American Politics Discussion Thread

[Commodore]

While we are at the Affordable Care Act. The ACA is more popular then Obamacare even though both are the same. 

Naming matters

Wonder how Romneycare would poll.

[Mjmd]

While we are at the Affordable Care Act. The ACA is more popular then Obamacare even though both are the same. 

Naming matters

Wonder how Romneycare would poll.

Probably horrible with Democrats 

[Commodore]

While we are at the Affordable Care Act. The ACA is more popular then Obamacare even though both are the same.  :crazyeye:

Naming matters

Wonder how Romneycare would poll.

Probably horrible with Democrats  :shakehead:

Horribly with everyone, most likely. Even with Romney, if you go by his 2012 campaigning.  :rolleye:

[Amicalola]

I could very well be wrong, but I don't think Democrats will do themselves any favours by trying to appeal to the right. Just look how close the race was even after 4 years of chaos. Those Republican voters are loyal, they are not going to budge. I would focus on trying to reach those who are not voting.

You aren't wrong, but I think there is a key. Republicans are rather short on actual policy in recent years. Most of their campaigning is "fear the radical liberal Left". Democrats need to be careful not to play into that fear (warranted or unwarranted). Example: sure American health care is a joke around the world, but lord help you if you try to change it. So for instance instead of trying to pass a Medicare for all plan that will give the Republicans ammunition, maybe try to fix and improve the Affordable Care Act. While its original passage caused a lot of uproar, Americans as mentioned have a rather short memory, so might be a better method.

Ending the privatization of prisons is a good example of a progressive policy that you can do while also not rousing the passions of voters. Trying to fix systems that already exist is usually not seen as "radical" as trying to implement new policy. It is certainly going to be a balancing act, but I'm not sure most Democrats understand they are even in such a situation. Sometimes this isn't going to be possible, but they should try to pick their battles carefully. 

I've said this before but Democrats can't afford to move more than a half step ahead of where American society is ready to be.

I think Republicans will be drumming up fear about the 'radical left Democrats' regardless of whether or not it's true, though. Joe Biden would be considered 'centre-right' in most countries; he's about as far from 'radical left' as the Democrats could get.  

More seriously, Jowy has a point; the American Right is scared away by Republican rhetoric regardless of what the Democrats actually do, so courting the Right with centrist policy may just lead to a scenario with a dissatisfied Left AND Right. I agree that the Democrats would require care in instituting policies common in other western countries, as the American public is probably actually not ready. But another problem; if the American public has watched something like Universal Healthcare work in virtually every other developed country for 50 years, and is STILL not ready for it, will they ever be? Perhaps the only way to convince the average conservative American that it works, is to put them in the system and have it work. The problem feels a bit like Chicken-and-Egg, I guess.

I've briefly touched on it before, but I think a lot of Americans (not necessarily here, but in the country) have a somewhat understandable lack of perspective for the rest of the world. They think the American way is the only way to do things, because they genuinely do not know any others except 'failed socialist' policies like Universal Healthcare. I can see why; it is an isolated country, and sole global superpower. That's gotta be pretty ego-boosting. But it still seems like a problem that needs to be addressed before the American public will ever be ready for such 'radical' policies.

[Cyneheard]

I've briefly touched on it before, but I think a lot of Americans (not necessarily here, but in the country) have a somewhat understandable lack of perspective for the rest of the world. They think the American way is the only way to do things, because they genuinely do not know any others except 'failed socialist' policies like Universal Healthcare. I can see why; it is an isolated country, and sole global superpower. That's gotta be pretty ego-boosting. But it still seems like a problem that needs to be addressed before the American public will ever be ready for such 'radical' policies.

America is a very isolated country, and the rest of the world pays way more attention to us than we pay to them. And that predated Trump, where we very much focused on our internal nonsense because we had to.

Health care is also a crazy complicated system that is incredibly fragmented in the US. We have legions of providers, hospitals, state governments running health care systems, Medicare and Medicaid, and different rules in different places. Also, health care is not a system that functions well if it's sabotaged - one of my big fears of creating a truly universal system is how much of a mess Republicans in states and in the courts can make of things. We've also got some Constitutional constraints (generally interpreted by conservative judges too) about what the federal government can/can't do on health care - our courts have a huge amount of room to make things worse that they can't on, say, tax policy. Gorsuch can't say "a 25% income tax rate is constitutional but a 33% rate isn't," but he sure can find a way to say that "the federal government can't be the sole insurance provider."

It's also got a huge number of entrenched powers that benefit from the status quo, and we waste a huge amount of money navigating our fragmented system. 

Bernie complains about insurer profits but that was something like $20-50B, that's a drop in the bucket in our $3.8T in health care expenses. (Insurance profits source: (this says $22B but I'm not sure if it's got everything https://content.naic.org/sites/default/f...tary_0.pdf) (health costs: https://www.cms.gov/Research-Statistics-...0in%202018.) Bending the cost curve is not simple, and it will require a lot of changes (including student loan reform! We have to pay doctors a massive amount of money because their student loan debts are massive)

A truly universal health care system, by being more efficient, will absolutely cost some powerful interests money because the efficiencies have to come from someone - and people are VERY loss-averse and risk-averse when it comes to their health care system.

So what's viable politically and policy-wise? A public option would do a lot of good - the more we can standardize systems the better, and if the public option is ineffective it won't thrive.

[suboptimal]

Bernie complains about insurer profits but that was something like $20-50B, that's a drop in the bucket in our $3.8T in health care expenses. (Insurance profits source: (this says $22B but I'm not sure if it's got everything https://content.naic.org/sites/default/f...tary_0.pdf) (health costs: https://www.cms.gov/Research-Statistics-...0in%202018.) Bending the cost curve is not simple, and it will require a lot of changes (including student loan reform! We have to pay doctors a massive amount of money because their student loan debts are massive)

It's not just their student loans that are massive. The premiums for their malpractice insurance are sky high, they have to hire a legion of staff (and provide health insurance for them) just to handle all of the paperwork required to navigate the healthcare system and then there's getting all the payments out of the system. There's so much overhead at the "front line" level it's ridiculous.

I've got a friend in private practice in the mental health profession and he does not take insurance. He's got one part time staffer to assist with billing, scheduling and what little back-office work there is. He also has plenty of clients to keep his practice not just going, but thriving, and they don't mind the fact that he doesn't take insurance. If anything, his hourly rates are comparable or slightly lower because he doesn't have that cost overhead to maintain.

[Commodore]

Single-payer universal health care requires more social unity than currently exists. There are...hopefully a minority, but definitely a plurality, of Americans who would seek to deny their political enemies healthcare because of who the other side voted for.

[Bobchillingworth]

As a reminder Democrats passed a version not far off of Romney's healthcare plan and then lost every branch of government. I don't expect people to know a lot of history, but that is recent enough people should be able to remember right?

Note though that many would take this particular example, where Democrats played it "safe" with an originally Republican plan, got attacked by Republicans as proposing radical policies regardless, and then got creamed in the midterms (though they didn't lose every branch of government), as evidence that chasing conservative-leaning voters is a fool's errand, and they'd be better off being bold and keeping their core supporters engaged and motivated.


Besides, it's not like Republicans are going to stop assailing democracy between now and the next major election- the Dems can still beat that drum if they care to.

[Cyneheard]

As a reminder Democrats passed a version not far off of Romney's healthcare plan and then lost every branch of government. I don't expect people to know a lot of history, but that is recent enough people should be able to remember right?

Note though that many would take this particular example, where Democrats played it "safe" with an originally Republican plan, got attacked by Republicans as proposing radical policies regardless, and then got creamed in the midterms (though they didn't lose every branch of government), as evidence that chasing conservative-leaning voters is a fool's errand, and they'd be better off being bold and keeping their core supporters engaged and motivated. 


Besides, it's not like Republicans are going to stop assailing democracy between now and the next major election- the Dems can still beat that drum if they care to.

I think that logic applies to everything outside of healthcare - where the Dems really aren't in agreement on what to do. For things like "how much do we care about the climate" or "what size checks do we cut", there's room for disagreement BUT at the same time getting 80% of what you want is helpful.

Health care doesn't really work that way. 80% of Bernie's or Biden's system is probably just a gigantic mess.

[SevenSpirits]

Single-payer universal health care requires more social unity than currently exists. There are...hopefully a minority, but definitely a plurality, of Americans who would seek to deny their political enemies healthcare because of who the other side voted for.

What do you mean by a minority plurality in the context of "Americans who seek to deny their political enemies healthcare"? I would have though that was just a dichotomy, but I guess you're seeing 3+ categories?

I am fortunate to have never heard of this position before. It's pretty depressing. I hope it's rare.