Beto O’Rourke’s Ambitious Health Care Plan

America's health care system remains a nightmare for countless Americans who are either under insured or find themselves with medical decisions being driven my insurance companies seeking to minimize payouts rather than doctors and medical professionals.  And even with "good coverage," the deductibles can be staggering and can financially strain average Americans who simply do not have thousands of dollars lying around. Something needs to be done, but the question is what.  Some Democrat presidential candidates are lauding "Medicare for all" - Medicare still is not free and requires regular payments - which those on the right (who put little value of on the lives of most of us) say is too costly. In a response to the problem, Beto O'Rourke seems to be fashioning a proposed solution.  A piece in Slate looks at the matter.  Here are highlights:

Beto O’Rourke may not be feverishly churning out policy white papers like some of his presidential rivals, but over the last few days, the hand-wavy former representative from Texas has at least started clarifying his position on health care. And for a candidate who seems to be carving out space in the Democratic field as a relative moderate, it’s strikingly ambitious.

While campaigning in Iowa on Friday and over the weekend, O’Rourke backed away from his previous support for Bernie Sanders’ single-payer bill. The former Senate candidate told an audience that he was “no longer sure” it was “the fastest way” to achieve “guaranteed, high-quality universal health care for all.” Instead, he talked up another piece of legislation currently kicking around Congress known as “Medicare for America.”

Introduced by a pair of progressive congresswomen, Reps. Rosa DeLauro and Jan Schakowsky, Medicare for America offers a sort of middle ground between a true, Sanders-style single-payer system—which would ban private comprehensive health coverage—and a more modest public insurance option. (It is extremely similar to a proposal crafted by the Center for American Progress, which I’ve described as “single-payer with American characteristics.”)

The bill creates a new, revamped version of Medicare that would be open to all adults and children. It would automatically enroll newborns, the elderly, and the uninsured. It would also bar insurance companies from selling policies to individuals that duplicated the government’s coverage, meaning it would largely wipe out the nongroup market as we now know it. However—and this part is key—the bill would permit businesses to continue offering private insurance as a benefit, as long as it was as comprehensive as today’s gold plans. Companies would also have the option of purchasing Medicare for their employees by paying a tax equal to 8 percent of their annual payroll. Individual workers could opt for the government plan, as well.

One of the major political selling-points of Medicare for America is that it wouldn’t necessarily force workers off of the health plans they currently receive through their jobs, which many people still like, or at least are hesitant to give up. Polling suggests that support for Medicare for All drops drastically when voters are told that it would eliminate private insurance . . . . (The Kaiser Family Foundation has found that 73 percent of Americans back the idea of a national health plan if it would let them keep their current coverage).

That seems to be Beto’s wager.

“It responds to the fact that so many Americans have said, ‘I like my employer-based insurance. I want to keep it. I like the network I’m in. I like the doctor that I see,’ ” O’Rourke said of the bill, according to the Texas Tribune. “It complements what already exists with the need that we have for millions of Americans who do not have insurance and ensures that each of them can enroll in Medicare. It then suggests additional investments in that program so it becomes the program of choice and people who have private insurance migrate over to the Medicare system.”

Another advantage to Medicare for America is that it would be cheaper than single-payer, at least so far as the federal budget is concerned. There are no public cost-estimates for the bill yet. But it would almost certainly save Washington money compared to the Sanders approach, because it would not require immediately transitioning the entire employer-sponsored market onto a government health plan. The new version of Medicare also wouldn’t be free for everyone; families earning more than 200 percent of the poverty line would pay premiums—they would go up with income, but be capped at no more than 9.69 percent of a household’s earnings—as well as copays and deductibles. Of course, the Sanders bill wouldn’t exactly be free either; instead of paying “premiums,” households would simply pay taxes. To a certain extent, the difference there is semantic. While Medicare for America is not a single-payer system, it could create the bones of one, and gradually transition the country in that direction over time as it automatically enrolled more individuals and more businesses chose to buy in. At the same time, by preserving private coverage, it could leave a pressure valve in place, giving voters another option in case the new system doesn’t work out quite as smoothly as its supporters hope (we all remember the rough early days of Healthcare.gov, after all). In the scheme of major Democratic health care plans, it’s arguably the second most far reaching after the Sanders bill; it would do more to fundamentally change the U.S. insurance system than the Medicare or Medicaid buy-ins that other candidates have talked about, which would basically graft a public option onto Obamacare’s framework. Medicare for America would be something genuinely different.

GOP Continues to Drive Young Voters to Democrats

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At the risk of sounding like Cassandra from the Iliad, I have been saying for a long time that the Republican Party has no long term plan for survival given what at times appears as it's deliberate efforts to alienate young voters, minorities, the LGBT community and non-Christians of every faith.  Meanwhile, there are no limits on the extent to which Republicans will prostitute themselves to the NRA, Christofascist extremists and corporate players who will happily buy them off ant the expense of the majority of their constituents.  Yesterday, GOP legislators in Florida displayed utter contempt for students from Marjory Stoneman Douglas High School who traveled to Tallahassee to lobby for changes to Florida's woefully lacking  gun laws.  Rather than display respect for the students, one legislator ranted at the students and then the GOP majority (as the students watched) voted down a motion to take up a ban on assault weapons such as the AR-15 used by Nikolas Cruz when he killed 17 people at the school on Valentine's Day.

A piece in The Week looks at the GOP's continued drive to alienate the  younger generations and argues that past experiences of voters drifting back to the GOP over time may not happen this time around.  Here are article highlights:

Will the former reality TV star currently working part-time in the White House do incalculable long-term damage to the Republican brand? It sure seems like it! After all, President Trump's horror-show of a first year in office has already diminished the number of Americans who self-identify as Republican, endangered GOP congressional majorities, and led prominent conservative intellectuals to abandon the party. . . . it is fair to wonder whether the Trump administration is indeed losing the future.

Still, Michigan State political scientist Matt Grossman recently tried to throw some cold water on the "Republicans are doomed" theory. . . . . Pointing to past Republican nadirs like the post-Watergate era and the end of George W. Bush's tenure, he reminds us that the GOP has recovered from worse fiascos before and that it will likely do so again.

While Grossman's piece is a useful corrective  . . . . it does neglect one critical component of what is happening in the United States today: For over a decade, young people have been voting overwhelmingly for progressives and, more importantly, telling pollsters that they identify with or lean towards supporting the Democratic Party.

If you think that's always been the case, you're wrong — despite the unpopular war in Vietnam and the swirling cultural revolution, Richard Nixon won under-30 voters in 1972. Ronald Reagan and Jimmy Carter split young voters evenly in 1980, while Reagan and George H.W. Bush crushed it with the young in '84 and '88.

Something remarkable began happening in 2004, though. That's the year John Kerry carried the under-30 vote by 9 points. And the next three presidential elections saw Democrats demolishing their opponents with young people by 34, 23, and 19 points. . . . . There is simply no precedent for such a yawning gap in a party's fortunes with America's youngest voters over the course of four presidential cycles since pollsters started collecting this kind of data. And it is an ominous sign about the future of the Republican Party.

Scholars believe that partisan identification becomes hardened fairly early in our lives. Despite popular tropes about how people start out as starry-eyed idealists and become more conservative with age, the overwhelming majority of Americans do not experience mid-life or late-life political transformations.

With millennials, Democrats have enjoyed roughly a 20-point advantage in party ID since Pew starting asking them the question 14 years ago. Millennials are now the largest living generation and are starting to vote in greater numbers. This is a huge problem for the GOP that both predates and is far bigger than Trump.

But the data gets worse for Republicans the deeper you dig into it. In 2016 exit polling, for instance, 18- to 24-year-olds went more heavily for Hillary Clinton than their older millennial counterparts, suggesting that, if anything, the Republican position is falling apart with the tail end of the millennial generation.

And it gets even worse for the GOP: A 2017 Pew poll found that fully a quarter of young Republicans had defected to the Democrats since 2015.

Nor does the increasing progressivism of America's youngest voters seem to be driven by short-term reactions to particular political figures or developments. Instead, the avocado toast and Instagram set is being driven into the arms of Democrats by their underlying beliefs. An astonishing 66 percent of respondents in that youthful age bracket told Pew that they favor single-payer health care. Nearly three-fourths of the youngest Americans favor gay marriage.

We are likely witnessing the maturation of the most liberal generation of voters since the New Deal. . . . . To reverse their decline, Republicans would have to make inroads either with Generation Xers or with even younger voters.  That is unlikely, to say the least.

My own three children have all fled the GOP despite being raised in a Republican household during their earlier upbringing and actively working on GOP campaigns.  Like the Millennials mentioned in the article, the support a single payer health care system, favor gay marriage and gay rights, and cannot abide the evangelical Christian and white supremacist core of the current GOP base. The more the GOP attacks the Affordable Health Care Act, rescinds gay rights and prostitutes itself to Christofascists and racists, the larger the exodus of younger voters.  

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Are Republicans About to Try Again to Throw Millions Off Health Insurance?

Talk in Washington, DC, is abuzz that congressional Republicans - and, of course, Der Trumpenführer - are about to make a second attempt to destroy Obamacare rather than fix it.  In the process, of course, they will throw millions of Americans off of healthcare coverage so that a huge tax cut can be delivered to the wealthiest Americans.  The last effort deservedly went down to defeat after setting off hostile town hall meetings where some Republican members of Congress fled from their own constituents.  Given that the true goal of "repeal and replacement" of Obamacare is a trillion dollar tax cut for the wealthy, there is no way in which the new, warmed over effort will bode well for a majority of Americans, especially the poor, those with serious illnesses and the elderly.  Paul Ryan, perhaps one of the most dishonest man in Congress and his allies truly wish these folks would simply roll into the gutter and die.  A column in the New York Times looks at the next GOP attack on average Americans for the sake of helping the few who already have so much.  Here are excerpts:

Republicans have spent many years denouncing Obamacare as a terrible, horrible, no good law and insisting that they can do much better. They successfully convinced many voters that they could preserve the good stuff — the dramatic expansion of coverage that has brought the percentage of Americans without health insurance to a record low — while reducing premiums, shrinking deductibles and, of course, doing away with the taxes on high incomes that pay for the program.

But health care costs money. In particular, if you want to make care available to Americans who have pre-existing medical conditions — including the condition of being not rich and being relatively old, but not yet eligible for Medicare — you have to find some way to subsidize them.

Obamacare provides those subsidies in part with direct public funding, in part with regulations that implicitly use premiums paid by the healthy to cover the cost of caring for the less healthy.

There are other possible ways to achieve the same goal, but the money has to come from somewhere.

Now you understand why there’s a predictable, repetitive rhythm to the health care story.

Again and again, we read news reports to the effect that Republicans are closing in on a plan that will break the political deadlock. They’ll repeal the Obamacare taxes and block-grant Medicaid! No, they’ll make insurance cheaper by eliminating the coverage requirements! Or, the latest idea being floated, they’ll let insurance companies raise premiums on people with pre-existing conditions and compensate by creating special high-risk pools!

And each time the plan turns out to have a fatal flaw. Millions will lose coverage; or they’ll keep coverage, but it will become so threadbare it’s almost worthless; or premiums will skyrocket for the most needy unless vast sums — hundreds of billions of dollars — are devoted to those high-risk pools.

The important thing to remember is that these problems don’t keep popping up because the people devising the plans are careless, and keep forgetting crucial issues. . . . . the task Republicans have set for themselves is basically impossible, their ongoing debacle over health care isn’t about political tactics or leadership. Even if Donald Trump were the great deal maker he claims to be, or Paul Ryan the policy wonk he poses as, this thing just can’t work.

The only way Republicans might have been able to do what they promised would be if they had some way to make health care much cheaper.

The truth is that while Republicans have portrayed Obamacare as a crazy, inefficient scheme, it has in fact been much more successful at containing costs than even its proponents expected.

There are some things we could do that would probably make it even cheaper, but they would all involve moving left — say, introducing a public option, or going all the way to single-payer. The G.O.P., which is determined to move right instead, reducing the public sector’s role, has offered no reason for anyone to believe that it could do better.

All of this raises the obvious question: If Republicans never had a plausible alternative to Obamacare, if this debacle was so inevitable, what was the constant refrain of “repeal and replace” all about?

The answer, surely, is that it began as a cynical ploy; at first, the Republicans hoped to kill health reform before it really got started. And now they’ve trapped themselves: They can’t admit that they have no ideas without, in effect, admitting that they were lying all along.

The Growing Support for a Single Payer Healthcare System

Last evening the husband and I were reviewing plan options for his salon staff (and us since I am about to roll off of coverage through my former employer that was far cheaper due to the size of the company).  The best description is to say that there are NO attractive options with the costs for us as a couple totaling to well over $1,500 per month ($18,000 per year).  That exceeds the individual annual payments on any of the mortgages on our properties and exceeds what we spend per year even when my hand surgery last year is factored in.  The winners in this game, of course, are the health insurance companies which laugh all the way to the bank.  It's little wonder that (i) health insurance companies are nearly universally hated and (ii) that more and more Americans - other than the wealthy, of course - support a single payer system.  A column in the Washington Post looks at this trend which collides head on with the GOP's effort to throw Americans off of insurance coverage to pad the wallets of the wealthy and insurance companies.  Here are excerpts:

Despite the rise of the tea party and unified Republican control of government, one decidedly anti-free-market idea appears ascendant: single-payer health care.

And it’s no wonder, given that a record-high share of the population receives government-provided health insurance. As a country, we’ve long since acquiesced to the idea that Uncle Sam should give insurance to the elderly, veterans, people with disabilities, poor adults, poor kids, pregnant women and the lower middle class.

Many Americans are asking: Why not the rest of us, too?

A recent survey from the Economist/YouGov found that a majority of Americans support “expanding Medicare to provide health insurance to every American.” Similarly, a poll from Morning Consult/Politico showed that a plurality of voters support “a single payer health care system, where all Americans would get their health insurance from one government plan.”

Divining the longer-term trend in attitudes toward this idea is difficult, as the way survey questions on the topic are asked has changed over time. Views of a health-care system in which all Americans get their insurance from the government single payer vary a lot depending on how you frame the question. Calling it “Medicare for all,” for example, generally elicitsmuch stronger approval, while emphasizing the word “government” tends to depress support.

But at the very least, some survey questions that have remained consistent in recent years show support has been rising back up over the past few years for the broader idea that the federal government bears responsibility for making sure all Americans have health-care coverage.

The increase in the share of Americans on government insurance is partly due to demographics (baby boomers aging into Medicare) and partly due to deliberate policy changes growing the pool of Americans eligible for government insurance (such as the creation of the Children’s Health Insurance Program and Obamacare’s Medicaid expansion).

In both the recent YouGov and Morning Consult polls, for example, the age group most opposed to single payer was the only one that basically already has it: those 65 and up. In other words, single payer for me but not for thee.

That’s not because older Americans hate their experience with Medicare and wouldn’t wish something similar upon their worst enemy. To the contrary, those on Medicare are more satisfied with how the health-care system works for them than people on private insurance are, according to Gallup survey data.

Rather, seniors are probably worried that expanding government coverage to more Americans could put their own generous benefits at risk. 

Trump supporters with deep hostility toward Obamacare, among other government programs. Some of these Trump supporters are, perhaps puzzlingly, themselves Obamacare beneficiaries, receiving government subsidies for private insurance on the individual exchanges. But often what these Trump voters say they want is not a return to pre-Obamacare days; rather, they want in on the great insurance deal that they think their lazy, less-deserving neighbors are getting.

House Speaker Paul D. Ryan (R-Wis.) and his congressional compatriots seem to further believe — despite all evidence to the contrary — that the private sector is on the verge of some innovation that will magically reduce health-care costs and give all Americans the coverage and care they yearn for. 

Americans as a whole pay through the nose for the least efficient and most costly health care system in the world.  Why can't this country learn from the experience of other advanced nations and opt for universal coverage and a single payer system?  Two reasons, I suspect: (i) many of the wealthy don't give a damn about their fellow citizens, and (ii) the evangelical Christians hate most of their fellow citizens and want to keep their monies for themselves.  

The Moral Bankruptcy of the GOP's Obamacare Repeal

The moral bankruptcy of today's Republican Party - and the 81% of evangelical Christians who voted for Der Trumpenführer - cannot be stressed often or strongly enough.  Nowhere is this moral bankruptcy more evident than in the GOP drive to repeal Obamacare.  Despite the lies and smoke screens being floated by Republicans, the underlying agenda of Obamacare repeal is to provide huge tax cuts to the wealthy (one estimate of Obamacare repeals is a $270 billion gift to high income households) while depriving millions of coverage,   Left without coverage, the uninsured will be left to secure treatment at non-profit hospitals that must treat - at least for now - the uninsured through their emergency room operations, the most expensive and least efficient method of healthcare delivery.  This, of course, leaves hospitals forced to recoup these costs by drastically raising prices for those with insurance and/or the ability to pay for care.  The result?  Americans pay two to three times more for healthcare than any other advanced country, all of which have some form of universal coverage.  An op-ed in the New York Times written by a hospice nurse aptly describes the GOP's moral bankruptcy on this issue.  Here are excerpts:

Imagine a car crash. There’s twisted metal, broken glass and the low moaning of an injured human being. An ambulance arrives, and two emergency medical technicians get out.

Now imagine this: One E.M.T. moves to the wreck, sees the wounded driver — a man, the one who’s moaning — and before doing anything else, flips down the driver’s seat visor, looking for an insurance card that isn’t there. Then he stands back up, frowns and shakes his head.

“No insurance?” his partner calls out. The E.M.T. shakes his head again.

Maybe nothing this extreme would ever happen. But contrary to what some congressional Republicans say, a world in which it could is the logical conclusion of their efforts to repeal the Affordable Care Act and set per capita caps on Medicaid — and the all-but-explicit desire among dozens of hard-liners.

The House leadership is making gestures toward covering the uninsured by retaining popular portions of the A.C.A. and offering a suite of “market-based” programs like health savings accounts and tax credits. In some ways, that’s their problem; if the Republican bill designed to replace the A.C.A. fails, it could well be because of pressure from the far right, which is insisting on repeal, full stop. For a large number of Congressional Republicans, any effort to cover the costs of care for the poor and uninsured smacks of socialism and unwelcome government interference in the market.

It’s easy, politically, to make that case against the A.C.A., since the Republicans have spent the better part of a decade demonizing it. And it’s easy to forget how bad things were for tens of millions of Americans before Obamacare.

To begin with, consider the numbers. A percentage of the 20 million Americans who gained insurance under the A.C.A. will very likely lose it if the law is repealed. Even with the provisions in the proposed American Health Care Act, the “replace” part of the Republican approach, an estimated 10 million people would fall off the rolls. . . . . a vast majority, will be terrified by the idea of living without health insurance. As was the case before the passage of the A.C.A., many of the uninsured — the terrified and relieved alike — will end up using hospital emergency departments for their health care needs, even if they cannot afford it.

[T]he opposite of the A.C.A. is not a free market. The Emergency Medical Treatment and Labor Act, a 1985 law, requires that hospital emergency departments treat all comers. So, while some uninsured patients will forgo care after repeal of the A.C.A., others, especially the seriously injured and mortally ill, will secure the care they need even if they can’t pay for it, even if they know they will never be able to pay for it. And in the end, all of us pay for that care through higher insurance premiums, increased hospital costs and overtreatment of the (paying) insured.

[F]rom decades of debate leading up to the A.C.A., the only way to rein in health care costs in a system without some form of universal public health insurance is to place limits on care for those without insurance or the ability to pay for it outright.

I remember a recent case, here in Pittsburgh. A woman, young and fit, moved to the city to be with her boyfriend. She didn’t have health insurance because she was new in town and hadn’t yet found a job. But she wasn’t worried; her youth, she thought, guaranteed her health.

But it turned out she had A.M.L. — acute myelogenous leukemia — a killer disease, the medical version of a high-speed collision. The first round of curative treatment required a six-week hospital stay, multiple infusions of chemotherapy and intensive round-the-clock nursing. And that was just the start. . . . . Treating A.M.L. can cost upward of $100,000. Neither she nor her boyfriend had that kind of money.

If the A.C.A. is scrapped and Medicaid is converted to per capita caps, partly to ensure that everyone who gets care pays her fair share, I worry about what will happen to patients like this young woman. Abandoning this patient to her terrible disease simply because she couldn’t pay for the cure feels sad and wrong. Just as sad and wrong as abandoning an injured patient at a crash site.

House Speaker Paul Ryan and others would take mock offense at the idea that they’re willing to let people go without care, but it’s the unavoidable logic of their drive to undo Obamacare — the part that Republicans would rather not talk about, even as it drives them to ram through the legislation without debate.

People without insurance and little money are still going to need care, some of it very expensive. To deny these people care by restricting their access at the source — ambulances, emergency departments, hospitals — would reflect equity in a you-get-what-you-pay-for model. But the human cost of limiting health care to those who can pay would be higher than any of us should be willing to bear.

 Congressman Joe Kennedy, III, correctly condemned the GOP in his statements - which the GOP chair cut short because they were all too true.

The Myth of Bernie Sanders' November Advantage

As noted in a post yesterday, in my view, it increasingly appears that Bernie Sanders is putting his own ego ahead of keeping a Republican out of the White House in November.  Despite the delegate math stacked against him, he is vowing to fight all the way to the Democrat Party convention and is beginning to demand that delegates ignore the fact that Hillary Clinton has won more votes and more delegates.  Why?  Because he claims that he has the best chance to beat Donald Trump or whoever becomes the GOP nominee.  A piece in Mother Jones makes the case that this supposed advantage is a myth.  Here are excerpts:

Soon after Sen. Bernie Sanders was declared the loser in the New York Democratic presidential primary on Tuesday night, his campaign manager, Jeff Weaver, was on MSNBC explaining the path ahead for the independent socialist from Vermont. Weaver contended, optimistically, that Sanders could potentially win all the remaining contests. When pressed on what the campaign would do should Sanders end up second to Hillary Clinton in the delegate hunt, Weaver said the campaign would spend the weeks between the final primary in early June and the Democratic convention in late July trying to flip the superdelegates who have declared their loyalty to Clinton.

To some, this might seem fanciful. . . . Weaver justified this possible strategy by insisting that Sanders is the Democratic candidate better situated to win in the November general election. Sanders, he argued, has more appeal with independents and younger voters and generates more enthusiasm.

Any conversation with a Sanders supporter inevitably turns to the polls. And indeed the polls do say what Weaver suggested. According to Real Clear Politics' average of recent polls, Sanders performs better than Clinton in hypothetical general-election matchups. Against Donald Trump, Sanders leads by 15 points, Clinton by 9. Against Ted Cruz, Sanders wins by 11 points, Clinton by 2. Many Bernie-ites point to these numbers and confidently declare: Case closed!

Maybe not. There is one missing factor in these polls, and it might be huge. Sanders has yet to face a true negative ad campaign aimed at destroying his public image. Were he to be the Democratic nominee, he would be confronted with hundreds of millions of dollars in negative ads designed to rip him apart. And everyone knows what that pummeling would focus on: He's a self-proclaimed socialist.

Clinton has taken a few pokes at Sanders, claiming his policy proposals are pie in the sky and his numbers don't add up. . . . But this is nothing compared with the onslaught that Sanders would be up against as the nominee. The ads write themselves: "Don't take our word for it, take his. He's a socialist!" Cut to a super-cut of Sanders proclaiming "I am a socialist" over and over.

Of course, almost all Americans are socialists to some extent. (You believe in Social Security and Medicare? Congratulations, you get your socialist card.) But the word still has the potential to frighten or put off voters in the crucial swing states. And there will be other lines of attack against Sanders: the usual tax-and-spend stuff Republicans always hurl at Democrats (but to a greater extent), the radical writings of his past, his unconventional personal life, and more. It's not difficult to imagine a veiled campaign that exploits the fact he's not a Christian.

Once, Devine continued, people said don't vote for a black man because he cannot win the presidency; now some say don't vote for a socialist because he cannot win. His implication was that such talk is nothing more than a self-limiting scare tactic among progressives.

Perhaps. These are all lovely assumptions, and they could prove true. Maybe the socialist charge will not have much firepower. But the point is that until Sanders is tested under such battlefield conditions, polls that compare his performance against Trump to Clinton's are meaningless. As the Clinton people will say—and they're not wrong on this—she has withstood decades of attacks, some real and fact-based, some phony and underhanded.

Sanders would be virgin territory for the dirt-throwers of the right. A clean canvas.  This is not to say that Sanders and his populist crusade would not be able to prevail against a billion dollars in ads assailing him as a crazy socialist hell-bent on raising taxes and expanding government. But until he's the target of such a blitzkrieg, hypothetical comparisons have little currency. Any sophisticated political operative knows these particular poll numbers are no basis for picking a candidate. Nor are they a rationale for Sanders, should he finish in second place, to continue his campaign.

[L]ast year Gallup released a poll asking voters about their attitudes regarding political candidates of various races, religions, and beliefs. . . . The label that fared the worst in this survey was socialist. Forty-seven percent said they would be willing to support a socialist candidate; 50 percent said they would not. . . . The poll was conducted last June, and it may well be that Sanders' performance in the months since has altered public attitudes toward a socialist candidate. Yet the survey's results do suggest the socialist tag could be a problem for Sanders in a general election.

There are some positions that I support - most notably a single payer, universal heath care system.  But with so much a stack in this election - likely 3 Supreme Court appointments among other things - winning in November is crucial and pragmatism is required.  

Panic Grips Clinton Campaign

While things on the GOP side of the aisle in presidential campaigns can only be described as insane, on the Democrat side, there is unexpected turmoil and Hillary Clinton's cake walk to the party nomination is seemingly burned to a crisp.  The result is what some describe as panic in the Clinton campaign as attempts are made to figure out what went wrong.  Here are highlights from one piece that argues that Hillary's problems stem from her own actions and bad choices, both past  - e.g., the freaking private e-mail server - and present:

Panic now grips the Clinton campaign. Polls show Bernie Sanders surging to a dramatic lead in New Hampshire and closing in Iowa. The Washington Post reports that Hillary's national numbers are dropping faster now than they did in 2008. The Clinton campaign has started throwing everything and the kitchen sink at Sanders, with the gutter award captured, thus far, by Senator Claire McCaskill who smeared him with the "hammer and sickle," transparently attributing the red-baiting to future Republican attacks of her own imagination.

But the question isn't what's wrong with Bernie -- he's soaring beyond all expectations. The question is what's wrong with Hillary? She has universal name recognition, unparalleled experience, the support of the big money and the political gatekeepers, the Hollywood glitz, the best political operatives, the pollsters, the ad makers, the establishment policy mavens, and political press coverage. Having learned from 2008, she's got the best ground operation in the history of Iowa caucuses that still may rescue her there. But she's sinking rapidly against a 73-year-old political maverick who is still just introducing himself to the American people.

Already the inevitable Clinton circular firing squad has begun firing its salvos: We should have gone negative on Bernie earlier. We should have used Bill more... or less. We shouldn't have bet the house on the first four primaries. Woulda, shoulda, coulda.

Inevitably, any Clinton campaign carries a lot of baggage that simply has to be overcome. . . . What is plaguing the Clinton campaign are less the sins of the past than the strategic choices of the present -- particularly her decision to be the candidate of big money.

Her ability to raise money helped scare away other potential contenders. Her continued commitment to this path is symbolized by the $33,400 a plate dinner Warren Buffet is hosting for her in Washington, D.C. on the eve of the Iowa caucuses. People who can afford $33,400 for one seat at the table aren't exactly the working people Hillary claims to champion.

Sanders, of course, made a different decision. . . . . He doesn't have anything like a traditional campaign fundraising operation. That independence gives both force and integrity to his core message that it is time to take back our democracy from the "billionaire class," the entrenched interests, and the Wall Street banksters.

Clinton argues that she favors fundamental campaign finance reform, but she can't "unilaterally disarm." Deep pocket Republicans are amassing huge war chests to assault her. She has to be armed with big money to defend herself.

But in doing so, Clinton "unilaterally disarmed" her own credibility. The Clinton family foundation and the family fortune have been built with large contributions and lavish "speaking fees," significantly from the biggest financial interests in the country. Wall Street made Hillary herself a millionaire . . . . 

The result is corrosive. When Clinton insists that her Wall Street reforms are far tougher than those of Bernie Sanders and Martin O'Malley, it rings false. She attacks Sanders for supporting Medicare for All which naturally is the bête noire of the private health insurance and drug companies.

When Sanders invoked the $600,000 Clinton received from Goldman Sachs alone in speaking fees (a bank that just agreed to pay $5 billion essentially for mortgage fraud) in the last debate, her only defense was to suggest that a similar criticism would apply to Barack Obama who also raised money from Wall Street.

This helps explain the remarkable excitement that Sanders has generated among the young. He passionately champions popular big reforms -- tuition free college, a $15 minimum wage, Medicare for all, a bold climate change agenda, breaking up the big banks and more. And his integrity and credibility are affirmed by his commitment to funding his campaign with the support of millions of citizens, not the big money of special interests.

As Greg Sargent of the Washington Post notes, Hillary's credibility gulf also undermines her argument about "electability." Democrats have a natural majority among the electorate, but only if they turn out. Even the Clinton campaign has been worried about whether HRC can generate the excitement among the rising American electorate to get them to the polls. Now, they worry about whether Sanders will generate so much excitement that he will flood the Iowa caucuses and primaries with a wave of new voters.

There's more.  Ultimately, the issue is one of electing a Democrat in November.  Either Hillary or Bernie will be light years better than any of the GOP contenders, all of whom would lessen my - and may other people's - legal rights. 

Vulture Capitalism and Pharmaceutical Companies

In the 2012 election cycle Mitt Romney was his own symbol of vulture capitalism - the GOP's god after tax cuts for the wealthy - and it came back to haunt him.  Now, as we begin the 2016 election cycle, Martin Shkreli, the former hedge fund manager known as the “Pharma bro,” has singlehandedly underscored the evils of unfettered capitalism.  Shkreli accomplished this by buying the rights to Daraprim, a drug used to treat severe infections in AIDS patients and infants, and then increasing the price to consumers by 5000%.  Drug prices in America are out of control - one can get the identical drugs in Canada for far less - and perhaps Shkeli's greed will trigger some much needed oversight of the shockingly greedy pharmaceutical industry.  A piece in Think Progress looks at the phenomenon.  Here are highlights:

Is the “Pharma bro” coming to Congress? He will if Rep. Elijah Cummings (D-MD) gets his way.

Cummings, the Ranking Member of the House Committee On Oversight And Government Reform, has requested a hearing next week to question Martin Shkreli, the former hedge fund manager known as the “Pharma bro.”

Shkreli has attracted attention since he hiked the price of Daraprim, a drug used to treat severe infections in AIDS patients and infants, by 5000%. Shkreli is the CEO of Turing Pharmaceuticals.
In an interview, Cummings called Shkreli’s actions “criminal.”

As a member of the Democratic minority, Cummings cannot unilaterally call the hearing. But he wrote a letter to Chairman Jason Chaffetz on Tuesday, requesting a hearing be scheduled.

Cummings notes that the committee had previously “agreed unanimously to investigate the increasing price of certain prescription drugs” but “has held no hearings and has issued no document requests to drug companies this year.”

Tuesday night, Shkreli told ABC News he would reduce the price of Daraprim. He would not specify the new price.

We need a national health care system that would bar sleaze bags like Shkreli from engaging in such vile conduct.

Bernie Sander's Unlikely Rise to Stardom

I will confess that for a long time I have liked some of the statements that Bernie Sanders and his followers have posted on Facebook.  He has a blunt way of talking about America's problems and is an unapologetic liberal in the good sense of the word.  Yet never did I expect his campaign for the presidency to take off as it has.  But then, neither did Hillary Clinton who so far remains way ahead of Sanders in polls.  Like his positions or not, Sanders is blunt speaking and direct.  He's in someways the polar opposite of Donald trump, but on speaking out he is cut from similar cloth.  The difference, of course is that Sanders believes what he says whereas the Donald merely likes to hear himself talk and to cause sensation.  A piece in The Atlantic looks at Sanders' unexpected rise.  Here are excerpts: 

There’s no way this man could be president, right? Just look at him: rumpled and scowling, bald pate topped by an entropic nimbus of white hair. Just listen to him: ranting, in his gravelly Brooklyn accent, about socialism. Socialism!

And yet here we are: In the biggest surprise of the race for the Democratic presidential nomination, this thoroughly implausible man, Bernie Sanders, is a sensation.

He is drawing enormous crowds—11,000 in Phoenix, 8,000 in Dallas, 2,500 in Council Bluffs, Iowa—the largest turnout of any candidate from any party in the first-to-vote primary state. He has raised $15 million in mostly small donations, to Hillary Clinton’s $45 million—and unlike her, he did it without holding a single fundraiser. Shocking the political establishment, it is Sanders—not Martin O’Malley, the fresh-faced former two-term governor of Maryland; not Joe Biden, the sitting vice president—to whom discontented Democratic voters looking for an alternative to Clinton have turned.

[T]ruthfully, the socialism rap has been blown out of proportion as well: Sanders accepts “democratic socialist” as an accurate descriptor of his philosophy, but he never sought it as an identity.

“The campaign is moving so fast the infrastructure can’t keep up,” Sanders confesses. “It sometimes reminds me of a military campaign, where the front line of the army is moving faster than the supply chain.” Since Berniemania began this summer, he and a small band of aides have been scrambling to turn it to their advantage.

Sanders and his team have a bracing habit of saying things politicians and their aides are not supposed to say—a minor violation of norms that reminds you how accustomed we are to being lied to in politics.

Another basic tenet of campaign spin is that consultants must never admit their candidate isn’t totally perfect, but Sanders’s people apparently missed that lesson as well.

Sanders is drawing a steady quarter-to-a-third of the vote in Iowa and New Hampshire, pulling within 10 points of Clinton in some New Hampshire polls. Some Clinton aides have begun floating the notion that she could lose one or both of those early-voting states, though this seems like an attempt to lower expectations. But Clinton is still the favorite of Democratic voters nationally by nearly 30 points. She has the money, she has the endorsements from the party elite, and she has the massive teams of staff and advisers.

When Sanders set out to run, he tells me, his main fear was that doing so might prove harmful to his ideas. . . . But the ideas that I am talking about—if the campaign did badly, then it would give the establishment the opportunity to say, See, Sanders ran on a platform calling for single-payer national healthcare system, and he did really poorly,” he continues. “He ran on a platform calling for the creation of millions of jobs through rebuilding the infrastructure—nobody really supported him. He talked about income and wealth inequality; it didn’t go anyplace. Those aren’t really good ideas!”

Now comes the ultimate test of Democratic unity: a dynastic, centrist, seemingly unstoppable frontrunner—someone who, despite decades in public life, had to convene a committee of 200 advisers to figure out where she stood on economic issues. Finally, the left has been pushed to the breaking point. It has turned, in protest, to the most un-Clinton-like candidate there is—the nutty Vermont uncle of Democratic politics.

At the press conference, I meet Les Bailey, a retired ironworker who lives in Marion, Iowa. He has a salt-and-pepper goatee and wears his hair in a mullet under a black Vietnam-veteran cap. In 2008, he wore himself out walking miles and miles knocking on doors for Barack Obama. Now, he thinks Sanders can win Iowa in a similar upset. “This is not the country I fought for, where billionaires buy elections and anyone can get a gun,” he says.

Every Sanders crowd is full of die-hards like Bailey, passionately committed to their unlikely hero. Every Clinton crowd, on the other hand, is full of lukewarm rank-and-file Democrats who will not hesitate to tell you they have some qualms about supporting her. As Sanders’s press conference ends, a line is forming around the block for the party Clinton is about to throw in the basement of the same building. “I’m with Hillary because I don’t have any choice,” a retired schoolteacher named Elwood Garlock tells me as he waits to pass through the metal detector. “I think she’ll be good. But it would be nice if she’d take up some of Bernie’s ideas.”

It is easy enough to see where Berniemania is coming from. Anti-establishment passion, left and right, is in the air. People are angry all over, fed up with a system that isn’t working, an elite that doesn’t listen, a politics perpetually conducted within a narrow, unrepresentative band of acceptable opinion. “I think there is a lot more anger and frustration on the part of the American people toward corporate America, toward the political establishment, toward the media establishment, than I think inside-the-beltway pundits perceive,” Sanders tells me. If he does nothing else in this campaign, he will have succeeded in driving home that point.

Sanders’s campaign is a temporary vehicle for those still naïve enough to see American politics as a vehicle for transformation rather than a hopelessly corrupt compromise. Yet he is also the product of a specifically liberal moment, when rising inequality has powered new skepticism about the adequacy of American-style market capitalism.

“We have some very specific proposals,” he says. “We want to raise the minimum wage to $15 an hour. I believe we need a massive federal jobs program to rebuild our crumbling infrastructure—trillion-dollar legislation, over a 5-year period, which would create 13 million jobs.” Sanders points to his longtime opposition to trade deals, including the Trans-Pacific Partnership, which is currently under consideration. His opposition to the Keystone XL pipeline. His support for single-payer healthcare, tuition-free public college, and worker-owned companies.

“Those are my views,” he says, a sarcastic edge creeping into his voice. “I suspect you will find them different from Secretary Clinton’s.”