Democrats Are Fighting Over Socialism, and the Socialists Are Winning
Bernie Sanders' Democratic rivals may laugh at his socialist pretensions. But in important ways, he's winning.

On Wednesday, Bernie Sanders, the independent senator and a candidate for the Democratic presidential nomination, delivered a major speech on socialism. Titled, "How Democratic Socialism Is the Only Way to Defeat Oligarchy and Authoritarianism," the speech sought to give us Sanders' own definition of socialism. But the address left enough lingering questions that it might better be understood as a declaration simply that Sanders is a socialist, whatever that is.
Socialism—what it is, whether it's any good, and who counts as a socialist—has become a major divide in the Democratic primary and is likely to play a role in the 2020 general election, no matter who is on the ticket.
Former Colorado Gov. John Hickenlooper (D), one of the many low-polling extras in the cast-of-thousands production that is the Democrats' 2020 primary, recently told a group of California Democrats that "socialism is not the answer," and has said he wants to differentiate his candidacy by opposing the idea.
In the run-up to the socialism speech, as Edward Isaac-Dovere reported in The Atlantic, some of Sanders' primary rivals offered careful non-responses, criticism, and reactions that are revealing in other ways: Sen. Michael Bennet (D–Colo.), another low-ranked primary candidate, heard the title of the speech and said, "I don't think the American people even know what that means." And it's not just back-benchers rolling their eyes. When Sen. Elizabeth Warren (D–Mass.), arguably the candidate closest to Sanders in terms of policy outlook, heard the name of the speech, she laughed.
Looked at one way, Sanders is losing the battle over socialism. His rivals laugh at him, and the leading contender for the primary, according to the (yes, still very early) polls is former Vice President Joe Biden, who has branded himself a moderate with an insider's track record, in direct contrast to Sanders' ornery outsider approach to politics. At the beginning of the year, a majority of Democratic and Democratic-leaning voters told Gallup they wanted a party that was more moderate, not more liberal. That hardly sounds like a recipe for a socialist takeover.
Yet Sanders has remained near the top of the polls all year, even in a primary field that looks like a Where's Waldo? splash page. Millennials have embraced socialism in record numbers, and socialism, once an insult even within the Democratic party, is no longer a dirty word, at least among the party's rising stars and most engaged activists. That's largely thanks to Sanders' scruffy insistence on using the word. (For someone who finds capitalism so distasteful, he's pretty good at marketing.) Candidates like Hickenlooper who have directly attacked socialism have faced strong internal resistance; he was loudly booed at the California Democratic Convention, and he and Bennett are far behind in the race.
Most importantly, the Democratic party has shifted its policy priorities. Sanders' agenda is not quite the Democratic party's agenda, but Democrats are far closer to Sanders' democratic socialist platform than they were a decade or two ago. The Democratic party may not be branding itself as the party of socialism, and compared with left-leaning parties around the world, its socialist tendencies are less pronounced, but it is certainly closer than it has been in decades. The Democratic party isn't really arguing about what direction to go, just precisely how far.
Beyond the Democratic party, an inclination toward socialism, or something like it, has taken hold: The generalized mood of American voters is more liberal than at any time in the last 68 years. Left-leaning economic theories have gained new prominence in the wake of the financial crisis.
Even Republicans seem to have developed a soft spot for what are essentially socialist ideas; President Trump campaigned on the promise not to touch Medicare or Social Security, America's largest socialized benefit programs. These entitlements remain vastly popular with seniors, a group that otherwise leans to the right. Over the last year, multiple polls have found a majority of Republicans support for Medicare for All, the most prominent of Sanders' policy goals.
Trump may be running (somewhat incoherently) against the word "socialism" but it seems clear that a non-trivial portion of his supporters favors at least some components of the democratic socialist agenda. Many voters, as well as at least a few politicians, remain confused about what Medicare for All means, but these surveys nonetheless suggest that the American electorate has socialist tendencies.
Which may explain why Sanders' speech was mostly a recitation of familiar talking points about the New Deal, socialism's various economic guarantees, the problems with Donald Trump, and the evils of "unfettered capitalism"—which mostly seems to be an objection to the existence of individuals who are very rich.
The democratic socialism Sanders is promoting has an agenda, of sorts, but deep down, it's less a platform than a tendency, a manner of understanding politics and economics that is light on particulars and heavy on easy assumptions about the way the world should be and what it should offer, namely a litany of government benefits, regardless of the political and fiscal hurdles involved. It's an airy and reckless populist fantasy of broad social and economic transformation—an ideology, yes, but also an attitude, one that will take whatever support it can get. And regardless of how Sanders himself fares in this race, it is likely to inform our politics for years to come.
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I appreciate that I live in a country where this is happening, but it changes nothing. Socialism doesn't work. It is fundamentally flawed, so all of this is really just a discussion about whether we will confront that fact now or later.
Sanders isn't my first choice. But you have to admit things would be going better under a Sanders Presidency than they currently are under Drumpf.
I mean, I doubt a Bernie victory in 2016 would have immediately caused a #SandersRecession.
I jist flag your posts without reading them so they disappear.
I'm sorry to hear that.
Maybe I could get around that by constantly changing my username like some people? Nah, that would be kind of pathetic.
Well……bye.
It's understandable you're still embarrassed about the time I provided more up-to-date links and proved you were wrong about Buttplug being banned.
Maybe switch back to "Tony admits he lies and cheats" until the sting wears off.
Poof.
I have a RIGHT to have the government force other people to pay for my basic needs!
Yikes! Doesn’t sound so good when you put it like that! Haha
Hopefully we'll get to meet in person when we're lined up in front of a large, solid, object "Red Dawn" style. Sadly, it'll be more likely that we'll starve to death midway through the second Five Year plan.
Rather than debating with socialists we should merely acknowledge that without socialists there can be no socialism, and proceed accordingly.
Fuel up the helicopters.
Socialism is flawed, but its also a major part of every government that isn't completely tyrannical. It's become an essential part of the power play between different factions within relatively peaceful modern democracies. The political elite use socialism to increase their own power and wealth, but they also realize that too much socialism kills the very wealth generation they depend on. They've figured out how to ride that line very well and I think they'll continue to do so forever, or at least until we hit some new paradigm in what it means to be human.
We Koch / Reason libertarians shouldn't fear the rise of socialism among Democrats. At least, not when the Republicans have surrendered to a far more insidious ideology — alt-right white nationalism.
#VoteDemocratForOpenBorders
#ImmigrationAboveAll
I see you're on quite a roll today; nice job taking on Tulpa by the way.
This is of course nonsense because the current definition of 'alt-right white nationalist' is basically anyone to the right of Maduro.
But if my choice was indeed between a 'white nationalist' and a communist, I'm picking the white nationalist every single time.
Agree, and its annoying a lot of people will interpret that as you being racist.
I believe its correctly framed as saying "I am willing to tolerate a racist if the alternative will literally put us on the path towards bread lines"
Better we just exterminate the communists as an existential threat to humanity.
Yep. Every last one of them.
The lucky ones will get the bread lines. Others will get the gulag.
Haha. Yeah. White people are terrible.
"At the beginning of the year, a majority of Democratic and Democratic-leaning voters told Gallup they wanted a party that was more moderate, not more liberal. That hardly sounds like a recipe for a socialist takeover."
In Suderman's world, what's Medicare for All?
Is that "socialism"?
Is it "moderate"?
Is it "socialist" in both intent and deed and also "moderate" because it's widely supported among Democrat voters?
If Bernie Sanders wants socialist Medicare for All, and Biden just wants people to be able to buy in to Medicare--which achieves the same ends by the same means--then what's the real difference between them?
A pox on both their houses and anybody who pretends there's an important difference between them.
If Bernie Sanders wants socialist Medicare for All, and Biden just wants people to be able to buy in to Medicare–which achieves the same ends by the same means–then what’s the real difference between them?
I haven't heard Biden's plan but it suggests that in Biden's plan, there will be a direct cost to the consumer, whereas with Bernie's plan, it will be "free".
There will be an intermediate stage as private insurance markets are destroyed. However, it's important to remember that Medicare is largely funded by the taxpayers, Medicare only covers a fraction of the actual costs of care, and the private insurers are gouged to make up for the rest of it.
So, ultimately, within a few years, letting anyone buy into Medicare will 1) give poor people benefits that far exceed the costs they're incurring, 2) have a disproportionate negative impact on the cost of private insurance, and 3) will ultimately depend on the taxpayers to keep the system afloat, and 4) will rely on the government bureaucrats to set reimbursement rates and premium prices.
How is that different from a more socialist system, like Medicare for All, where the taxpayers keep the system afloat, prices are set by government bureaucrats, poorer people get benefits that far exceed what they pay for, etc?
There is no difference. It's the same thing. It's just the Biden's "Let's let people buy into Medicare" can pretend that the results will be completely unexpected, where Bernie's plan doesn't pretend that giving ownership of the healthcare system to the government wasn't the plan all along.
Maybe think of it this way: You already know that Medicare is a socialist program. Why wouldn't letting everyone buy into it also be a socialist program? And why would that be fundamentally different from plan that gives Medicare to All? Medicare people pay a piece of their costs, too. I don't see the fact that the government might set a premium higher for people under 65 as a significant distinction--not over time. In fact, Bernie's Medicare for All scheme would probably work the same way as Biden's at first. The transition to totally "free" care for everybody would probably phase in over time under Bernie's Medicare for All scheme, too.
Exactly. This was also the point of Obamacare. It's nothing but a runway to single-payer.
They couldn't/can't just say that of course, so instead they pretended they had an awesome plan to lower costs and expand coverage and give everyone what they want. Of course the intention was always to simply overstress the system, drive up costs, and anger political opponents.
Then when it all fails (as it was always designed to) they can blame the greedy insurance companies and evil conservatives for 'sabotaging' their otherwise perfect plan to help everyone. A complicit media helps tremendously here.
Next step then becomes 'well shucks, we tried our best but this system is just completely broken now... guess the only answer is a total government takeover!' as though that wasn't the intent all along.
Throw in a healthy dose of demagoguery and identity politics just for good measure (republicans want you to die! the healthcare system hurts POC most of all!) and here we are. Grand, isn't it?
You’re already seeing this in comment sections everywhere.
it’s important to remember that Medicare is largely funded by the taxpayers, Medicare only covers a fraction of the actual costs of care, and the private insurers are gouged to make up for the rest of it
That's not how it works at all. Medicare Part A (hospitals), B (doctors/serv) and D (pharm) are separately financed.
Part A is funded almost exclusively by the Ponzi part of the scheme (the HI tax on younger workers) but it pays FAR more to hospitals than it would pay if it were a private group. Those costs of care are mostly fixed costs - the costs of capital equipment, excess capacity, hospital staff, etc - but the way private markets deal with excess capacity is to drive it out via lower ROI. Hospital bed utilization in the US now is roughly 50% (rural) and 64% (urban). Equipment utilization is about the same. The US is massively 'overprovisioned' and that excess capacity is what jacks up the prices that hospitals charge. Essentially, hospitals are able to charge for the costs of having two beds and unused equipment for every night someone spends in hospital. No other industry is able to raise prices when they have that sort of excess capacity. Much less invest even more in capacity then. The medicare payments structure enables that sort of shit in healthcare. THAT - not 'underpayment' is how Medicare drives up costs for everyone else. If everyone was on Medicare, those costs would not increase much at all - because we already have excess capacity and too many underused machines and such. Even someone who loves rationing wouldn't see the point with 50-65% utilization. And when that 'trust fund' disappears, prices paid will go down with no impact on anyone outside the rent-seekers.
Part B and D are more 'traditional' looking market dynamics where marginal costs of care are also variable costs. Those are funded about 20% or so by beneficiary premiums and 80% by general revenue (prob half taxpayer and half debt). That is where there might be some validity to the notion that Medicare 'underpays' and thus transfers costs to the private sector. But even there, it ain't really true (x prob for GP). But too long to explain.
None of this is an argument for Medicare for All. It IS an argument that Medicare needs massive structural reform - and NOT for any of the usual bullshit ideological reasons because those reasons don't have jack to do with how the real world works.
Medicare only pays for a fraction of the cost of care.
Medicaid pays even a smaller fraction for the cost of care.
If you believe otherwise, you are wrong.
Because hospitals can't go after patients for the costs that Medicare and Medicaid incur and aren't reimbursed by government, that doesn't mean that hospitals don't lose money on every Medicare and Medicaid patient they treat--and it certainly does mean that they have to cover those losses by gouging private pay patients for the difference.
Here's an excellent chart showing you how woefully wrong you are.
https://www.aha.org/system/files/research/reports/tw/chartbook/2016/chart4-6.pdf
As that chart shows, private pay patients and insurance companies are routinely forced to pay about 150% of the cost of care--because Medicare and Medicaid only pay for a fraction of the cost of care. That's why HMOs and the like try to trap you to stay in provider networks where they have contracts that limit their cost exposure.
That percentage of the cost of care for Medicare and Medicaid patients that private pay patients have to cover went up as the Medicaid rolls expanded in the wake of ObamaCare. Why wouldn't they? If hospitals are losing money on every Medicaid patient, what do you think happens--they make it up in volume? The whole point of forcing younger people to buy insurance they didn't need by way of the ObamaCare mandate was to try to make up for the underpayment losses that insurance companies are gouged to make up for. The mandate failed miserably to achieve that.
Meanwhile, IF IF IF Medicare is opened up to everybody, why wouldn't just about everybody (except for stupid people) choose a Medicare plan that only has to pay for 85% of the cost of care--instead of a private plan that gets gouged to cover 150% of the cost of care?
Biden and Sanders are depending on you to not to be smart enough to understand basic concepts like this. Please disappoint them. The most basic aspects of what you think you know about healthcare are wrong--and I don't blame Suderman. I blame you. You're supposed to be able to think critically. Can you? When someone comes along and covers your face with how wrong you are, do you learn from it? That'll be interesting to see.
How's it feel to be so wrong? Doesn't it feel like shit? Good. That's the way being wrong is supposed to feel. It's supposed to discourage your from maintaining your wrongness.
FFS. THINK!
If a hospital costs $1 million/day to operate whether you come in as a patient or not, that is a FIXED COST. If all you get is a bandaid what is the 'cost of care'? Is it the $1 for the bandaid or $1million and one? If two patients come in that day for a bandaid - do you charge $1 million to the second if you charged $1 million to the first? How about a third (and last) patient that day who comes in for a triple-bypass on a preemie? Do they pay the entire fixed cost?
There is a TON of arbitrariness in how that hospital can allocate fixed costs across all the different 'care' that it provides. It is simply ludicrous to take their word that their 'cost of care' is determined in the same sort of way that a food truck selling high-volume burgers is.
Medicare - or any group that covers lots of people - should be far more interested in the actuarial stuff that drives capacity/utilization for the population THEY cover. X million people live in this region and they will have Y heart attacks and Z babies and # transplants which will require AB cardiologists and CF gerontologists and ABC beds. This stuff is quite predictable when the coverage group is large. And it is EXACTLY what govt should be doing re the people it CURRENTLY covers. But paying for that capacity is a fixed payment that is entirely separate from any individual 'care' transaction. The covering group takes the risk that their capacity decision is wrong - but they're taking that risk anyway by paying the damn bills.
There's a ton of ways to hive those capital/capacity issues off from transactional issues. But the US govt is the ONLY govt on this planet that refuses to do that for the people it covers. And THAT is why health care costs so fucking much here.
Think?
I worked hospital reimbursement in an acute care hospital in Los Angeles for over seven years. After that, I was the Quality Control analyst for a software company that did all the grouper, payer, billing, and reporting for all the largest hospitals and hospital chains in the country. I'm not claiming any special expertise on this, but I will claim some familiarity. I've thought about it a lot . . .
How much can the hospital in New York bill for this Medicaid patient? How much can they bill for that insurance patient? How much are they losing on Medicare patients? Are they breaking even? How many private pay patients do they need to offset the average losses of one Medicare patient (AKA "Case Mix")? I was the guy that made sure all these questions were answered correctly by our software for hospitals in all 50 states plus a number of U.S. territories.
But you don't need to know how to do any of that. All you need to do is just think.
As for facts, all you need to know is that Medicare and Medicaid only pay for a fraction of the cost of care, and providers have to gouge private insurance companies and private payers to make up for the losses. Adding more people onto the Medicaid and Medicare roles makes that worse. The more people you have shoplifting from a store, the more you have to charge people who pay for the product to break even. If you believe otherwise, you are wrong.
Here's a really interesting story about the CEO of the Mayo Clinic explaining why they have to start prioritizing private pay patients over Medicaid patients--in the wake of the expansion of Medicaid after ObamaCare. See if you can follow the facts:
"Mayo reported a sharp increase in the amount of unreimbursed costs related to Medicaid patients, from $321 million in 2012 to $548 million in 2016. The figures include its campuses in Arizona and Florida. Mayo nonetheless remained profitable in 2016, with income of $475 million."
http://www.startribune.com/mayo-to-pick-privately-insured-patients-amid-medicaid-pressures/416185134/
Get your head around those numbers.
The Mayo Clinic lost $548 million treating Medicaid patients in 2016, but they made a profit of $475 million.
Feel this fact in your bones.
Got it? Good.
-$548 million + $1.023 billion = $475 million.
How did they make up the difference? Where did that $1.023 billion come from?
We know they didn't get it from Medicare--because Medicare pays rates that are below the cost of care.
The answer is that the Mayo Clinic had to charge private insurers and private payers more than the cost of care to make up for their losses on Medicaid patients (and their losses on Medicare patients are the same).
You should read and get your head around that whole story.
Also understand that the primary concern of the central planners who set payment rates for Medicare and Medicaid at the Centers for Medicare and Medicaid Services (CMS) is not making sure that hospitals are being completely reimbursed for the costs of care. It's making sure Medicare and Medicaid beneficiaries get the care they need whether they can pay for it or not.
Your ideas don't comport with reality. Everything you seem to think you know about this is either irrelevant or wrong.
All you are arguing for is that Medicare/Medicaid need drastic reform because their payment structure is distorting everything. I AGREE.
The next step that you are taking - implying that Medicare/aid aren't paying ENOUGH is simply and flatly wrong (for most things - I agree that everything preventive is massive underpaid cuz we've structured everything short-term/annual rather than longer-term where preventive works).
And then you are combining that with tired old socialism memes to produce an even worse implication - that if we can say eliminate Medicare/aid then those currently covered by govt will magically pay more so that those not covered by govt can pay less. That's fucking insane. Those actually covered by govt (the poor, the high-utilizing elderly, the disabled) are not going to somehow become high-income folks 'paying their fair share'. They were charity cases (read - ENTIRELY UNREIMBURSED) BEFORE govt - and they would remain charity cases if govt went away.
All even Mayo is saying is - We don't do charity anymore. Every patient must be profitable by whatever means we choose to allocate costs. We expect to rent-seek even off of charity patients cuz our 'profits' (they are a non-profit) are only going to be used to increase capacity/grow not to endow a fund to provide care. And hey we're not even going to break out those 'unreimbursed' by the two radically different parts of even the Mayo system - the Rochester complex (which is the famed nationwide tertiary care facility that handles all the toughest stuff that specialists elsewhere can't figure out) and the 60+ other facilities they own in that region that do all the standard stuff for people living nearby.
We've cobbled together a CRAPPY system over the decades. Even Mayo is part of that crappiness and brokenness. And imo Mayo is world-class mgmt and should be the sort of folks to head up Medicare (or VA or both) and reform it.
"The next step that you are taking – implying that Medicare/aid aren’t paying ENOUGH is simply and flatly wrong"
If after all the facts you've been shown already haven't convinced you that both Medicare and Medicaid pay pay providers less than the cost of care, then why would anyone bother discussing this (or anything else) with you?
If you can't be persuaded by facts and logic, that doesn't make you smart, and the ability to ignore facts doesn't make you right either.
I'd point to all the hospitals that have closed since 2000 and point out that almost all of them are in poor urban and rural areas where there aren't enough private pay patients for providers to gouge to cover the losses hospitals suffer by treating Medicaid and Medicare patients:
"Health care officials are also nervously eyeing several other city hospitals bleeding red ink. Brooklyn's Brookdale Hospital Medical Center, which employs more than 3,600 people, lost more than $50 million in 2011. Wycoff Heights Medical Center lost $12.3 million.
Kenneth Raske, the president and CEO of the Greater New York Hospital Association, which keeps a tally of the closings, said the struggling hospitals tend to serve mostly people who have no insurance or those in the federal Medicaid or Medicare programs."
https://www.nbcnewyork.com/news/local/New-York-City-Hospitals-Closing-Health-Care-Changes-Industry-Consolidation-218582501.html
That's the third source I've used to show you that Medicare and Medicaid reimburse less than the cost of care. I could post a dozen more, but you don't care about facts--not if they contradict what you already "know", which, by the way, is the mark of an idiot.
I don't blame Suderman, either. It's not his fault that you're oblivious to facts, immune to logic, and completely uninformed on what may be the most fundamental aspect of the problems with our healthcare system. Maybe you should blame your parents, but maybe you should blame yourself.
"Medicare, Medicaid Reimbursement $76.8B Under Hospital Costs . . . Medicare and Medicaid reimbursement shortfall grew $8 billion from the previous year."
https://revcycleintelligence.com/news/medicare-medicaid-reimbursement-76.8b-under-hospital-costs
That's $76.8 billion that hospitals needed to overcharge non Medicare and Medicaid patients in 2017--just to break even.
Do you really imagine that all these different sources, the CEO of the Mayo Clinic, the AHA, et. al,. are all in a conspiracy to try to trick you into thinking that Medicare and Medicaid don't cover the actual costs of care?
Do you imagine that dozens of hospitals in poor areas, with local demographics that feature high concentrations of Medicare and Medicaid patients, closed their doors in an elaborate conspiracy to trick you into thinking that Medicare and Medicaid don't actually pay enough to cover the costs of care?
Because it seems more likely to me that if they had to close because there weren't enough privately insured patients in their area to gouge to make up for the difference.
The other explanation that seems more likely to me is that you're just way too proud of your uninformed opinion. And your opinion is sooooooooooo uninformed. You couldn't voice your uninformed opinion in any operating committee meeting in any hospital anywhere in America without being laughed out of the room. I've worked with hardcore, socialist leftists in the hospital industry who would laugh in your face for denying these facts. You make chat room creationists look smart.
You're wrong.
And that's okay. I've been wrong about things I thought I knew. I'll be wrong again. I hope to God people will tell me when I am so I'll stop making an ass of myself. Do you? The reason my posts are so long is usually because I'm hoping somebody that knows more about the topic than I do will show me where my reasoning is wrong.
Do you really imagine that all these different sources, the CEO of the Mayo Clinic, the AHA, et. al,. are all in a conspiracy to try to trick you into thinking that Medicare and Medicaid don’t cover the actual costs of care?
No. I am saying that they have a direct interest in increasing the amount of money that Medicare pays and will forever. And they have a direct interest in ensuring that the balance sheet 'stuff' (capacity/equipment/etc) they have been buying with their 'profits' (most hospitals are technically non-profit) generates a sufficient ROI so they can keep doing that. Mentally they are all in a 'growth'/volume mindset - and have been for decades - and they are expecting Medicare/aid to keep funding that growth and that way of doing business.
It is identical to the MIC mindset or the higher ed mindset. It is how cronyism works when it gets embedded into the very way those industries look at the world.
If govt didn't exist and those hospitals were to say - we need to raise prices on the poor, the fixed-income elderly, and the disabled, you would see the idiocy of what they are saying. If govt were merely an agent of those groups, the same. But give that govt agency a name and make it an entitlement and hey presto you have a money tree and can now charge the poor (and bill the govt) the same as the highest price the rich are willing to pay for it.
All that said - I really don't see why libertarians are aligning with conservatives on this issue - since conservatives in the US (unlike Europe) fall into only two groups on this - don't touch my Medicare entitlement and kick the poor brown people in the teeth. Neither of which are remotely libertarian.
Why do insurers let themselves be gouged like that? If there were a store where favored customers were served at a loss, and they expected you to make up the difference, would you shop there?
Insurers do what they can to protect themselves. For instance, this is why they charge you a different rate for "in-network" and "out of network". This is why you need to make sure you procedure is pre--approved--at the facility where you're having the procedure. This is why they're so careful to only approve things that "medically necessary".
This is why they fought so hard for the ObamaCare mandate--they need people to pay into the system who don't and probably shouldn't buy health insurance because they're unlikely to use it. This is why they've continued to raise their premiums to such high levels. This is why regulators have allowed them to keep raising their premiums. This is why private insurers have occasionally abandoned certain states altogether.
Their worst nightmare is that you get into a terrible car accident and are air lifted to the closest hospital, which happens to be a hospital outside of their network. At that point, you're admitted through the emergency room, and the guys in the business office at the hospital throw a little party. They can pretty much charge as much as they dare--without drawing a lawsuit.
Anyway, the insurers do what they can to defend themselves.
The interesting question to ask is what community hospitals do to protect themselves. One of the things they do is shut down if they're in an area with low rates of private insurance. One of the things they do is gouge the fuck out of private insurers every chance they get. And one of the things they do is abandon the profit motive. Last I checked, more than 70% of the community hospitals in this country are non-profit. They have no hope of making a profit, so they try to break even and stay open for political reasons--Medicaid patients vote, too!--and to keep the money flowing for the doctors and others who work there.
This is terrible, of course, because, as you know, contrary to what the progressives say, the profit motive keeps costs down like nothing else will. Maximizing profits is about maximizing the difference between revenue and costs. Because you competitors won't necessarily raise prices to meet yours, the best way to maximize profits is to minimize costs. Without the profit motive, that incentive goes away and bad things happen.
Anyway, if more people opt into Medicare under Biden's plan, it will exacerbate the problem. It will mean even more consumers go from getting gouged by way of private insurance to being the cause of the gouge by way of Medicare underpaying for services. You saw those round averages in my link above? Private pay patients can pay 150% of costs while Medicare pays as little as 85% of costs. That isn't a one-to-one ratio because older people use health insurance more frequently and for more expensive treatment. What happens when even more people are opting into Medicare?
https://www.youtube.com/watch?v=yFeWw2YFXlM
Ken you are not wrong and have a lot to say.
I would add that community hospitals, or medical practices, which no longer exist where there are big systems willing to buy them up, either close or merge.
Rural community hospitals can only exist if there is enough taxpayer money to supplement them.
As you know the supply and demand curves are inelastic.
The consumer has no price information and does not care. The end supplier doc or hospital worker does not either. The hospital just wants to keep afloat. The middleman government or private insurer operates at marginal gain or loss.
Many a doc has told me I don’t care. This is not what I signed up for. Many a patient just wants something they can afford.
So y’all tell me what you want. I do not know.
Making Medicare and Medicaid pay for the full cost of care is so expensive, the taxpayers would revolt. We've been trying to shore these programs up so we can push back the date when they fail entirely, but because they're the ultimate cause of the problem, the problem can't be solved without cutting them down and making them smaller. That ObamaCare expanded Medicaid is by far the most incompetent thing Obama ever did--but that was the whole point of ObamaCare. The purpose of ObamaCare was to expand the Medicaid roles--and protect the private insurance and provider industry from the consequences of expanding Medicaid. Everything else about Medicaid was incidental to that--including taxes on Cadillac healthcare plans and hospital investments in new technology.
Cutting Medicare is politically infeasible.
All of the well-intended solutions that don't involve slashing Medicaid are of little or no value.
For instance, what if insurance companies were forced to compete across state lines? Wouldn't that help?
Not really. How will making insurers compete across state lines to offer you a policy that needs to cover 150% of the cost of care change the fact that no matter where you are in the country, insurers are being gouged for an average of 150% of the costs of care because Medicare and Medicaid patients are under reimbursing the system?
What bout price transparency?
I suppose that's great, too, but I'm don't see how making people aware that they're being gouged to make up for the underpayment of Medicare and Medicaid is likely to change the fact that hospitals need to overcharge private pay patients just to break even.
Again, there is no solution that doesn't involve cutting Medicaid. And you might think it extremely difficult for Congress to get the will together to cut Medicaid--except that Paul Ryan's House passed a bill that would have cut more than $772 billion from Medicaid. Donald Trump personally twisted the arm of every senator that got in the way of passing that bill in the Senate because he wanted to sign it, but a handful of senators, including Rand Paul, opposed the bill--because of what it didn't do.
Again, take a look at the bill here:
https://www.cbo.gov/publication/52849
Peter Suderman vocally opposed that bill. Have you ever seen Peter Suderman argue for cutting Medicaid?
It really shouldn't be controversial or surprising to hear that a libertarian website thinks that a socialist redistribution of wealth program is the cause of the problem or that cutting it might be the solution. Isn't is surprising, though, if after all these years, we can't find a single instance on a libertarian capitalist website of Suderman blaming the socialist program for the problems associated with his area of expertise? What are the chances of that happening on a random walk?
I feel like Stephen in front of the Sanhedrin.
Your job was to keep an eye out for the messiah. You spotted him when he arrived, and then you had him crucified! They dragged him outside and stoned him to death for saying that.
The purpose of libertarian capitalism is to oppose authoritarian socialism. We had a chance to cut $772 billion from Medicaid, a socialist wealth redistribution program, to address the root cause of our healthcare problems--but when it came, we crucified it.
The insurance mandate was authoritarian. I'm glad it's gone, but it was not the cause of the problems in our health insurance markets. Anyone who opposed a bill to cut $772 billion from Medicaid--because of what it didn't do--has no business saying things like "Fuck you, cut spending". I don't remember Suderman ever claiming to be a libertarian or a capitalist, maybe he's just been introduced that way, but libertarian capitalists have no business opposing a bill that cuts $772 billion in spending on Medicaid because of what that bill doesn't do either.
"The mandate failed miserably to achieve that."
There never was an actual "mandate" since it was never enforced by way of the "penalty." It actuality, it was a "voluntary mandate." The Democrats never had the courage to put their political capital where their mouths are.
Wasn’t a mandate?
That’s odd, I’ve had to show proof of coverage when filing taxes the last few years, or pay a fine.
If you mean that nobody came to my door with a gun and forced me to purchase something I didn’t need, then I guess it all depends on what your definition of “mandate” is.
Which would destroy us even more than Obama's national debt. Medicare spends over 500 percent of receipts. We pay into SS for 40 to 50 years ( me 47) and when retiring we pay a premium payment for Medicare, a supplemental private health plan and a prescription plan. So if younger people pay the same the Medicare deficit will be much, much higher and what I wonder is how high the National Debt has to go before we start having runaway inflation. I actually thought that time was a while back.
I suspect the check on inflation is about a few things. One is productivity gains, which are moving along nicely. Another is that we have these trade agreements that keep goods flowing in from overseas and prices in check. The other is that because we're the prettiest horse in the glue factory, people in the other countries keep flooding into dollar denominated securities every time something goes wrong elsewhere in the world.
All of this has given us a false sense of security on spending. Inflation hasn't been in double digits since 1981? Have high interest rates been a concern for most consumers since the S&L crisis or circa 1991? People have forgotten what it's like, which is dangerous by itself. The purpose of fiscal conservatism isn't to make sure that the laws of economics come down hard on sinners.
We want people to avoid the consequences of their bad decisions by teaching them to avoid bad decisions. Wild animals learn from their mistakes. Surely, we're smarter than them, aren't we? Surely, we can persuade our fellow Americans that the consequences of their bad choices are likely to be worse than whatever problem they think they're solving. Nancy Pelosi said that to find out what's in ObamaCare, we had to pass it. Why?
Why can't we just point to the likely consequences of Medicare for All and Biden's "Public Option"--and avoid the whole catastrophe before we experience it?
We have no business “teaching them to avoid bad decisions”. As individuals, other people’s bad decisions should be of no concern to me. I realize that’s not the world we live in.
Trying to be “practical” with ideas of “social responsibility” dilutes individualism.
Not a direct cost, a subsidized one.
If it's voluntary you can still opt out.
The socialists may believe something incredibly stupid and destructive, but that puts them one up over most of their competitors within the Democratic party, who don't actually believe in anything coherent. And transforming the universities into indoctrination centers gives them an unending supply of activists to replace the ones who grow up and wise up.
Worse, tolerating groups like the Antifa when they were attacking the right allowed a Red Guard dynamic to set in; I think a lot of the less insane Democrats are actually scared to dissent from socialism at this point.
Exactly on one side you have dedicated socialists who believe and on the other unprincipled political opportunists who will just go with what will give them votes.
Democrats are done.
Question is, will Republicans and conservatives be able to form a strong enough resistance to creeping socialism.
Free shit versus no free shit.
I don't like the odds.
We are truly fucked. One party is outright socialist in everything but name, and the other wants to be socialist just without the name "socialist". Both parties what a blinkered strong man in charge of absolutely every detail of the economy and our personal lives.
Who would have thought importing a bunch of third worlders from socialist countries, combined with Soviet subversion of our universities, would result in socialism becoming popular. Really activates my almonds...
Also, leftism isn't liberalism.
Socialism was popular long before any of that happened. It was attractive to people who were already middle-age or even seniors when Hitler and Stalin were still rising to power. How do you think we got Social Security, agriculture subsidies, the income tax, etc.?
I'm seeing a lot of terms thrown around without definitions. Here are the definitions:
Ownership: The right to make choices about how, if, why, where, and when something is used and, especially, who get to use it.
Socialism: Public ownership of the means of production + the redistribution of wealth.
Capitalism: Private ownership and prices set by markets.
Authoritarian: Using the coercive power of government to force people to do things against their will.
Libertarian: Someone who believes that people should be free to make choices for themselves.
Market: People making choices.
Democracy: The belief that our elected representatives should make choices on our behalf.
Anyone who uses these terms in some other way is using them improperly at best. They may be using them improperly because they're ignorant or because they're dishonest.
If Bernie Sanders means something other than socialism when he uses the word, then he's using the word improperly at best. When Bernie Sanders says that he's against "authoritarianism", he's being deceptive. "Democracy" is NOT the opposite of authoritarianism. People can be and are forced to do things against their will by the government in a democracy. Democracy may be less authoritarian than "authoritarianism"--but "democracy" is always necessarily more authoritarian than "libertarianism".
In fact, "Democratic socialism" can only be fundamentally authoritarian from the perspective of a libertarian--someone who believe that individuals should be free to make choices for themselves.
This has been beaten to death, but Bernie Sanders is pushing for a kind of Fascism at its core.
No, Bernie's not a militaristic nationalist xenophobe, but in the economic realm, he is in fact advocating for fascism: A system where the means of production remains in private hands, but the results of production are organized and directed by the state towards national goals.
That's Bernie Sanders. The Science is Settled.
A system where the means of production remains in private hands, but the results of production are organized and directed by the state towards national goals.
^ Absolutely this. I've heard "Democratic Socialism" described as meaning essentially replacing all corporate boards with the Voters, which as you say, is better described as "Democratic Fascism," at least economically speaking.
And there will be no efficiency issues with having a direct democratic referendum on every business decision every corporation makes.
No no comrade. No need for a democratic referendum on every business decision. We just need state apparatchiks in these corporations to ensure the correct decisions are being made, for the good of the people of course.
Yeah, that's what representative democracy is all about--elitists making choices on our behalf. And that is why representative democracy should only be used where it's absolutely necessary to the operation of free society.
Our president should not be able to declare war without the consent of our representatives in Congress is one example of where representative democracy is necessary. Our president should not be able to bind the United States to treaties without the consent of our elected leaders is another example.
"No taxation without representation" was supposed to be the flip side of "He who pays the piper gets to call the tune". The obvious implication of "No taxation without representation" wasn't supposed to be that 49.9% of the American people are at the mercy of the 50.1%.
Representative democracy is a necessary evil at best--like compelling witness testimony in trials. Representative democracy should be restrained to within its proper purview. The Constitution does a pretty good job of doing that. Unfortunately, the American people haven't done a very good job of punishing politicians for ignoring the Constitution.
Democrats are directly using economic patriotism as they call others fascist.
Projection ain't just a river in Egypt.
Fascism is a D's idea of "moderate"
"Democracy: The belief that our elected representatives should make choices on our behalf."
Democracy is rule by the demos, the poor. The origin is Greek.
You fucking pretentious lowbrow dilettante troll.
I'm bad, yes. But correct.
I think what you're calling "socialism" is really communism -- the government running everything.
Modern socialism is the government deciding how much money you get to keep, then paying off various voting blocs with what they take.
It's all in how you sell it. Nobody's stupid enough to eat shit, but call it kopi luwak coffee and people will pay big bucks to drink shit. Bernie's a communist but he called himself a democratic socialist and now he's even backing off that and talking about "economic rights", but it's still the same shit.
But people will buy it. They scoffed at the idea that Social Security would somehow lead to socialism, that Medicare and Medicaid and food stamps and WIC and housing vouchers and all the rest of the Great Society entitlement programs would somehow lead to socialism. And they were right - all those entitlement programs didn't lead to socialism, they are socialism. The evil trick to selling this socialism was to call them "entitlements" - it's not charity, it's just the basic human needs that the world owes you by virtue of the fact that you exist.
And now here's Bernie expanding tenfold the amount of shit the world owes you and you're entitled to demand as your right and lots of people are nodding right along with him. Most of the other Dem candidates, for example. The world doesn't owe you shit, you goat-fucking old retard, and - in a just world - your proposal to steal everybody's shit and redistribute it as you see fit should get you dangled over a bridge by a short length of piano wire.
Tell us how you really feel about Socialism and comrade Bernie ... lol
I have a RIGHT to have the government force other people to pay for my basic needs. And even some of my wants. Haha
Pete is honorably (for the most part) struggling with the fact that Americans have ALWAYS embraced "white socialism"--a welfare state that caters to people who "work hard and play by the rules", as Tricky Bill Clinton put it back in the day.
Ronald Reagan recorded that hilarious "Medicare will destroy western civilization" when he was a semi-retired actor. When he was president, he "saved" both SS and Medicare, with a whopping tax increase.
When he first ran for president in 1976, he tried to tell farmers about the free market. They said "We don't give a damn about the free market. Tell us where you stand on parity."
"Well, I don't know what parity is," quoth Ronnie.
In 1986, trying to "save" the Senate, he bragged that his administration had spent more on agricultural welfare (he didn't call it that, of course) than all previous administrations combined!
We get it, you hate Reagan.
So, how did he define socialism?
But it's democratic socialism, see? The real socialism!
Yeah, they'll actually say that, or words to that effect.
Socialism is always democratic, since socialists simply imprison or kill enough opponents until they have majorities.
In claiming that "the generalized mood of American voters is more liberal ...", you are conflating social progressivism with economic progressivism.
Are we trending more liberal on social issues? Yes, clearly.
Are we trending more progressive on economic issues? Only among a very loud but tiny minority. The rest of the country understands that quacks like Sanders and Ocasio-Cortez are worth watching only for their entertainment value.
vote out incumbents.
>>it seems clear that a non-trivial portion of his supporters favors at least some components of the democratic socialist agenda.
you guys (Reason) keep putting this forward: "it seems clear ... portion of T's people" or like the other thread "majority wants socialism" or whatever, but you don't put any numbers behind the claims ...
To be fair, any numbers the "experts" came up with would probably be misleading at best or total BS at worst.
sure, i wouldn't believe them ... they still need a goal though, so i gave them "find concrete numbers for your baloney" ... snipe hunt
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Thing is the stuff he is talking about does not look like real socialism to me. Having higher taxes and more government programs is not socialism. It is just bigger government.
We already have big government he just wants to make it huge.
So he is a faux socialist. I wonder if he is just using it as a brand.
Until they get around to nationalizing industries. Or at least appointing political officers to large corporations, like in the Bill Elizabeth Warren recently floated.
Don’t kid yourself, given the chance, they would remake America into A new Soviet Union or Venezuela.
In the days socialists went after agriculture, manufacturing, resources. The failure of that was profound.
Now the targets and battlegrounds are Facebook, Amazon, Google, Uber, YouTube, big media, the control of information. The flow of goods and services. It is frightening.
To some extent it happens from both sides of the x axis. I tend to live on the other axis. Most people do not get know it exists.
What does this mean for individual autonomy and freedom? That is the the first principle to me. To tell me you want this or that it needs to push hard.
Sanders already wants to nationalize health care and education.
Warren would go further and nationalize social media.
We're doomed.
The worst part of socialism isnt even nationalization, it is price controls. This is why people like Sanders are dangerous.
Venezuela spent less GDP on Gov than we do.
Anything the elites of both/either party hates is probably very good for the regular guy. As for "a majority of voters"; the fact that the Bell curve shows us what the problem is doesn't give me much hope anything will change.
Socialism has become a religious faith, based on emotional responses not reason.
[…] about that.” In another Fox News interview the following month, Conway commented (accurately) that “Bernie Sanders’ ideas are terrible for America.” She has repeatedly […]
Well we know how accurate polls are. Right?
Typical Reason.
Conservatives get into an intramural fight and it gets covered by people who largely despise all of them, but clearly choose sides in the fight.
Leftists go at it and it's a topic for Suderman.
Voters want safety and security.
Democrats want economic security in the form of healthcare and college tuition. They want their white collar jobs protected. They want higher minimum wages.
Republicans want security against crime and illegal immigration. Immigrants being blamed for lower wages and crime.
On a daily basis, these two groups make largely the same decisions and live the same lives. They just have different opinions on the root cause of their troubles and what government should do about it.
Both agree that government should do something about it.
Romney called it..when 50% of the population does not pay federal taxes, why oh why would they care about the 50%, or the significant top 20%, emphasis on the top 5%- - that do?
If we get into another war in the middle east, the GOP is done and its gonna get socialist ugly in this country. John Bolton should be locked in a rubber room.
Romney's math is off.
only by 3 percent
And you’re celebrating, asswipe.
Bernie needs to go away. The conundrum is he is the sort of ideologue who never goes away.
At least future President Warren is clever enough to use the socialism tag against him by proclaiming herself a proud capitalist who wants capitalism to work better. Same as Bernie, but he's so precious he has to use the S-word and treat politics as an exercise in explaining to people why it's not so bad.
"Future President Warren". That's funny. You're funny.
Warren thinks she can run the banks and the high tech companies and big pharma better than the executives who are paid millions and have spent their whole careers in those industries. She's a megalomaniac.
Do you want 4 more years of Trump? Because this is how you get 4 more years of Trump.
So what? Bernie is winning the battle but will lose the war. Socialism is something that will never be accepted in this country because it requires ceding too much power to a strong central government. The election of President Trump was a rejection of a strong central government which is what Obama, Bush and Clinton were attempting to build. Obama took the push too far and the center of the country pushed back by electing someone who promised and has dismantled much of it by repealing regulations and reigning in agencies.
Dismantled? They're still spending 4 plus trillion every year. Nothing's been dismantled.
Elementary spoiler votes. George Wallace got electoral votes from 4 Dixiecrat states in 1968 on a ban abortion, bust hippies and Make Segregation Great Again. Frightened Republicans promptly incorporated those policies and the Solid South has been largely Republican ever since and unemployed communists became Dems. Those votes sent a message entrenched politicians could not ignore. LP votes have for the most part been undoing that damage since the ensuing election.
[…] gave a long-awaited speech about the meaning and import of his preferred ideological label, “democratic socialism.” Also last week, Sen. Elizabeth Warren (D–Mass.) began eclipsing Sanders in some […]
[…] gave a long-awaited speech about the meaning and import of his preferred ideological label, “democratic socialism.” Also last week, Sen. Elizabeth Warren (D–Mass.) began eclipsing Sanders in some […]
[…] gave a long-awaited speech about the meaning and import of his preferred ideological label, “democratic socialism.” Also last week, Sen. Elizabeth Warren (D–Mass.) began eclipsing Sanders in some polls, Joe […]
[…] gave a long-awaited speech about the meaning and import of his preferred ideological label, “democratic socialism.” Also last week, Sen. Elizabeth Warren (D–Mass.) began eclipsing Sanders in some […]
Hickenlooper (like Webb last time) is the only one who could beat Trump.
So of course he's polling at 0 percent.
RIght?
It really seems like they're destined to choose the craziest idiot they can find. Which works fine for me. I'd rather have Trump than even the "sanest" Democrat around nowadays.
I'm beginning to think of Biden as the Dems' safety school. If none of the shiny objects make it through the gauntlet, Joe is available. Bernie is pretty clearly old news. His fifteen minutes are over.
[…] Read Full Article » […]
What has this country come to... Ugh.