Mon Jun 06, 2011 at 05:45:31 PM EST
    I think the real rub here is that there are people who view single payer as the only way and the idea of a true public option isn't enough for them.

    I think we end up with a public option in the exchanges that keeps all prices in check. That's where the slippery slope heads, not a voucher program as BTD indicates.


    The real "rub" is that you don't know (5.00 / 1) (#17)
    by Anne on Mon Jun 06, 2011 at 06:04:16 PM EST
    what you're talking about.  A "public option" that exists within a  private system only encourages the continuing inequities in care and costs, with the worst - and most expensive - being shifted to that public entity:

    Should PNHP support a public Medicare-like option in a market of private plans?

    Response by Drs. David Himmelstein and Steffie Woolhandler:

    The "public plan option" won't work to fix the health care system for 2 reasons.

    1 - It foregoes at least 84% of the administrative savings available through single payer. The public plan option would do nothing to streamline the administrative tasks (and costs) of hospitals, physicians offices, and nursing homes, which would still contend with multiple payers, and hence still need the complex cost tracking and billing apparatus that drives administrative costs. These unnecessary provider administrative costs account for the vast majority of bureaucratic waste. Hence, even 95% of Americans who are currently privately insured were to join the public plan (and it had overhead costs at current Medicare levels), the savings on insurance overhead would amount to only 16% of the roughly $400 billion annually achievable through single payer - not enough to make reform affordable.

    2 - A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan - which started as the single payer for seniors and has now become a funding mechanism for HMOs - and a place to dump the unprofitably ill. A public plan option does not lead toward single payer, but toward the segregation of patients; with profitable ones in private plans and unprofitable ones in the public plan.

    What a refreshing thing it would be if just once or twice you would bother to make some kind of effort, just a little one, to learn something about the issue you're opining on.  I know, as sure as I'm sitting here, that if a Republican had spent 18 months to give us a warmed-over version of the Bob Dole plan, you would hate it.  Hate it.  And all the reasons and excuses you keep trying to find and make why ACA is just so swell would evaporate in a NY minute.


    Right (1.00 / 1) (#30)
    by AngryBlackGuy on Mon Jun 06, 2011 at 09:28:05 PM EST
    Me and Krugman and the silly public option that we and dozens of other prominent liberal economists believed would have worked.

    Silly us.

    I bet the economics degrees they put in the Wendy's happy meals would have gotten us to your level Anne.

    I know as much about the issue as your googling fingers do my far angrier than me friend.  Just argue your point. I assume that your abilities to search the net and find a citation that supports your point are as good as mine.


    Describe "the public option" for me. (5.00 / 1) (#33)
    by Anne on Mon Jun 06, 2011 at 09:48:35 PM EST
    Tell me what its provisions were.  

    You can't.  Because they never existed.  "Public option" is a bumper sticker, ABG - it was never an actual plan.  It was a distraction, meant to placate the single-payer advocates - who, by the way, were never fooled by it.

    I notice you didn't bother to argue the points made by the people at PNHP, though; do you have anything to counter their response to why having a "public option" within the current private system isn't workable?

    I didn't think so.

    But, hey - all is not lost - I'm still laughing at your including yourself in with the "other prominent liberal economists."


    Dear Anne (none / 0) (#35)
    by AngryBlackGuy on Tue Jun 07, 2011 at 09:39:42 AM EST
    Please make discussing policy points with you more fun.


    Angry Black Guy

    All of what we are talking about is hypothetical Anne. We have no idea what a US version of single payer would look like.  We have no idea what it would do to the economy to eradicate the core business of an industry employing millions. Etc. If we were going to have a serious discussion of single payer that delved into all of the economic ramifications, let me tell you what you'd have to have (the mythical numbers which you believe exist and don't):

    1. Number of jobs lost due to the massive hit to the insurance industry.

    2. The economic and legal costs associated with the 10-20 years it will take to unwind all of the existing contracts between providers, employers, doctors, the government, etc. that would need to disappear to implement the plan.

    3. The obvious constitutional challenges to such a plan.

    The reality is, Anne, that anyone seriously advocating a single payer plan that will eliminate private insurers from the primary market (and who believes that such a plan could be implemented nationally in less than 10-15 years let's say) is ignorant of one of two issues:

    • the constitutional issues
    • the impact to an industry that is one of our nations largest employers (equivalent to telling the auto industry that no more cars will be made in the US and expecting it to not have an impact)

    Please stop pretending that single payer possible in the United States anywhere in the near future because it is not, and pretending that it is is a complete waste of time.

    Which is why no one other than people like you talk about it seriously.


    Oh, for the love of God... (5.00 / 1) (#36)
    by Anne on Tue Jun 07, 2011 at 10:42:09 AM EST
    I guess you never bothered to go look at the enormous amount of information available at the website for Physicians for a National Health Program, and instead are just pulling information out of thin air.  

    If you had, you would know that there are plenty of people other than me - smarter, more experienced, with years of work in the health field, with experience with insurance companies - who have been talking about, working on, doing the research, doing the studies, drilling down into the numbers - who absolutely do take single-payer seriously.  They have approached the idea based on the experience of other countries that have gone to and have successful single-payer systems, have gone into it with the example of Medicare, which, back in the day of much less sophisticated technology, managed to get eligible seniors enrolled in one year.  They've looked at and addressed all of the questions and roadblocks they knew would be raised about why it would be "impossible" to bring the US into the 21st century and adopt a single-payer plan.

    The people of Vermont seem to be taking single-payer insurance seriously, and didn't consider it a waste of time, and there are people meeting and talking about this - quite seriously - in other states.  Are they ignorant, too, ABG?  Should we not take them seriously?

    You, yourself, have stated on numerous occasions that you see ACA as a stepping-stone to single-payer; why would you say that if you believe it would be impossible to achieve?  Was it just another example of your saying something just to give yourself credibility with those who don't think single-payer is a waste of time?  You know, like how you always make sure to tell everyone you're a liberal right before you recite a list of Republican talking points, and how much you admire the Clintons right before you trash them?

    You won't do the math, you won't do the research, in spite of having resources gift-wrapped for you to make it easier.

    I guess it all comes down to this: Obama said single-payer was off the table, so you are deaf, mute and blind when it comes to looking at, hearing or talking about anything that might reveal just how stupid that decision was.  But - if he announced this afternoon that he was getting behind single-payer, you'd be on that bandwagon faster than you can say "I love Barack."

    You are fooling no one, ABG.


    We didn't end up (none / 0) (#22)
    by Big Tent Democrat on Mon Jun 06, 2011 at 07:32:36 PM EST
    with a public option so how is it to the point that we could have ended up with a public option?