I am proud today to say I voted for this president.

[grantcart]

58. What you have failed to understand from the beginning, don't understand today

and probably won't understand for some time in the future is:

Expansion of federal power has always been accomplished on a narrow principle and expanded as people see the results and gain confidence in that role.

That is not simply an American process either. Single payer coverage in Canada started with a very narrow hospital coverage in a single province. It then went on to cover catastrophic illness. After a process of about 15 years they finally got single payer coverage. Mind you this came in a system that combines executive and legislative power in a single party through Parliament.

You can look at the same thing happening in all of our federal insurance programs as well. Social Security had a very narrow mission in the beginning. Look at any federal agency, CDC, FDA, USDA, they all started on narrow missions and expanded as people gained confidence in it. Flipping the switch and going national with a direct challenge to the entire health insurance industry would be difficult in a Parliment system but would is impossible under our divided divided power system where 40 Senators from the 20 smallest states accounting for less population than the 2 Senators from our largest state can bring everything to a halt. While it is true that the UK flipped the switch on a big conversion, they did so only after a prolonged war that brought together all classes under a shared sacrifice and with the defense sector already overtaking most of the medical resources of the private sector. In addition to that after getting it passed in our system you then have to get a Republican supreme court to pass that it is constitutional.

For 100 years progressives have wanted to establish legislation establish federal jurisdiction in controlling the health insurance industry and the health system. For 100 years we have failed. We now have that and it has passed the Supreme Court. It will never be taken away.

The real point of the Public Option is to reduce the Medical Loss Ratio to single payer levels. Before the AHCA medical loss ratios in many plans were 35%. Single payer systems typically cost about 7-9%. The ACHA capped it at 20% (25% for small plans). Billlions were saved on premiums and billions were refunded. Moreover, and this is the key point, the structure is in place to bring it down to 18% or to add a public option, maybe on a state by state basis first.

Your cynacism is hard earned and you wear it proudly so I don't expect things like establishing the principle of federal involvement in health care, the reduction of the MLR, the comparing of the context of countries like ours (Canada) or a restatement of the non Parliment radical division of political power to have any impact on your practiced bashing of President Obama. However I will leave you with this: Continuing to diminish the historic achievements of this President is exactly what the reactionary right wing wants you to do.l