Why didn't Bernie get Vermont to pass single payer?

[hill2016]

I mean if he couldn't even get it passed in his home state how would he be able to get it through a much more ideologically divided country?

[Dawgs]

1. :facepalm:

[Rosa Luxemburg]

154. 'grasping at straws' 'scraping the bottom of a barrel'

indeed, facepalm

[cali]

2. uh, because he isn't king of Vermont and isn't even a part of state government

That failure belongs to Shumlin

[senz]

95. Now why would you wanna throw logic into something like this?

Spoil sport. They have sooo much fun with their little inventions.

[brooklynite]

103. Fair enough: to what extent did he try to help get the Shumlin's State initiative passed?

How did it turn out?

[cali]

126. Sanders lent significant support to the effort

Shumlin really screwed up. He was elected in large part because of his position on single payer which the majority of Vermonters support. Partly, his poor relationship with the legislature is to blame and after being elected he focused more on other issues.

[Snotcicles]

104. Some states have to small of a population to make it cost effective.

You need a massive pool paying into it.

[MuseRider]

124. You ALWAYS have to come in

and spoil all the fun.

Thanks cali, once again.

[hill2016]

170. I've been hearing so much

about how Bernie will use his "bully pulpit" to push progressive legislation through Congress. Why didn't he practice that in Vermont with the people nearest and dearest to himself?

Or are you saying he didn't care enough to try to get it through his home state?

My question remains: if he can't even get single payer passed in his home state (with his bully pulpit), how can he get it through a much more ideologically and politically divided nation?

[cali]

191. you don't know what you are talking about. as per usual, hilly supporter.

[Maedhros]

3. I'd say that's more the responsibility of Governor Shumlin.

http://www.politico.com/story/2014/12/single-payer-vermont-113711.html

Vermont under Shumlin became the most visible trailblazer. Until Wednesday, when the governor admitted what critics had said all along: He couldn’t pay for it.

“It is not the right time for Vermont” to pass a single-payer system, Shumlin acknowledged in a public statement ending his signature initiative. He concluded the 11.5 percent payroll assessments on businesses and sliding premiums up to 9.5 percent of individuals’ income “might hurt our economy.”

[cali]

6. he's such a turd. he only got elected because of his promises of single payer.

[George II]

94. But obviously he tried, he didn't just talk about it. And he recognized the problem of funding....

....that many others (including Sanders) either don't see or choose to ignore.

[cali]

118. that is a matter for debate. his administration screwed up in a major way

on the health exchange, Shumlin has a very rocky relationship with dems and progs in the legislature. You do not have the knowledge about Vermont politics you think you do. At frickin' all.

[SonderWoman]

53. So Bernie couldn't even rally the troops in tiny Vermont, but....

It's all Obama's fault that he couldn't get repubs to go along with single payer in house and senate?

"POS Used Car Salesman".

[cali]

60. lol

[George II]

98. Even though he's not governor, a state's Senator should have at least a little influence....

....in getting things done in his home state.

In Connecticut Richard Blumenthal and Chris Murphy speak out all the time on state-wide issues, and people listen to them.

I wonder why that is?

[hill2016]

171. good question

wondering why too

[cali]

4. oh and welcome to du, new poster.

[Fearless]

5. Why didn't Obama?

[SouthernProgressive]

7. Going out on a limb with little to back me up.

I am going to assume Vermont has a very high rate of insured. They might also have good county programs that pick up the rest. In Pasco county Florida, often known as one of our most backwards counties, they have amazing health programs available to pick up where others fall short in the arena of healthcare. I personally know people who moved a couple of miles just to be in the Pasco limits. If anyone is ever interested, take a look at what Pasco does for mental health care. It is truly wonderful. One with very limited means can get therapy and a psychiatrist for almost nothing. That includes medication. It is one area that is getting it right. What makes no sense is that it is also very well known as one of Floridas most laughed at counties. Vermont may be similar(not the laughable part). Maybe someone will know better.

On top of what I first mentioned, I believe Vermont to be a pretty wealthy state. The wealthy, as a group, are an impediment to single payer. Hard to say for sure on that one as Vermont often marches to the beat of it's own drummer. It is a state where assumptions are hard to make.

I also don't think Sanders, Hillary or O'Malley will get single payer passed. The members of our party in congress are going to have to keep fighting for the ACA for the coming years. It has to be viewed as a success going into the next stage of negotiations.

[cali]

16. partially right.

Vermont does have a high rate of insured because the state has worked on that for decades, but we are not a wealthy state. We're middle of the pack, 29th I believe.

It sounds like what you're referring to in Pasco, is CHC care, which Bernie has been a great champion of. In fact, in exchange for his vote on the ACA he asked for and got hundreds of millions for CHCs.

[SouthernProgressive]

25. They do amazing work in Pasco and it makes a big difference.

I wish more would look into increasing these programs until we get some form of universal healthcare. Far too many in my area are on the streets simply because they don't have mental health care available to them. Pasco gets it right, or at least tries to. I assumed there was something similar going on across Vermont.

I should have also mentioned that Sanders is a Senator, not the Governor, as you mentioned above. He has some influence in this area but that is limited. It would be like blaming Grayson in Florida for not passing single payer. A stretch, I know. So is the op in my opinion.

[cali]

46. yes. Community Health center do great work in preventative medicine

across the nation. In Vermont they're one of the largest providers.

[MaggieD]

18. We are a country that moves incrementally on issues

The ACA is a good start down the road to single payer. It would have been nice to see Vermont test out single payer. Just as MA showed people that world would not end if LGBT people were allowed to marry, people might have been able to see that single payer would improve all aspects of health care in this country.

Change comes slow in the US. We just have to make sure we are putting one progressive foot down after the other. In time we get to the desired destination. Except on race. That one is very frustrating to me.

[SouthernProgressive]

27. Change does happen slow and that is by original design.

I think it is a huge part of our success. It is also why I mentioned that congress is going to have to continue to sell the ACA for another four or five years, possibly longer, before the next big fight even comes up. When was the last healthcare fight that involved all US citizens? Back in the ninety's? And it didn't really come back up in reality until Obama's first term.

[morningfog]

8. Do you understand that we have varying levels of sovereign governments in this country?

Bernie Sanders is a Senator in the federal government, representing the state of Vermont. He is not in the state government.

[MaggieD]

11. My senators and congresspeople secure funding....

... for state projects here, don't yours? My senators are influential on major policy issues within my state, aren't yours?

[morningfog]

14. That wasn't the question asked.

You and your ilk won't get far with this effort. You are better off with race bating.

[MaggieD]

19. Are you calling me a "race baiter"

Based on what?

[morningfog]

30. I am not calling you a race baiter.

This argument that you and the newbie are trying is dead on arrival. It's just pathetically stupid.

Stick with what has been successful for you. You know, what garners the most flames.

[MaggieD]

32. Glad you walked that back

And changed it to a different insult. I just don't understand why you feel the need to personally attack people who disagree with you on an issue.

[morningfog]

41. I didn't walk anything back.

You just didn't understand.

[Nitram]

49. Morning, when the fog clears up, let us know.

You just called someone a race baiter because you didn't have a logical point to make.

[morningfog]

50. It was an asinine post from a serial disruptor.

Logic is simply is not at issue here.

[Cha]

140. All that one ever has is personal attacks. When I see that name I expect it. then it doubled down

to insult again.

Just because Maggie has a different view they call her a "serial disruptor".

[morningfog]

142. They spend more time on forced vacations and

admit they were previously banned outright. They are a serial disruptor.

[short circuit]

150. She IS a serial disruptor

Her transparency page is out there for everyone to see.

[SidDithers]

158. ...

Sid

[Cha]

141. That's their MO.. has been for awhile. They call you a "serial disrruptor" because you have a

different point of view. They can't handle that.

As a another poster said.. "You just called someone a race baiter because you didn't have a logical point to make."

http://www.democraticunderground.com/?com=view_post&forum=1251&pid=548259

[short circuit]

151. Case in point.

http://www.democraticunderground.com/?com=profile&uid=106348&sub=trans

[Cha]

155. "You just called someone a race baiter because you didn't have a logical point to make."

http://www.democraticunderground.com/?com=view_post&forum=1251&pid=548259

Maggie has a right to her point of view.. all you want to do is censor her on DU.

That's not Democratic.

[short circuit]

156. I have nothing against censorship

But telling lies and when confronted about it, goes on a personal attack is her M.O. - and I don't think MaggieD is really a Hillary supporter, but rather a serial disruptor.

[Cha]

157. I can see that.. an alternate point of view is all the majority of DU needs now to Censor Voices

like Maggie & Bravenak.

[morningfog]

164. Plenty of posters manage to express a wide variety of views

without getting posts hidden.

MaggieD is no victim. Bravenek is a different story. She isn't here to disrupt. She had some justified heated exchanges and ended up on the wrong side of jury decisons.

MaggieD is a previously banned disruptor who spend more time without posting privileges than with. It's all on her.

[Cha]

167. Maggie is great.. and a Hillary Supporter. now the poster who was calling her a "serial disruptor"

is banned for being a previously banned troll.

[Bobbie Jo]

163. Um, you've been here a week.

Tell us more about "serial disruptors."

Thanks

[Cha]

166. And, now he's gone Bobby Jo..

http://www.democraticunderground.com/?com=profile&uid=325601&sub=trans

[Bobbie Jo]

168. heh

His screen name was prophetic, no?

Short Circuit

[Cha]

169. Yeah, not very optimistic..

[Cha]

165. Well your CT is Wrong Short Circuit.. Maggie is a Hillary Supporter.. Maybe it's you who is the

"serial "disruptor"?

[cali]

17. And Bernie secured waivers for Vermont.

[MaggieD]

22. But no federal funding

Again, it failed for lack of a plan to pay for it.

[George II]

149. In most states the Federal Representatives and Senators still have a lot of influence...

....on legislation within their home states. At least that's been the case in the states in which I've lived.

And that's in states with millions of people and many Representatives (although still only two Senators)

One would think that influence would magnify in a state of only 600,000 people and only one Representative to go along with its two Senators.

[hill2016]

172. hm..

are you saying people don't listen to him in his home stage?

He has no "bully pulpit" there?

[morningfog]

192. Is that what I said? Welcome back!

[MaggieD]

9. Because he has minimal influence on the Dem party there

Just like in congress. I know a lot of folks won't like my answer, but all evidence points to the fact that it is the truth.

It failed basically because there was no viable way to pay for it. If Bernie was influential you would think he would have pitched for some federal funding under the reasoning that it would be a great experiment to test the greater viability of single payer throughout the nation.

http://www.politico.com/story/2014/12/single-payer-vermont-113711.html

[AgingAmerican]

21. Or better yet

The mayor of Burlington has zero control over state politics. Nor was he ever a state senator.

The viability of single payer has been proven in every industrialized nation on earth, except the US. No need to 'experiment'.

[senz]

100. + 1

[cali]

31. no, that would be quite wrong, mags.

As is the politico article. Bernie has a great deal of influence on the dem party here and many friends within it. In fact, the chair of the Vermont dem party just quit her post to head up his NH campaign. A couple of dozen state legislators have endorsed him, and dem politicians universally ask for his endorsement and for him to campaign.for them. He campaigned for Shumlin and Miro Weinberger, mayor of Burlington.

You know jack about my state. Of course that doesn't stop you from....

You wouldn't like it here. It's liberal.

[wendylaroux]

38. ha!!!

she is a hoot!

[cali]

40. I would use other descriptive words.

[wendylaroux]

45. i know:(

very good at it's job though.

[MaggieD]

48. Tell that to the Bernie fans

I agree that Senators have great influence over state politics in every state, especially on large ball issues.

I do know jack about your state. I grew up in the Berkshires and have spent plenty of time in Vermont. Also have relatives there. Regardless, you're arguing for the sake of arguing, it appears. We both agree that he is not in any way impotent when it comes to state politics.

[cali]

68. well as a hill acolyte, you know about fandom for a political candidate

[MaggieD]

72. Seems I have to tell you this every single day....

There are lots of candidates I could support and would support if they were running. If I was an "acolyte" as you claim I would not be in the "any Dem but Bernie" camp.

Notice I have no avatar or sig like all the Bernie people? I am not the acolyte here.

[cali]

75. lol. I ain't buying and neither are most people here

Your paeans to Hillary, if not lyrical are heartfelt- when you're not to busy exercising.creative license to bash Bernie.

[beam me up scottie]

135. ^^^THIS^^^

The right wing of the party is only interested in smearing progressives, they don't like having facts thrown at them.

Thanks for nailing it in this thread, cali.

[Cha]

146. BS himself said.. there weren't enough votes in Congress for Single Payer but too many

like to ignorantly blame President Obama.. they had 10 or so ******* Votes!

[hill2016]

175. yup

one does wonder why Bernie never addresses the cost part of his platform and how he'll work with others to make it happen (if he couldn't even get it done in Vermont).

[AgingAmerican]

10. As mayor of Berlington?

Or as a FEDERAL Senator?

[hill2016]

173. as an influential political figure

in the state of Vermont.

Couldn't have tried harder on such an important issue to him?

[Vinca]

12. You might ask Governor Shumlin. That would be more appropriate.

[tularetom]

15. Damn you!

I was just about to post the very same words. Verfuckingbatim. :-}

[djean111]

20. This has been posted before. It is just being recycled.

And I really am starting to question why this crap is posted, because there is absolutely zero chance of this crap convincing any Bernie supporter to start supporting Hillary.

[MaggieD]

24. It's not stupid at all

Can a candidate get things done is perhaps one of the most important questions a voter can ask themselves. In Bernie's case I have come to the conclusion that the answer is no. And that is a HUGE reason why I do not support him.

[AtomicKitten]

28. It's recycled bullshit because they have little else.

second verse, same as the first

[jeff47]

34. Plenty of other long-term posters who are Clinton supporters have said the same thing (nt)

[fredamae]

23. What control does he hold

over the state leg? I know in My state...Fed reps don't dictate policy to my state legislature.

so, wth?

[MaggieD]

26. Do you know any of them?

Just because the influence they weld is not plastered on the front page of the paper doesn't mean they don't have any influence. Granted, they do not play small ball, but on major issues they certainly have influence. Particularly senators. I promise you that your senators and governor are very well acquainted.

[cali]

33. I do. Bernie is very well liked in the legislature by dems

And members of the Vermont Progressive Party.

The problem was Shumlin.

[MaggieD]

36. Ask Shulmin if Bernie is powerlesss on large ball state politics

As many claim or assume here. The answer will be a resounding no.

[cali]

43. you are contradicting yourself

And you still don't know jack about my state.

[MaggieD]

44. I'm not contradicting myself

The argument here among Bernie supporters is that he has no influence over state politics. That simply is not true. In any state.

[fredamae]

54. Can you show me an example

of any issue in Any state where a Federal lawmaker wielded power over state legislatures to Force any issue?
To your question "do you know any of them?" Yes, I do. I know a lot of them, in my state.
Being acquainted to the guv is fine and govs Do have special attention paid to bills they want passed...but, as I have witnessed here...that doesn't guarantee Anything.
The burden lays with how much power he (or any other senator) weilds over Any state leg.

[MaggieD]

61. Well ask them then

You'll see that I am correct.

[fredamae]

62. Ask whom

what question?

[seabeyond]

29. Bernie Sanders' Single Payer Vermont

The numbers were stunning. To implement single-payer, the analysis showed, it would cost $4.3 billion in 2017, with Vermont taxpayers picking up $2.6 billion and the federal government covering the rest. To put the figures into perspective, Vermont’s entire fiscal 2015 budget, including both state and federal funds, is about $4.9 billion.

Shumlin’s office estimated the state would need to impose new personal income taxes of up to 9.5 percent, on top of current rates that range from 3.55 to 8.95 percent. Businesses would be hit with an 11.5 percent payroll tax, on top of 7.65 percent payroll taxes employer pay for Social Security and Medicare.

Vermont is without a doubt the most liberal state in the union. It is the only state that has single payer healthcare as law. Bernie Sanders was instrumental in fighting for that law. He made lots of speeches advocating it, much as he is doing now running for president.

But when the time came for the hard work, the difficult task of pushing, cajoling, persuading, 'leading the people' as Sanders likes to say, to get Vermonters and the legislature to accept the necessary tax increases to make single payer a reality, Bernie Sanders was AWOL.

http://www.dailykos.com/story/2015/06/27/1397137/-Bernie-Sanders-Single-Payer-Vermont

i figure this will be a discussion in debates. i am interested how sanders addresses it.

[cali]

39. sigh. false hillaryite hit piece from some asswipe who gets

Destroyed in the comments.

[seabeyond]

58. daileykos isnt ok? what ever. i will listen to him during debates. i have not heard it addressed

on the campaign trail.

[cali]

70. so you approve of every critical Hillary diary posted there

Logic is your friend.

Well, maybe not your friend.

[ALBliberal]

186. Isn't Sanders advocating Medicare for all under the federal government?

[hill2016]

174. yeah

I'm wondering why Sanders has never addressed the cost part of his policies.

[SonderWoman]

35. The same reason it probably won't pass nationally...

No one fully has a realistic plan to pay for it. And not just pay for the policy but for much needed additional hospitals as well.

[MaggieD]

42. Because it costs so much

I think what a lot of folks forget is that healthcare spending accounts for almost 18% of our GDP. Sadly it's been for profit for so long that we have come to depend on it economically for jobs. If only the country had listened to Hillary and Bill back in the 90's.

[SonderWoman]

51. Not to mention the votes. Even with Dem majority...

It had no chance.

[Ron Green]

63. This is the very reason to enact a single-payer system.

18% GDP and rising is unsustainable. All over the world, publicly-funded systems give better outcomes at lower cost. The oligarchs are to blame for the U.S. "system." You know, those people who give money to your candidate?

[MaggieD]

65. Taking 18% off the GDP away is not viable

Economically.

[Ron Green]

71. What???

[cali]

76. it's bizzaro time.

[MaggieD]

87. What part do you not understand?

[Ron Green]

96. I don't understand how spending much LESS than 18% of GDP

on health care can be a bad thing. Other nations spend about half, sometimes less, of what we do.

[MaggieD]

101. Because as we've moved from a manufacturing economy....

... To a service based economy. Sadly for profit healthcare is tied to lots and lots of jobs. It's not something we can change on a dime at this point.

[Ron Green]

138. Well, that's a different way to look at it. Kind of like

the weapons industry employs lots of people so we shouldn't move too quickly away from that, either.

[MaggieD]

139. As I said, every modern Dem president has cut military spending....

and gotten NATO more involved in the world police job. All to the good. Many of the MIC jobs are overseas, so I think we can decrease spending without hitting jobs too badly here. We just have to be strategic about it.

Keep in mind that Bernie is a big supporter of the ridiculous trillion dollar boondoggle that is the F-35 fighter jet. I presume because it brings jobs to Vermonters.

[Warren Stupidity]

159. for profit health care is not a major employer.

The health services sector - people providing health care - nurses doctors etc - they are the vast majority of the health sector work force and there would be more doctors nurses etc under a standard universal system like most other modern nations have. And the costs per capita and overall would be lower, as they are in all other modern nations, and the services delivered would be superior by all standard measures of population health as they are in most other modern nations with universal systems. Some people in the insurance industry would lose their jobs. Overall it would be a huge boost to the economy.

[Armstead]

56. Are we dumber than every other advancced nation on earth?

Somehow they seem to make it work.

I know, I know. You'll trot out horror stories about otehr nation's systems. But I'll respond by saying our system is already a mess, and much more unfair.

...And by its very nature healthcare will never be a smoothly operating fiscally controllable system, because it deals with unpredictable life-and-death changes and does cost money.

But this excuse that the United States is too damn stupid to do any better than we've got?

To repeat from elsewhere...That's not realism, it''s defeatism.

[SonderWoman]

59. They make it work with much smaller populations and...

Far less military spending. Plus, if I'm not mistaken, it's built into their post WW2 Constitution's. Cost is only one aspect, the procedural process of making it happen is a whole other beast.

[Armstead]

67. I will stand by my original point

If one assumes the United States is incapable of instituting even a partial, clean form of public social insurance based on income (universal access), even if it is within a mixed system, then that is saying that we are a nation of self-defeating, helpless morons.

I believe we can aim for much better (not just the gift to the insurance companies that is the ACA). At one point the idea of healthcare and retirement income for seniors seemed far-fetched. Hell, at one time the idea that women might be able to vote seemed wildly unlikely.

Don't you believe we can even try to do better? Or has that spirit been totally beaten out of us?

[SonderWoman]

73. I believe we should continue to work towards progress in this area, while...

Also believing it will be nearly impossible as long as Republicans are in control of any chamber of government.

[Armstead]

78. Well you're opening up a whole can of stuff I haven't time to go into here now

Other than to say until we start basing our goals and public message on some clear principles, and actively push for them, and publicly advocate for them, it won't make a damn bit of difference who controls which branch of government at any given time. We've had ample evidence of that over the last 30 years.

In the scenario you outlined above, we;ll be told by "realists" that we have to keep our powder dry or those nasty old GOP boogeymen will take power away.

[SonderWoman]

84. Its not the believing in it part that is unrealistic, its...

The procedural process part that is unrealistic. We would need an overwhelming super majority in both houses.

[Armstead]

91. As i said above, there's a whole lotta aspects and levels to this...

And I'm sure you don't want to open up my Hoover Dam of possible verbiage -- and luckily I haven't got time to go into it anyway.

I will simply say that the perennial litany "reasons" why Democrats are unable/unwilling to articulate a clear liberal vision anymore on some basic core principles is as much a part of the decline of the last 35 years as the GOP's inverse relentlessness in pursuit of a clear conservative vision.

Hence, without a strong counterbalance to the GOP Corporate CONservative message, the country has moved so far to the right that even relatively modest versions of the positive liberal advances of the past are made to seem impossible.

That is at the base of much of the movement that Sanders represents. It's not radicalism. It's simply attempting to revive -(and I know it's a cliche, but I don't care) a contemporary version of FDR can-do liberalism (or progressive populism or whatever you want to call it).

[MaggieD]

69. Yep, it's easy to afford socialist programs

.... if you rely on another country to be your military.

[Armstead]

81. Reducing that is part of the agenda

We have to stop putting so much money into the military. That doesn't mean having no military, but loosening the grip of the Military Industrial Complex and all of the waste and corrupting that entails. And not starting idiotic wars that make things worse instead of better.

[Angry Dragon]

82. what is the problem with socialist programs??

[morningfog]

85. A country as rich as the US cannot afford a military and health care coverage?

It has to be one or the other?

Really?

[MaggieD]

88. We are 15 trillion in debt

By which measure does that make us rich?

[morningfog]

90. Yet we can afford the largest military in the world but cannot afford healthcare for our people?

[MaggieD]

92. Hey, I'm all for military cuts and....

.... Getting NATO more involved. And every Democratic president in modern times has done just that. None more brilliantly than Obama, IMO.

I think what you forget is that we have the most stable economy in the world, and are an economic super power because we have the strongest military in the world.

I think it's kind of naive not to understand how the two are intertwined.

[morningfog]

112. You made a lot of assumptions based on nothing.

This discussion is not on the need of our military or even the size. You have taken the position that we cannot afford healthcare for our citizens as well as our military. Does it have to be one or the other?

I think it is naive, or perhaps disingenuous, to suggest we we cannot afford healthcare but can afford the military. It is a question of priority. Try to focus on the issue we are discussing. One step at a time.

[MaggieD]

116. Again you put words in my mouth

As far as my "assumptions" why don't you tell us why you think the US has the most stable economy in the world? Do you seriously not believe it has much to do with having the strongest military in the world?

Here is a good article you may wish to read:

http://time.com/3899972/us-superpower-status-military/

[morningfog]

121. You are having a rambling conversation in your head to which I am not privy.

I have not idea how you got to where you did.

Best of luck to you. And congrats. You have managed to make it a few days without re-banning!

[Warren Stupidity]

161. universal healthcare saves money and boosts the economy

and it has fuck all to do with the military, other than perhaps we could roll our veterans socialized health care system into the standard universal system instead of having it be a separate budget item with separate and redundant costs.

The argument being presented here is standard rightwing republican crap.

[senz]

105. lol -- you sound just like a Republican!

[MaggieD]

109. How so? Cons love being the world's police

[Warren Stupidity]

160. All of the other modern industrial nations have their own military forces.

None of them think that they have to rule the planet. That would be the difference. But you basically seem to be a republican on these issues. You are against medicare for all and for a huge bloated military. Those are republican positions.

[jberryhill]

79. The VA is larger than many national health care systems

[SonderWoman]

83. How's that working out?

[jberryhill]

86. In comparison to what?

By and large, it serves millions of satisfied customers.

If you think that private hospitals are having better outcomes in the cities they serve, then it is clear that you don't care for numbers much.

http://www.washingtonpost.com/blogs/federal-eye/wp/2014/04/17/va-hospitals-on-par-with-private-sector-for-patient-satisfaction/

"The American Customer Satisfaction Index for 2013 shows that the VA health network, which serves more than 8 million veterans, achieved marks equal to or better than those in the private sector."

Unlike private companies, the various levels of government oversight in the VA health care system are effective at exposing problems that get swept under the rug elsewhere.

So, what is it that you are comparing with VA performance, and what conclusion have you reached on what data?

The UK's NHS rates about 70%

http://www.kingsfund.org.uk/projects/bsa-survey-2013

"While satisfaction levels have not recovered to the high of 70 per cent recorded in 2010, they remain high by historical standards. In only two of the past 30 years have satisfaction levels been greater than those recorded in 2012 and 2013."

So, yeah, the VA, which serves 8 million, does a better job than the UK's NHS, which serves a comparable number of people.

[MaggieD]

89. It's working so well they are outsourcing some of it to private corps

In order to decrease the ridiculous wait times. I think some folks don't understand that having a program in this country doesn't ensure it will be adequately funded. Rethugs gave zero thought to the extra stress the VA health system would undergo as they waged two wars at the same time.

[Armstead]

93. Health care is NEVER going to be efficient or economically rational

Unfortunately it deals with highly unpredictable, erratic and basic matters of life, and health and sickness and death. And treatment is not cheap.

So using a yardstick to compare it to, say manufacturing widgets or delivering some predictable, controllable service, is not going to work. Period. It doesn't matter whether its public, private or a hybrid.

But if the profit motive is removed, and it is no longer a cash cow, it would do a lot better than what we've got. If the focus is on delivering service to as many people as possible as efficiently as possible (within the nature of the beast), we could of a lot better.

[MaggieD]

99. So how do you replace the contribution to GDP?

I hear what you're saying, but it's a lot more complicated than that, actually.

[Armstead]

108. It will always contribute to the GDP

In terms of jobs for doctors, nurses, office workers, etc. and business for suppliers, etc. and the other etc.s that it pours into the economy. And there can still be private practices and related businesses.

It is complicated, but it's a matter of reorienting it, making access affordable for EVERYONE, setting different priorities (a hospital should not be subject to the pressures of Wall St. and investors)....

One key point is coverage an access. Regardless of whether we continue to have private insurance or not, there should be a baseline program (expanded Medicare, whatever) whose sole purpose is to make available coverage to everyone at rates that are reasonable and affordable. That can be done.

[MaggieD]

111. Sure it can be done - just not on a dime

That is why the ACA is a very important incremental step in the right direction. First, we need to bend the cost curve downward (by a lot). Otherwise it is as unaffordable nationwide as Vermont found it to be for their state. And it would be very disruptive to our now service based economy, of which 18% is based on health care and associated industries.

So I think we are in agreement on the objective if on nothing else related to health care. Should have been done in the 90's, IMO. But the majority didn't see it our way back then. Sadly.

[Armstead]

114. It's not new issue but needs a new starting point

I wont hash over differences over the wisdom of the ACA. It's better than what was in some respects, but it has gaping holes, and is counterproductive in some ways. But your mileage may vary.

But I do think that -- whatever term one wants to give it -- the Democratic Party ought to be the party that clearly lays out as a goal the ability of everyone to have access to truly affordable care through a "social insurance" alternative. (expanded Medicare something new, whatever). And sell its merits clearly.

Couldn't happen overnight, the GOP would fight like wolverines -- but if a substantial majority of the Democratic Party actually stood for it and pushed for it, enough of the public would start to see it as a common sense solution that we could get there a lot quicker and more cleanly than all this waffling.

[MaggieD]

119. The ACA was the new starting point in 2010

You don't seem to want to engage on the issue of the massive economic disruption that would result if we don't get costs down first, so I will just leave it at what I have previously stated.

[Armstead]

128. I appreciate the need to contain costs

I don't disagree with the need to contain costs. That should be part of any mix. (Though as I said, the economics of healthcare are inherently unruly)

But I think access to coverage, and cost to consumers, are still critical priorities. (And preventing the impending mergers of big insurers currently underway). People are still either getting hammered or falling through the cracks of eligibility, etc.

As for a starting point, Every new government develops their own phrases "brand" to define their goals and proposed programs (New Deal, Great Society, New Frontier, etc). If suppose one could look at a push like i reffered to as the next step in ACA, or something else...that's less consequential than actually making the effort itself.

[MaggieD]

130. We are approaching 90% insured

And we have a ways to go before the penalties are significant enough to get to 95% or more - which is needed to reduce costs. In addition, we have health care providers learning to live with and subsist on much lower reimbursement. That doesn't happen overnight either. Health care providers - physicians, hospitals, clinics, labs, etc are actually not very good at "business."

Also remember, almost 50% of us have employer based health insurance. So moving to single payer requires a huge shift in that regard as well.

It would be economically disastrous to move much faster than we are. Don't get me wrong - I am anxious for single payer as well. My personal opinion is that commercial insurance adds not one whit of value to the equation of healthcare. However, it does provide a hell of a lot of jobs.

Regardless, single payer would be a huge, monumental change, and if not accomplished incrementally it would very likely fail. IMO.

We're on the same page, primarily. I just think it is more complicated than many assume. It would have been a lot less fraught if we had done it in the 90's but we didn't. (I do health care policy and consultation for a living).

[Armstead]

134. In my real life....

I'm a journalist. (Despite my sloppy typing and ranting on DU).

I remember covering the same basic problems and issues in healthcare back in the 1990's and even the 80's. (While also remembering how some of it was better then too.) So it gets depressing when i see so little progress being made, and is one reason my patience gets thin about it.

[MaggieD]

137. Chin up - we have made progress

I agree the pace is frustratingly slow. I think the LGBT movement taught me patience. I remember being pissed as hell when we were advised to pursue DP instead. But it worked. Patience in our system of politics seems to be a requirement. I've learned to appreciate the value of simply putting one foot in front of the other and to just keep marching toward the goal.

By the way, being a journalist was my dream job when I first went to college. But it was the Reagan years and I couldn't afford to take chances on getting a job when I finished, so I chickened out and went into healthcare instead. In my later years I was solicited to write for several different publications, and I loved the work. But it is hard. Writer's block and deadlines are a killer!

[Warren Stupidity]

162. Outsourcing is the republican way of pretending that defunding programs is a solution.

[jeff47]

117. We're already paying for it.

When I go to the doctor, I pay them. I also pay my insurance company for their policy. I also pay my pharmacist.

Creating a single-payer system does not magically make it cost something. It just means you pay different people.

[hill2016]

176. hopefully

something that Bernie will address soon (his realistic plan).

[phleshdef]

37. Um Vermont DID pass single payer but then discovered they couldn't realistically fund it.

The problem is, Vermont is a very small state, not a lot of people. A bigger pool is needed to make single payer work. Their pool isn't big enough so the governor backed out.

[Snotcicles]

115. Sorry, I said the same thing in post #104. Some people don't have a clue how insurance works

but that never stops them from trying to bash Bernie Sanders. And there are a few in this thread that that seems to be their only purpose of being on DU.

[dsc]

131. actually their smallness is likely helpful

they have maybe one teaching hospital, if that. They have none of the problems of poverty that many other larger states have (so they are way healthier than most states) and they have a likely more active population given that there are many outdoor activities in VT. If a small, white, realitively wealthy state couldn't get this off the ground that bodes ill for any such national plan.

[phleshdef]

188. No, there really isn't enough income coming into Vermont.

California or New York would be a much better state to test such a system.

[hill2016]

177. funny

I keep hearing how the small European countries (some of which are not much bigger than a US state) have a wonderful universal health care system. What's the minimum size needed?

[phleshdef]

189. Its not about size as much as it is about having enough people to produce enough revenue.

And those "small" European countries have a lot more people AND revenue than the state of Vermont.

[Nitram]

47. Hill 2016, you've hit the nail on the head.

If Bernie could do 10% of the things he's promised to accomplish it would be a minor miracle. He still has to work with a GOP House and probably a filibuster-vulnerable Senate. Just because he really means it when he says it doesn't mean he can get it done. That's just wishful thinking. If he couldn't do it in Vermont, how can he do it as POTUS?

[AgingAmerican]

52. He wasn't governor

Nor did he hold state office. That's why. Duh.

[SonderWoman]

55. So he couldn't even rally the troops in his home state?

[AgingAmerican]

66. He has never held state office

Oh and by the way, single payer was passed in Vermont. It is called, 'Green Mountain Care'.

https://en.wikipedia.org/wiki/Vermont_health_care_reform

[hill2016]

179. and

I'm assuming it's in place now?

[Zorra]

57. Bernie is a US Senator, not a Vermont State Senator.

US Senate

https://en.wikipedia.org/wiki/United_States_Senate

Vermont State Senate

https://en.wikipedia.org/wiki/Vermont_Senate

http://civicseducationinitiative.com/take-the-test/

[cali]

74. sorry, as a person who actually lives here, that's bullshit.

And someone who posts flamebait and then ducks, is not only a..., but also none too brave.

[cali]

64. when you post an inflammatory op and then don't respond that

speaks to who and what you are..

[DissidentVoice]

77. Unfortunately, Bernie didn't have any input at the state level

I also find the Governor's reasoning of "we can't afford it" somewhat suspect.

My feeling is that there are RW elements in Vermont who probably had their "input" ($$$) into squashing it.

Vermont may not have the RW strength of somewhere like Indiana or Texas but they are all over, and Limbaugh and Fox are received in Vermont.

I have to say that the ACA may be a "start," but it simply does not go far enough.

President Obama disappointed me by caving to Max Baucus on the public option, which could have started the path to single-payer MUCH quicker. However, he didn't disappoint me as much as President Clinton did in 1994, when he just caved to the Republicans, lied down and let them kick him, and then jumped on their bandwagon on a lot of things.

The Republicans, despite what they say, are going to have to wait for the proverbial cold day in hell before they get the ACA repealed. Even in their most-conservative districts, there are going to be people who like and benefit from the ACA.

I really hope (probably in vain) that Bernie Sanders isn't poisoned by the DLC mindset and that he will push for single-payer if elected.

[cali]

80. no, it wasn't the right which really is weak here. it was Shumlin.

[SonderWoman]

107. Did Bernie even try? A speech? Anything?

[cali]

120. yes. it really was mostly shumlin's fault. And it's complicated

From the massive fuck up with the Vermont health exchange to his poor relationship with the legislature. Shumlin ran on single payer. There was and still is majority support for it. He put little effort into it once elected.

[hill2016]

180. so

you're saying that Bernie can't use his bully pulpit in his own home state?

[Capt. Obvious]

97. Just Asking Questions

[beam me up scottie]

129. First cousin of Just Saying...

[taught_me_patience]

102. Because it probably involves people having to pay for things with taxes

vs. money falling out of the imaginary money tree.

[senz]

110. Hey I don't mind paying taxes that go toward improving the General Welfare.

But then I'm a patriot and a liberal.

[taught_me_patience]

113. I don't mind either.

but Bernie seems to think only the rich should fund all of his ideas.

[frylock]

133. The rich should pay their fair share..

which in turn would help to fund his proposals.

[hill2016]

181. oh wow

that's tough to sell, man.

Hope Bernie can be honest about the costs of his platform.

[arcane1]

106. You really need to get a new act. This one has become stale and predictable.

And it isn't even amusing anymore. Just dull and boring.

[Recursion]

122. Because nobody has come up with a way to pay for it

Same problem it has at the national level.

And, no, waving your hand and saying "it's cheaper" doesn't count. Somebody needs to actually work out how much it will cost and what tax rate levied where will be required to pay for it. Vermont came up with something like a 12% payroll tax and got scared off.

Most countries in Europe do it with a 10% or so national sales tax.

[Romulox]

123. We're already paying for it.

[Recursion]

125. Well, no, we're not. Lots of people go without medical care

We pay more because our doctors make a lot more than doctors in almost any other country.

To provide more medical care than we are now, we will have to either pay more directly or find some way to make doctors do more work for less money.

One basic way to do that is to increase the number of doctors or allow a lot of what doctors currently do to be done by LPNs, RNs, etc. But the AMA strongly opposes both of those ideas and has a lot of clout.

[DanTex]

143. Doctor salaries make up only a small part of the difference.

You'll read a lot of people saying __________ is why we spend so much more, but the actual reason is a bunch of different factors added together. Which also means that there's no simple fix.

One of the best overviews of the problem I've seen (I got this link from Krugman) is here:
http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/

A brief summary is in this chart:

[nichomachus]

127. For the same reason Hillary didn't in NY or even the USA -- where she had two chances. n/t

[The Velveteen Ocelot]

132. Because he's a US Senator and not part of his state's government?

You do know how that works?

[hill2016]

182. I keep hearing about this thing called

bully's pulpit that's going to get all this proposals passed through a republican controlled house.

Doesn't it work in his own home state?

[The Velveteen Ocelot]

187. I have never known my own US senators to get involved or make statements,

at least publicly, regarding any specific state legislation. Whether there are ever some back-channel discussions, I have no idea. But because of constitutional principles of federalism, federal elected officials tend to stay out of the business of the legislatures of their home states, as they should.

[artislife]

136. One rec...enough said.

[MoveIt]

147. Hey Now I was told that they are not into this for the "popuplarity contest"

They are clearly here for the Lulz at everyone's expense.

[cherokeeprogressive]

144. Another Hillary Clinton supporter shoots an arrow into the sky...

And misses.

[TheKentuckian]

145. Probably for the same reason Clinton passed Stop and Frisk to harass black folks in New York.

Is this the ridiculous game the one we are going to play?

[timesup]

148. Someone doesn't understand what Senator responsibilities are, look that up please.

You can blush later, it happens.

Hilarious ? be sure to ask him it when he visits your town.

I would love to see the shock on his face being asked that, although it might be one he has heard a bunch of times already and make light of it without pausing too, he does work pretty well on his feet unlike a lot of...

[BlueCaliDem]

185. And plenty don't understand the limitations of presidential powers.

People actually believe Bernie Sanders' sales pitch that he'll get a national $15 minimum wage, national single-payer, national higher taxation of rich people...all without Congress, too.

[HassleCat]

152. Why didn't Obama pass single payer as part of ACA?

I think this has been explained about 10,000 times, but it has to do with the fact that single payer is an idea whose time has not yet come. When it does, it will be because progressive politicians pushed for it, tested the waters, floated trial balloons, that sort of thing. Remember, Hillary Clinton made a run at health care reform and came up short. It just wasn't time. Not her fault.

[Motown_Johnny]

153. Why didn't Hillary get NY to pass stricter gun laws?

I mean if she couldn't get it passed in her "home" state how would she be able to get it through a much more ideologically divided country?

[underthematrix]

178. He lost the VT Gov's race

[hill2016]

183. his bully pulpit

doesn't work in his own home state?

[underthematrix]

184. It seems to me VT loved him as their

champion of issues and causes but they didn't think he had the leadership skills to frame and implement a policy agenda. I think that's interesting and definitely gives me pause.

[Ino]

190. Why didn't Hillary get any health care bill passed?

She wrote the damn thing! She was FLOTUS! She had a bully pulpit!

I can't believe you dared to ask such a question.

[Live and Learn]

193. Why did Hillary fail in her attempt to get any health care passed?

I already know the reason but if you are going to ask a ridiculous question, shouldn't we be able to play?

[Nitram]

194. Your handle is the answer to your question.

Obama learned a great deal from Clinton's failure to get a health bill passed. He's one person who does learn from history.

[WI_DEM]

195. simple, he isn't the governor of Vermont.