I voted for Bernie twice in part because I wanted to move the Overton Window on health care. Biden could easily have run on a safe platform of defending the ACA and protecting people with preexisting conditions. This status quo defense worked for most 2018 swing district Democrats. Instead, Biden is going further. According to Paul Krugman, Biden is meeting somewhere in the middle between ACA and Sanders. I think this is a good thing. Auto enrolling low income workers ensures my older sister always has insurance, no matter her job status. Expanding the premium subsidy helps me friend who is an independent contractor in Chicago. Doing both of these things should lower my own costs through my employer health plan negotiated by my union.
So the lower middle class, middle class, and upper middle class will all be covered in addition to the seniors already covered by Medicare and the low income families covered by Medicaid. Sounds like universal health care to me. Unlike the Sanders plan, this plan will have the votes in the House and Senate to pass in the first 100 days. I say vote for this man, help him pass this plan, and then push him to do better down the road. As more and more Americans have access to health care, as more opt into the public option, and as more people qualify for subsidies, we will see the popularity of the ACA surge through the roof and the conversion to true single payer will be a much easier political sell.
Not if the Supreme Court strikes it down.
Let’s hold the champagne a bit longer.
There is no middle way and the Professional Reasonable People will not be happy with what needs to be done.
If ACB gets on the bench (which still seems likely despite all the recent drama), then Biden has no choice but to add 3 justices. He can argue it from both perspectives. The Democrats won the popular vote in the last six out of seven elections, including the election that supposedly prevented Merrick Garland from getting on the court. Clearly we had an up or down vote on “who do Americans trust more to appoint justices?” and the Democrats won, I am confident Biden will win an even larger margin of the popular vote this time.
So there’s your rationale for selecting one justice to balance out Gorsuch who should not have been nominated for a seat Democrats deserved, another to balance out Kavanaugh who should never have been confirmed due to his allegations, and another to balance out ACB since a majority of Americans wanted the Democrat to replace her in 2016. I think a majority of Americans would back this change along with a filibuster proof Senate.
So we got to work to make both of those things happen! Charleys fundraiser is a great idea.
Don’t count your votes until the Blue Dogs chicken.
Each day reveals more evidence that Donald Trump and his GOP enablers are assets of a hostile nation, acting in response to hundreds of millions of dollars of dirty Russian money transferred to them over the last five years.
I think that every judiciary appointee of Mr. Trump should be impeached by the House — then tried by the Senate and removed unless a majority of a newly-seated and untainted Senate approves them after January 20, 2021.
There is compelling evidence that both Mr. McConnell and Mr. Trump are improperly influenced by hostile interests. Mr. McConnell intentionally, publicly, and successfully derailed judicial nominees of Mr. Obama starting the moment Mr. McConnell became majority leader.
Left unchecked, America will be living with a corrupt judiciary improperly influenced by a hostile foreign power for a generation. The problem is much larger than the three Supreme Court appointees (although they, of course, must be included in this process).
In the aftermath of WWII, Germany pursued an explicit process of de-Nazification (https://www.bbc.co.uk/bitesize/guides/zwrfj6f/revision/5#:~:text=Denazification%20was%20the%20process%20of,was%20made%20punishable%20by%20death). If America ever rids ourselves of Mr. Trump, then we must pursue an equally vigorous and successful de-Trumpification program (subject to Constitutional protections, of course).
I think that a lot of the political bloviating–on both sides– about the effect of this nomination on the ACA is absurdly overblown. The individual mandate of the ACA was challenged, and the Sebelius decision ruled it beyond the scope of the commerce power, but nevertheless upheld it as within the taxing power. The 2017 tax bill eliminated the penalty entirely, and so this new litigation argues (i) that a tax that requires no payments and raises no revenue is not a tax, and so the individual mandate is thus unconstitutional; and (ii) that because the ACA has no “severability” clause, the Court must strike down the ACA in toto, rather than just the individual mandate.
The 5th Circuit bought both of those arguments, and struck down the entire statute– the appeal of this ruling is what is on next month. The individual mandate is probably dead meat under the Sebelius decision, and has been irrelevant for several years anyway because there is no penalty whatsoever for violating it. The real question is whether the unconstitutional portion of the statute can be “severed,” or whether the entire ACA must be overturned.
The 5th Circuit ruling is directly counter to the majority opinion, authored by Kavanaugh, from last July’s robocall case. There were 7 votes there in favor of presuming severability (Gorsuch and Thomas were the other two). The 5th Circuit view on severability doesn’t even really match up to Thomas and Gorsuch, and may have had zero votes.
That means that Barret is unlikely to have any effect on ACA at all, at least in this case. Even if the present court is deadlocked on the issue 4-4, all that defeating the nomination would do would be to leave the 5th Circuit decision intact, which would in fact kill the entire ACA anyway.
I think the best argument for expansion is to have one Justice per circuit with the Chief Justice responsible for the federal circuit. Also, we should say that we are unpacking the Court since the Republicans packed it with their hypocritical treatment of the Scalia and Ginsburg vacancies. Kavanaugh, OTOH, got his seat fair and square.
I cringe each time I hear Biden talk about “Affordable Health Care” but I realize that going full “Medicare for All” is a battle we can’t win, not yet. Once the “public option” is in play and age of eligibility lowers to 60 (and then 55 and then 50…) private insurance will be as rare as private detectives, private schools, private security, and so on.
Um, the private items in your last sentence aren’t that rare.
Ayum….they are not as plentiful and powerful as private health insurance companies….and that’s the point.
Private schools and security are pretty goddam powerful. And getting more so.
Here’s a little morsel for y’all to gnaw on.
Pharma TV spending held steady in 2019, finishing the year with a total for the category at $3.79 billion.
Next you hear people talk about the “liberal media” and wonder why universal single payer is not presented in a fair an honest way, much less with a liberal bent, recall the old saying about being unwilling to bite the hand that feeds it.
Is the “liberal media” really ready to cut off almost four billion dollars in ad revenue to make America healthier an save a fortune?
Other sources (cf. https://www.marketingcharts.com/advertising-trends-108995) report that the total TV spending in 2019 was $70.6 B.
Pharma TV spending was therefore about 5.4%.
The same source cited by your link (ispot.tv) reports the top 10 spenders in TV advertising this week (https://www.ispot.tv/top-spenders-tv-ads). Here’s the list:
I note that pharma companies don’t even make the current list.
I agree that “the media” is not liberal. I agree that “universal single payer” is not presented in a fair and honest way.
The piece you cite does support your suggestion that the Pharma industry has bought the media with a flood of self-serving advertising.
If the source of media advertising drives the content of media reporting, then we should expect the media to be dominated by human interest stories about people who love their property insurance carrier, people who love their phones, and so on.
I grant you that every ad from Domino’s should be accompanied by a fact-check and disclaimer that the advertised product does not actually qualify as “pizza”, and that that vital consumer information is completely missing from mainstream TV. The chef’s in my family tell me that a famous chef (I don’t remember which one) says that EVERY chef should be forced to eat a Domino’s pizza once a year to remind themselves of how bad takeout food can be.
There are many reasons why universal government-sponsored single-payer health care is steadfastly resisted by elected officials. I think that pharma spending on advertising is near the bottom of a priority-sorted list.
I don’t think that Pharma bought the media, they just bought a percentage of it. Pharma is a smart organization. For example, they will hire a doctor to be a presenter/promoter/authority for their particular drug or medical device. This physician will be the doctor at the podium at the hotel conference room, standing before an audience or medical professionals who enjoy a free lunch at the conclusion of the presentation.
Here’s the thing: The target of all this, the hotel conference room, the free lunch, the swag, none of it is aimed at the audience. The target is the presenter, the doctor at the podium. The goal is to make them sympathetic to their product, a friend, an ally. It has been proven that this “presenter” is the doctor who becomes the one who overprescribes the drug or test or device.
The mark is that doctor, not the audience. This, I believe, is part of the plan. Remember, only the USA and New Zealand allow the advertising of prescription drugs. Follow the money.
I guess I misunderstood your comment then — that comment was all about the media.
I think there are several interconnected chicken and egg questions involving big Pharma, health care providers, and the health insurance industry.
I agree with you about following the money. I suspect that the latter — the health insurance industry — has the most direct influence.
The things we’re talking about — advertising, lobbying health care providers, lobbying elected officials — all involve drugs that are already approved by health insurers. Most of those drugs are already approved by Medicare/Medicaid.
Those insurance approvals in turn are closely related to how much the insurer pays out in claims for the various disorders that the drugs treat.
There is a huge positive feedback loop between the amount the insurers pay out for a disorder and the amount health care providers bill for the same disorder. The fee-for-service model that is so prevalent in our current health care system motivates health care providers to choose procedures based on what the insurers will pay. The result is what I like to call the “Wallet Biopsy” diagnostic approach.
I left the Mt. Auburn Hospital practices because, after several years, I realized that each visit was like a trip to K-Mart — the providers literally had a list of what procedures were most profitable for the insurance carrier they knew we had. Each time I saw the provider, she asked me about my cigar habit and my diet. When I got the EOB, it included charges for “tobacco cessation counseling” and “obesity counseling”. I was unable to get any of those providers to actually do anything about the actual issues that I actually cared about. That doctor got $75 for a 15 second exchange — “Are you still smoking cigars?” “Yes.” “You really should cut back or quit.”
I agree with you that advertising prescription drugs is awful. I agree with you that most of those “conferences” are corrupt boondoggles. I suspect that those are symptoms, rather than causes, of the fundamental failure underneath our current system.
I think the health insurance industry is pulling the levers on most of this.