Dem Post Mortem

[Jarhyn]

Amazing endorsements of that post you have there. Sorry @Swammerdami, you're in bad company there.

Look at this strawman of an argument! Your supported candidates were the ones who rolled over. Gore rolled over. If Gore had had the strength progressives demand of candidates, Gore wouldn't have lost.

But this isn't about Gore, however weak he was in the end This is about Hillary and Harris.

There is a really easy way to make sure that Dems who can win who are not going to bow to fascist aims win: vote for the Dems who are not going to bow to fascist aims. Support those Dems. Don't pretend that they are "unelectable" because their "unelectability" is a Tinkerbell effect, and it ends as soon as you stop letting yourself and your peers believe it without challenge.

It's really that simple.

Of course, the Dems you elect, the actual people you think can "win elections" do not make Americans lives better, now or ever really. All they do is, ironically, act conservatively to resist the backslide of the whole country, but in the weakest way possible.

They don't oppose citizens United or big money in politics.

They don't support corporate tax rates that would actually improve the lives of their constituents.

They don't even support raising the minimum wage.

They don't support single payer solutions.

They don't support taking big pharma down a peg.

If all you support is keeping the trains running on time, you will eventually be issued a ticket on a train you would rather not be on.

You're still not showing how alienating even more voters is supposed to help.

You want a candidate that supports what you want, but that's unelectable and would lose abysmally.

Alienating them with what? The expectation they compromise and seek coalition first within their own party?!?

How is that too much to ask?!?

 

[Loren Pechtel]

The UK and Australia are having problems supporting their single payer system, at least that's what I've read over the past few years.

You shouldn't believe what you read.

The problems are largely engineered by people who want the systems to fail, for financial and/or ideological reasons.

Decent healthcare is unaffordable in exactly the same way that US budget deficits are unavoidable - only if you accept the unspoken premise that taxation is fundamentally evil and unconscionable.

No.

The problem is that voters vote based on their perception of value. And the reality of healthcare is that most spending is on a fairly small number patients. So long as emergencies are dealt with reasonably well and minor stuff is dealt with reasonably well most voters will feel enough is being done. And they will see the system being funded at a level well beyond what they use. Every UHC system falls into this trap.

You fail to understand that government can't simply tax if the voters don't believe they are getting enough value for what they pay.

 

[Jarhyn]

voters vote based on their perception of value

And whose fault is it that Democrats cannot transmit a uniform message of the value of their policies?

Progressivism is largely built around getting people excited over the actual benefits to them which political activism can bring.

When the "center" is controlled by people who actively try to shush that excitement and control and silence the desire people who have for that action, and then compromise instead of with the people who are willing to sell out to those who want kings, you end up getting kings.

You are the people who MUST eventually side more with us than them, and if you won't, you will get kings because we won't end up siding with anyone; we will be their first victims.

 

[Swammerdami]

If no one is perfect, is forbidding criticism of certain "heroic" men really wise?

So, apparently you support the removal of Lincoln's name because he was racist. Instead of being heroic, he was merely "heroic." Is there anyone you DO find heroic, whom you would be happy to see honored with statues and namings? Or should such honors be reserved for inanimate objects: the heroic Oak Tree, noble Denali Mountain, or the Magnificent Rings of Saturn?

(My go-to example of an undersung American hero is John Brown, whose martyrdom really was a key to Emancipation.)

 

[Politesse]

I do not in general find monumentalism and hero worship to be a great thing, but I'm also sure it's not my place to tell any particular community what to name things after. Perhaps you want me to share your anger or bafflement that someone would make a different choice than you would, but it has never been my assumption that everyone agrees with me, or should. So yes, I guess I "support" them naming the school whatever they like. Whose business is it but the school's, really?

But the deification of the presidency is certainly a broader trend that I am extremely wary of. Elevating a John Brown or an Ohiyesa or a Sally Ride as a hero is a bit more innocuous, since they did not occupy powerful political offices thaf others now fill and seek to expand. But I would still favor teaching kids real history in all of its messiness to the "pageant" style of education I received as a youth. Thank god I picked up reading early!

Abe is a distant cousin of mine, by the way! Via marriage, I'm a Todd relation.

 

[bilby]

The UK and Australia are having problems supporting their single payer system, at least that's what I've read over the past few years.

You shouldn't believe what you read.

The problems are largely engineered by people who want the systems to fail, for financial and/or ideological reasons.

Decent healthcare is unaffordable in exactly the same way that US budget deficits are unavoidable - only if you accept the unspoken premise that taxation is fundamentally evil and unconscionable.

No.

The problem is that voters vote based on their perception of value. And the reality of healthcare is that most spending is on a fairly small number patients. So long as emergencies are dealt with reasonably well and minor stuff is dealt with reasonably well most voters will feel enough is being done. And they will see the system being funded at a level well beyond what they use. Every UHC system falls into this trap.

You fail to understand that government can't simply tax if the voters don't believe they are getting enough value for what they pay.

You have utterly failed to understand my point.

For any level of healthcare, there is a total cost, $X, that is the lowest cost at which this level can be provided to everyone.

In any healthcare system that is funded via corporations that insure people, rather than via taxation, the cost is $X + $P, where P is the profits taken by the insurers.

The question you raise; of what to include, or to exclude, is a totally separate question. It is true that in a direct democracy, there would be a tendency for the level of healthcare to be higher - for more rare and expensive treatments to be done. But direct democracy doesn't exist anywhere today.

It's also true that for-profit insurers will strive to avoid covering literally anything they can get away with denying. That you see this as desirable leaves me questioning your morals.

But ultimately both systems have a level of care set by government. The government can be the single payer, save the middleman costs, and provide UHC; Or can just tell the insurers what they are legally permitted to cover (or to not cover). Either way, it ultimately comes down to the voters - because if it were doen to the insurers, almost every claim would be denied, and policies would literally cover nothing (while giving the impression that they covered everything, right up until you needed to make a claim).

The difference being that the vast majority of voters in the OECD are poor people who are not opposed to highly progressive taxation, because they know they will never earn enough to pay the top rate, and that if they do, they will easily be able to afford it; While voters in the US think that they are about to become billionaires, and believe the insane propaganda line that says the thing standing in the way of that, is taxes.

Outside the insanity of the USA, governments can and do "simply tax". Taxes are just not a big fucking deal for most people; They are painless and simple, and they are unavoidable and largely unimportant.

Unlike the US tax system, which has been deliberately mis-designed to make paying taxes as noticable and painful as possible, even for ordinary working citizens.

Americans have, for decades (maybe centuries), been trained to hate taxes. Europeans understand that taxes are necessary, and have been allowed to make them as painless and unobtrusive as possible.

 

[Loren Pechtel]

it makes sense that free care for all is becoming hard to afford.

It really doesn't.

"Free" care for all costs no more than "for profit" care for all; Indeed, it must by simple arithmetic cost less.

The only way to make it cheaper than that is to not allow "all" to have healthcare.

Faced with the choice of "These poor people get no care" vs. "These high income people pay progressively more income taxes", I plump for the latter as the only morally defensible option.

Except the reality is: Care is rationed by means of delays.

When "We can't afford healthcare for these people" meant "If you tax me enough to pay for it, I will go hungry", there might be some sympathy from me. When it means "If you tax me enough to pay for it, I will not own a private jet", My sympathy is less marked.

It means the voters won't vote to spend what it costs.

 

[Spacetime Inhabitant]

Americans pay twice as much per capita for healthcare than the people of any other nation. They aren't paying it via tax, but directly. It's like if you buy a car for say $20,000 from a car dealership; just because you are not paying the money to the government does not mean that the car is free.

 

[Swammerdami]

...
Americans have, for decades (maybe centuries), been trained to hate taxes....

As I read this I recalled that -- as you yourself pointed out IIRC -- the Boston Tea Party, an insurrection which led to the Revolutionary War, is misrepresented in American folklore.

The Boston Tea Party was in response to a tax on British tea, but the problem was NOT that the tax was too high. The problem was that the tax was so LOW that legitimate British tea competed with and reduced the profits of Boston's illegal tea smugglers (e.g. John Hancock and Samuel Adams)!

 

[southernhybrid]

I support universal health care, but anyone in the countries that have free care for all and think their country isn't having problems providing it isn't paying attention. I'll add one link but if you don't like that source, you can find similar information on many other links. And yes, this primarily hurts older adults. This is why I think the only possible solution is to have premiums based on income, just like we do for Medicare. Even at that, Medicare is in trouble, at least partly imo, because doctors order too many tests and procedures and some patients insist on tests and procedures that they don't really need.

Ok. We are off topic, but that's what we always seem to do.

https://www.skynews.com.au/australi...e/news-story/8002378db4b6c1c02e1491bdf4ea887f

New data has revealed the true extent of the crisis in Australia's healthcare system, as patients avoid primary care due to cost, face extreme ambulance wait times and hospitals fail to meet waiting room timeframes in emergency departments.

The Productivity Commission's latest Report on Government Services has revealed the shocking state of Australia's healthcare system, with primary care, ambulance services and hospitals all in crisis.
Among the headline findings were revelations the number of Australians avoiding or delaying seeing has GP doubled, some states recorded ambulance wait times of 30 minutes or more and public hospitals are struggling to see emergency patients within target timeframes.

Every state and territory was struggling to meet benchmarks in at least one area the report found, with workforce sustainability also a key concern.

In the meantime, emergency departments are under increasing strain due to declining primary care use, with hospital wait times ballooning in many states and territories.

Residents in Western Australia, South Australia, the Australian Capital Territory, and the Northern Territory were no longer being seen "within clinically appropriate timeframes" for immediately life-threatening Category 1 cases the report found, while nationally just 65 per cent of patients across all cases were seen on time.


https://www2.thehealthyfat.com/cid/701Vo00000ecuTeIAI

 

[bilby]

I support universal health care, but anyone in the countries that have free care for all and think their country isn't having problems providing it isn't paying attention.

...to the pervasive propaganda on the topic.

I'll add one link but if you don't like that source, you can find similar information on many other links.

Of course you can. The disinformation campaign has been widespread and relentless for at least four decades.

And there are lots of real problems - caused by the spending cuts that the propagandists have demanded.

Cutting taxes forces cuts in spending. Cuts in spending cause problems in service delivery. Problems in service delivery are presented as "UHC has all these problems, we need to fund it less, to tackle the waste". So both taxes and spending are cut further.

This has been happening for a long time. It's a concerted effort from anti-taxation campaigners, many of whom are media moguls, and have a bigger megaphone than anyone sane.

Your link is, ironically, to exactly such a source. And of course there are many more - thousands more - to be found.

The simple solution to all the problems described in that article is to reverse the tax cuts of the last forty or fifty years, and use the additional revenue to pay for more doctors, more nurses, more hospitals, and to lower or eliminate gap payments, so that most providers return to Bulk Billing.

But you won't see Sky News ever even hint that tax cuts are not a good thing, nor that further tax cuts are not a desireable way forward.

 

[southernhybrid]

I support universal health care, but anyone in the countries that have free care for all and think their country isn't having problems providing it isn't paying attention.

...to the pervasive propaganda on the topic.

I'll add one link but if you don't like that source, you can find similar information on many other links.

Of course you can. The disinformation campaign has been widespread and relentless for at least four decades.

And there are lots of real problems - caused by the spending cuts that the propagandists have demanded.

Cutting taxes forces cuts in spending. Cuts in spending cause problems in service delivery. Problems in service delivery are presented as "UHC has all these problems, we need to fund it less, to tackle the waste". So both taxes and spending are cut further.

This has been happening for a long time. It's a concerted effort from anti-taxation campaigners, many of whom are media moguls, and have a bigger megaphone than anyone sane.

Your link is, ironically, to exactly such a source. And of course there are many more - thousands more - to be found.

The simple solution to all the problems described in that article is to reverse the tax cuts of the last forty or fifty years, and use the additional revenue to pay for more doctors, more nurses, more hospitals, and to lower or eliminate gap payments, so that most providers return to Bulk Billing.

But you won't see Sky News ever even hint that tax cuts are not a good thing, nor that further tax cuts are not a desireable way forward.

Ok. But your government site also mentions some funding problems. I'm not saying that the taxes shouldn't be raised, I'm just saying that it appears as if your healthcare system is underfunded and it is primarily hurting older adults, who usually need a lot more care compared to younger adults. I still like the idea of charging premiums based on income like we have with our US Medicare system. Due to all of the advances in healthcare in recent decades, care has become a lot more complicated and expensive, regardless of who is paying for it. Based on your post, it looks like you agree that your system is underfunded. That was my point.

As you know our idiot, psychopathic president wants to cut taxes and cut medical care for the poor, aka Medicaid. That's a different problem. I fully support the right of all citizens to have access to decent healthcare, but it must be adequately funded in order to be successful.

American doctors haven't gotten increases from our Medicare system in years, at least that's what they say. I'd like to see them salaried with regular raises as well as having their student loans paid for if they practice in needed areas. The low reimbursement has resulted in a shortage of primary care physicians, since most specialists make substantially more income compared to primary care providers. I've read that in Canada, the UK and Australia wait times for elective surgery are very long. Is that true? It's not that way here, not even if one uses Medicare for payment. At least not so far. A lot of doctors in the US don't take Medicaid as it has the lowest reimbursement rate of all, while many if not most will take Medicare.

One other problem, which isn't as bad as it was 20 years ago, is the demand for aggressive end of life care in the US. When I was working in home health about 20 years ago, it was common to see people have G-tubes for feeding, hospitalization for terminal diseases, dying people placed on respirators etc., despite having no quality of life. This is often very expensive and it only prolongs suffering. Do you know if your country spends much on aggressive end of life care? Just wondering as to me that is a huge waste of medical resources and money. Palliative care or hospice care by a competent team is a much better alternative imo, once we reach a certain point.

OK. I'm done.

 

[bilby]

Ok. But your government site also mentions some funding problems.

No shit. It's almost as though governments were made up of people who have been subjected to the same relentless propaganda as the people.

 

[bilby]

I still like the idea of charging premiums based on income like we have with our US Medicare system.

We do that. It's called the Medicare Levy, and is collected alongside income tax by the ATO.

 

[bilby]

Based on your post, it looks like you agree that your system is underfunded.

I do. But I strongly disagree with the implication that this is an inevitable consequence of UHC being fundamentally "too expensive" to fund properly through reasonable progressive income taxes.

Tax cuts need to be reversed. It's that simple. But nobody ever seems to have the guts to say so.

 

[bilby]

I've read that in Canada, the UK and Australia wait times for elective surgery are very long. Is that true?

That depends on how you define the weasel word "elective". If surgery is needed, IMO it's not elective, and if it's not needed, IMO it shouldn't be funded by government at all. But lots of needed surgeries are claimed to be "elective", so wtf does the word even mean?

Regardless, nobody will be allowed to die because their surgery is postponed. Critically or dangerously ill patients are operated on without delay.

Cutting "wait times", by simply denying a big chunk of uninsured people access to the waiting lists, is not an improvement.

 

[bilby]

Do you know if your country spends much on aggressive end of life care?

I really don't know. I think it is a decision made by patients (or their designated representatives, typically family members, for patients who are unable to express their desires) on a case by case basis.

If you want it, you can have it. I can't imagine many people want it for non-religious reasons though - perhaps the US has a religion problem, rather than a cost problem, in these cases.

 

[Jarhyn]

Based on your post, it looks like you agree that your system is underfunded.

I do. But I strongly disagree with the implication that this is an inevitable consequence of UHC being fundamentally "too expensive" to fund properly through reasonable progressive income taxes.

Tax cuts need to be reversed. It's that simple. But nobody ever seems to have the guts to say so.

The fact that Bernie did is exactly the reason the Dems wouldn't let him on a stage to talk over the direction of the party in debate: because the people now controlling the party have too much money to allow the democracy to actually be representative, mostly because they have the money to run the press to say "oh no, don't tax the rich".

What, you think people want to not be taxes would only choose overt tactics, and to only focus resources on only pushing those who already serve their interests directly to serve their interests?

 

[bilby]

The fact that Bernie did is exactly the reason the Dems wouldn't let him on a stage to talk over the direction of the party in debate

It may have contributed. I sincerely doubt that there was only one single reason though. His not being a member of the Democratic Party can't have helped.

Most political parties don't ask non-members to set the direction they take.

 

[Jarhyn]

The fact that Bernie did is exactly the reason the Dems wouldn't let him on a stage to talk over the direction of the party in debate

It may have contributed. I sincerely doubt that there was only one single reason though. His not being a member of the Democratic Party can't have helped.

Most political parties don't ask non-members to set the direction they take.

People considering someone running under the party name as not a party member is exactly the sentiment which causes those who share his values to not feel like the party will help them or support them.

Political parties have an ethical obligation to let those whose votes they seek set their direction, and as I keep saying you cannot expect a vote if you do not return those expectations by letting them shift the needle.