Republican Failures On Health Care Raise Calls For Single-Payer Health Plan

The failure of  the Republican attempt to repeal Obamacare is a tremendous defeat for Donald Trump, along with Paul Ryan, which may hinder their ability to pass other parts of the Republican agenda, such as rewriting the tax code. The inability of Republicans to come up with a reasonable solution for our health care problems highlights the inability to solve the problem by relying on the market, and has revived calls for a single-payer health care plan.

The Week has this argument for Why Democrats should push ‘Medicare for all’ now even before it the Republicans gave up on their plan:

The AHCA is a monstrous bill that would leave at least 24 million more people uninsured by 2026. But whether or not it fails, the Democrats shouldn’t sit idly by and wait for Republicans to slowly bleed ObamaCare to death by other means. They need a counter-offer, one that’s more compelling than the creaky status quo. They need a single-payer, Medicare for all plan. Here’s why.

The first reason is that single-payer is quite clearly the best universal health-care policy option for the United States. As Dr. Adam Gaffney explains, the U.S. model of multi-tiered health insurance has generally lousy and highly unequal outcomes, both here and in European countries with similar structures like the Netherlands. Complicated public-private hybrid systems mean much larger administrative costs, and the fact that markets are extraordinarily ill-suited to deliver health care means tons of difficult regulation.

Indeed, the distance in uninsured people between ObamaCare and single-payer is actually greater than that between ObamaCare and the Republican plan. Complicated, janky programs tend to let people fall through the cracks.

..The AHCA is extraordinarily unpopular because it takes coverage and subsidies away from people, and a majority believe that it should be the government’s responsibility to make sure everyone is covered. Fundamentally, Medicare is very popular, a fact only partially covered up by generations of red-baiting and duplicitous austerian propaganda. If Democrats had simply bulled ahead with a single payer-esque plan in 2009, instead of the complicated and heavily means-tested ObamaCare, they almost certainly would have done better than they actually did in the 2010 election.

And even for people who are skeptical of going full-bore all at once on single-payer, it still makes an excellent opening bid. Start with single-payer for all during the next bite at the health-care apple, and you could end up with a plan of combining Medicare and Medicaid, enrolling all people under 26 and over 55, and putting a Medicare buy-in on the ObamaCare exchanges. (That might begin chipping away at the employer-based system and be a somewhat more gradual route to single-payer.) Just witness the original opening bid for ObamaCare, which was far more generous before it got badly whittled down by conservative Democrats…

It also makes an excellent organizing signpost. Medicare for all is simple, easy to understand, and hard to argue against or distort. Most people know someone on Medicare who can testify to the generally good care, or who is counting the days until they can enroll and have the peace of mind that comes with quality coverage. Fabricated agitprop like the mythical ObamaCare “death panels” will be a much harder sell.

Erica Etelson is one of those writing op-eds promoting a single-payer plan, and taking the Democratic Party to task for failing to do so:

With Trumpcare dead on arrival in Congress, Democrats have an opening to propose what they should have pushed for in the first place: single-payer health care for all. Fifty-eight percent of Americans, including 41 percent of Republicans, favor a federally funded health care system that provides universal coverage. Only 48 percent want to keep Obamacare as is.

Though Democrats are loathe to admit it, Obamacare is far from perfect. Some people pay higher premiums and out-of-pocket costs than they can afford. In some areas of the country, choices of doctors are limited. Compared to nations with single-payer systems, health outcomes are poor. And a small but vocal minority of Americans are troubled by Obamacare’s individual mandate which, they believe, infringes on their liberty…

Bernie Sanders ran with remarkable success on a Medicare for All proposal that generated enormous excitement among the progressive wing of the party and sent shivers down the spine of the Democratic corporate establishment. Hillary Clinton, a one-time champion of single-payer, pounced on Sanders with alarmist, counterfactual claims that Sanders’ proposal would increase costs and make people worse off.

While the GOP is still cringing over the humiliating defeat of its seven-year promise to repeal Obamacare, Democrats should kick them while they’re down by introducing single-payer legislation. Even Trump-collaborator, Sen. Joe Manchin, D-WV, is starting to wise up, thanks to his constituents; at a recent town meeting, Manchin praised Canada’s health care system and said he was taking a look at single-payer as an alternative to Obamacare…

We watched the Democratic National Committee undercut Sanders’ candidacy. And we’ve watched the Democrats disappear the single-payer option by refusing to support Rep. John Conyers’, D-MI, single-payer bill (HR 676). Enough.

The Democrats’ lackluster opposition to Trumpism does not match the fierce and relentless resistance of their base. They can and must stop doubling down on the centrist “pragmatism” that has alienated growing numbers of voters and start acting like a party more committed to the health and well-being of the 99 percent than protecting the power and profits of oligarchs.

This populist moment in American politics is the Democrats’ to seize. With a strong majority supporting single payer, the Democrat have a golden opportunity to give their dwindling base a reason to come home. As Trump said moments after conceding defeat, “Here’s the good news: Health care is now totally the property of the Democrats.” Good news indeed, if the Democrats know what to make of it.

Donald Trump now has the opportunity to work with Democrats, and any Republicans who are willing, to fulfill his campaign promises of giving us a great health care plan which will cover everybody. Of course he will not do so, and will probably continue to work to undermine the Affordable Care Act.

Obamacare Repeal Fails

Donald Trump and Paul Ryan are both losers.

In a spectacular political defeat for Donald Trump and Paul Ryan, the legislation to repeal Obamacare has been pulled as it was clear it was going down to defeat. It was far easier for Republicans to vote to repeal the Affordable Care Act over fifty times in the past when they knew it would be vetoed if it made it through both houses of Congress than it is now that they would be held accountable for a replacement. The New York Times reports:

House Republican leaders, facing a revolt among conservatives and moderates in their ranks, pulled legislation to repeal the Affordable Care Act from consideration on the House floor Friday in a major defeat for President Trump on the first legislative showdown of his presidency.

“We’re going to be living with Obamacare for the foreseeable future,” the House speaker, Paul D. Ryan, conceded.

The failure of the Republicans’ three-month blitz to repeal President Barack Obama’s signature domestic achievement exposed deep divisions in the Republican Party that the election of a Republican president could not mask. It cast a long shadow over the ambitious agenda that Mr. Trump and Republican leaders had promised to enact once their party assumed power at both ends of Pennsylvania Avenue.

Paul Ryan apparently was  surprised to find that it is complicated to sell Americans on health care plan which will cost them more and provide less.

Trump May Be Terrible, But Few Regret Not Voting For Hillary

Donald Trump has given us numerous reasons to dislike and distrust him. His policies, such as the Republican health care plan, have turned out to be horrible for the bulk of his voters. I have seen multiple media and blog stories suggesting that many Trump voters regret voting for him. A new poll suggests that is not the case. An article in The Washington Post discusses a recent poll to determine if Trump voters regret their votes, and how they wish they had voted:

Our Mood of the Nation Poll from Penn State’s McCourtney Institute of Democracy provides answers. Conducted by YouGov, the poll tracks the mood of the public through traditional survey questions and numerous open-ended questions that allow citizens to express themselves in their own words. The poll’s methodology is described here.

Our Feb. 23-27 poll asked a nationally representative sample of 1,000 Americans to report on how they cast their vote in November. The results of these reports closely align with other national polls, with Hillary Clinton voters comprising 49 percent of the sample, Trump voters 46 percent, with 3 percent and 2 percent for minor-party candidates Gary Johnson and Jill Stein, respectively.

Who would vote differently?

On the next screen, we asked everyone, “Suppose you could go back in time and vote again in the November election. What would you do?”

Respondents were presented with the same choices — Trump, Clinton, Stein, Johnson, someone else, or not vote at all. Of the 339 poll participants who originally voted for Trump, only 12 (3½ percent) said they would do something different.

It will be interesting to see if this changes over time. It is one thing for Trump to propose policies which harm his base. It is a different matter for these voters to realize it. Perhaps this will change if more of Trump’s policies are enacted.

I find it interesting that not only do few Trump voters regret their votes, but that of the twelve people who say they would change their votes, only three said they would vote for Clinton while seven would vote for Jill Stein or Gary Johnson.

I wish we had similar data on those who voted for Stein or Johnson. Not surprisingly, I have seen many comments from Clinton supporters on social media suggesting that Stein and Johnson voters should regret their votes. However, while a few might exist, I have seen no evidence of any Stein or Johnson voters wishing they had for Clinton.

It is one thing to oppose Trump’s policies. It is a different matter to think that we would have been better off if a corrupt, socially conservative,  warmonger such as Clinton had won. There is at least some consolation following Trump’s election in seeing how quickly we have developed strong opposition to his policies. If Clinton had won, those on the left who are actively opposing Trump would be finding ways to excuse and defend Clinton’s actions and policies, as we frequently saw during the campaign. Those who say there has been no evidence of wrong doing by Clinton, despite all the evidence raised of corrupt and dishonest behavior on her part, are objecting to the corruption seen from Trump, making it far less such corruption would become institutionalized as it would have been if Clinton had been elected.

While large portions of the pro-Democratic media have shown an extraordinary amount of hypocrisy in accepting Clinton’s actions, there has been opposition to Trump from both the left and segments of the right. For example, even the pro-Republican Wall Street Journal is running an op-ed about Trump’s lack of credibility. The article both gave examples of the frequent falsehoods from Trump and noted the consequences:

If President Trump announces that North Korea launched a missile that landed within 100 miles of Hawaii, would most Americans believe him? Would the rest of the world? We’re not sure, which speaks to the damage that Mr. Trump is doing to his Presidency with his seemingly endless stream of exaggerations, evidence-free accusations, implausible denials and other falsehoods…

All of this continues the pattern from the campaign that Mr. Trump is his own worst political enemy. He survived his many false claims as a candidate because his core supporters treated it as mere hyperbole and his opponent was untrustworthy Hillary Clinton. But now he’s President, and he needs support beyond the Breitbart cheering section that will excuse anything. As he is learning with the health-care bill, Mr. Trump needs partners in his own party to pass his agenda. He also needs friends abroad who are willing to trust him when he asks for support, not least in a crisis.

This week should be dominated by the smooth political sailing for Mr. Trump’s Supreme Court nominee and the progress of health-care reform on Capitol Hill. These are historic events, and success will show he can deliver on his promises. But instead the week has been dominated by the news that he was repudiated by his own FBI director.

Two months into his Presidency, Gallup has Mr. Trump’s approval rating at 39%. No doubt Mr. Trump considers that fake news, but if he doesn’t show more respect for the truth most Americans may conclude he’s a fake President.

Assuming we survive his presidency, there are also long term political advantages to having Trump in the White House destroying the Republicans, as opposed to seeing Clinton destroy the Democratic brand. Getting rid of the Clintons gives the Democrats a chance to reform the party–which they may or may not take advantage of. If Clinton was elected, we would probably see a continuation of the trend for Democrats to lose in Congressional and state governments, with opposition to Clinton likely to give Republicans a super majority in the Senate and potentially control of enough state governments to enable them to rewrite the Constitution. Having Trump in the White House, as terrible as that is, at least means that the Democrats not only have a real shot at taking control of the House in 2018, but Stuart Rothenburg is writing today that Republican “gains probably won’t be anywhere near what they might have been with President Hillary Clinton in the Oval Office.”

Public Corruption Prosecutor Hired To Investigate Trump

The Wall Street Journal reports that New York’s attorney general has hired a top public corruption prosecutor to go after Donald Trump:

New York state’s attorney general, to date one of the most vocal antagonists of President Donald Trump, is preparing to escalate his office’s litigation against the president’s administration.

Democrat Eric Schneiderman has hired one of the top public-corruption prosecutors under former Manhattan U.S. Attorney Preet Bharara to focus specifically on issues involving the Trump administration. Howard Master, who prosecuted the Manhattan U.S. attorney’s case against longtime New York state Assembly Speaker Sheldon Silver , is expected to work on both continuing and new White House-related matters for the attorney general, as well as on high-level public-corruption cases.

The hiring of Mr. Master, whose title will be senior enforcement counsel, signals Mr. Schneiderman’s continued intent to take on the Republican president…

Since Mr. Trump took office, Mr. Schneiderman has been one of a group of Democratic attorneys general who have directed both legal challenges and critical rhetoric toward the president on matters including his executive orders on immigration and refugees, climate change and threats to deport millions of illegal immigrants, among other issues.

Last week, Mr. Schneiderman’s office joined Washington state’s lawsuit against the Trump administration’s revised immigration order. “The Trump administration’s continued intent to discriminate against Muslims is clear,” Mr. Schneiderman said at the time, “and it undermines New York’s families, institutions and economy.”

In addition to challenging White House policies in court, Mr. Schneiderman’s office is expected to explore whether it has any standing to pursue cases that hinge on the Constitution’s emoluments clause, according to people familiar with the matter. That provision prohibits federal officeholders from accepting payments from foreign governments…

State attorneys general have wide berth to challenge the legality of federal policies and laws that impact their states and citizens. In the lawsuit against the revised immigration executive order, for example, the complaint alleges that the policy harms New York’s health-care institutions, its tourism industry and its colleges and universities’ ability to recruit international students.

The New York attorney general also has broad powers in prosecuting financial fraud through the Martin Act, a state law that has more lenient requirements than on the federal level.

In addition, James Comey has verified in Congressional testimony today that the FBI is investigating alleged Russian interference in the election, and whether there was any collusion with the Trump campaign. So far, there has been no evidence released of collusion between Trump and Russia. Comey also stated that there is no evidence to support Trump’s claim that Barack Obama wire tapped Trump Tower.

Jake Tapper On Holding Trump Accountable For His Dishonesty

Jake Tapper’s appearance on Bill Maher provided some hope about the future of media coverage in challenging government, but the interview also got back to partisan double standards. The Hill summarized some of the good points (with full video above):

CNN’s Jake Tapper on Friday tore into President Trump’s claims of news media bias, saying “there’s no bias when it comes to facts and there’s no bias when it comes to decency.”

“I’ve never really seen this level of falsehood,” Tapper said on HBO’s “Real Time with Bill Maher.”

“Just quantitatively. It’s not just, ‘If  you like your doctor you can keep your doctor,’ it’s conspiracy theories based on nothing that have members of his own party distancing themselves from him.”

Maher noted that Tapper “sounds different” lately in adopting a more critical style in “speaking truth to crazy.”

“Politicians lie. It wasn’t invented on January 20,” Tapper said, but Trump is trying to “discredit the entire fourth estate, the entire media, we’re all fake news except for ‘Fox And Friends.’ ”

“The truth of the matter is that there’s no bias when it comes to facts and there’s no bias when it comes to decency,” Tapper added. “It is empirically indecent to make fun of the disabled. You don’t have to be a Democrat or a Republican or Independent or socialist or libertarian. That is just indecent. My children know better than that.”

Having the media point out when Trump is lying is far better than the common practice of the media reporting what both side say as if they are equally valid. Trump lies quite frequently in an administration which has become known for its use of alternative facts, and this should be pointed out. The news media provides an important service when it points out when politicians are lying.

While I applaud Tapper for trying to hold Trump accountable, he did drop the ball when Bill Maher reverted to partisanship in complaining about the coverage of Hillary Clinton’s scandals. Clinton violated email policies established to promote transparency in government as documented in the State Department Inspector General report, and then went on to repeatedly lie about the situation. This included her lies about the initial FBI report.  Clinton’s statement that, “Director Comey said my answers were truthful” was the first lie listed by Glenn Kessler (listed in no particular order) in his listing of The biggest Pinocchios of 2016. She also grossly violated the ethics agreement she entered into before being confirmed as Secretary of State.

Candidates of both parties should be held accountable for their lying.

Clinton Supporter With CIA Background Says No Collusion Between Trump And Putin

There is no question that Russia has attempted to influence elections in other countries, just as the United States has. There is also no question that both Vladimir Putin and Donald Trump have views which are in opposition to liberal democratic ideas. The degree of Trump’s business involvement with Russia is unknown, partially due to Trump refusing to release his tax returns. Claims from Clinton supporters, claims that Russia is responsible for Clinton losing the election are debatable, and there is zero evidence of any conspiracy between Russia and Trump to influence the election. A former acting CIA director, who did support Hillary Clinton, has joined those who say there was no collusion between Russia and Trump. NBC News reports, which has often been quite favorable to Clinton, reports:

Former Acting CIA Director Michael Morell, who endorsed Hillary Clinton and called Donald Trump a dupe of Russia, cast doubt Wednesday night on allegations that members of the Trump campaign colluded with Russia.

Morell, who was in line to become CIA director if Clinton won, said he had seen no evidence that Trump associates cooperated with Russians. He also raised questions about the dossier written by a former British intelligence officer, which alleged a conspiracy between the Trump campaign and Russia.

His comments were in sharp contrast to those of many Clinton partisans — such as former communications director Jennifer Palmieri — who have stated publicly they believe the Trump campaign cooperated with Russia’s efforts to interfere in the election against Clinton.

Morell said he had learned that the former officer, Christopher Steele, paid his key Russian sources, and interviewed them through intermediaries.

“On the question of the Trump campaign conspiring with the Russians here, there is smoke, but there is no fire, at all,” Morell said at an event sponsored by the Cipher Brief, an intelligence web site.

“There’s no little campfire, there’s no little candle, there’s no spark. And there’s a lot of people looking for it.”

While Russian hacking to release DNC email would be objectionable, it should also be kept in mind that there has been no evidence that any of the released information about Clinton and the DNC via Wikileaks was inaccurate. If this information did harm Clinton in the election, this ultimately would indicate that it was a mistake for the DNC to nominate a candidate as flawed as Clinton, or for the DNC to violate their own rules to rig the nomination for her.

Rachel Maddow Trolls Twitter With Virtual Non-Story On Trump Tax Returns

Rachel Maddow had Twitter excited yesterday evening when she tweeted: “BREAKING: We’ve got Trump tax returns. Tonight, 9pm ET. MSNBC. (Seriously)” I was immediately suspicious as to whether she really had anything. After all, MSNBC pretends to be a news channel. If they really had a major scoop, they would have announced it at the time on whatever show was on. Instead they used this to build excitement for Maddow’s show, and then waited until after the first break to show what they had.

It turned out that she had virtually nothing. All she had was two pages from Trump’ 2005 tax return which showed that he reported an income of $150 million and pain $38 million in federal income taxes. If anything this helps Trump, debunking claims from Hillary Clinton that Trump has “paid nothing in federal taxes.” There was certainly nothing here linking him to Russia. The little information released was so favorable to Trump that some are speculating that Trump was behind the “leak” of these two pages.

We did learn that Trump has taken legal deductions to legally minimize his taxes. Shocking. I do that too (even if not on the level which Trump is able to). He has also supported elimination of the alternate minimum tax. A wealthy Republican wanting to change the tax laws to reduce taxes on the wealthy is hardly a scoop.

I might say that Maddow has jumped the shark here, but I already thought she did this with her fallacious claims blaming Clinton’s loss on third party candidates rather than on Clinton being a terrible candidate who ran a horrible campaign, and her fear mongering on Russia which has reduced her to the level of a liberal Glenn Beck. Once a journalist loses their credibility as Maddow has, this usually cannot be regained, making last night’s fiasco nothing more than confirmation of where Maddow stands.

Donald Trump’s relationship with Russia remains an open question. There have certainly been some items to raise questions, such as the incidents involving Jeff Sessions and Mike Flynn. It does appear that many who have spoken with the Russian ambassador, including advisers to Clinton as well as Trump, have been Retconned into forgetting the meeting.

Thomas Wood has put together an impressive “Russiagate Timeline.” There is certainly enough smoke to demand an investigation, including a review of Trump’s tax returns. However, despite claims from Clinton supporters, there is zero evidence of the key question of whether there was any coordination between Trump and Russia to influence the election.

How Donald Trump Has Hurt American Democracy, And How The ACLU Plans To Fight Back

Brian Klaas, a fellow in comparative politics at the London School of Economics, and author of The Despot’s Accomplice: How the West is Aiding and Abetting the Decline of Democracy, has written about five ways in which President Trump has already hurt American democracy — in just 50 days These include Trump’s attacks on the integrity of voting, the integrity of his own election, flouting ethics guidelines without consequence, attacks on the independent judiciary, causing tens of millions of Americans to further lose faith in basic institutions of American government, and his attacks on the free press. More on the final point:

Trump has attacked a cornerstone of every democracy: the free press. He has called legitimate media organizations “fake news” no fewer than 22 times on Twitter in the first 50 days — and many more times in speeches. Worse, Trump called the press the “enemy of the American People,” language that echoes Mao and Stalin rather than Ronald Reagan or John F. Kennedy.

Trump only views the press as a legitimate player in American democracy insofar as it is willing to affirm his narrative. To Trump, negative polls are fake. Unfortunately, his attacks are working. A recent Quinnipiac poll showed that 81 percent of Republicans agree that the media is “the enemy of the American people.” Eighty-six percent of Republicans trust Trump to tell the truth rather than the media (up from 78 percent just two weeks earlier). Throughout history, the blurring of the line between fact and fiction has been a critical precursor to the breakdown of democracy and the creeping advance of authoritarianism.

Klaas concluded:

The Constitution and checks and balances are not magical guardians. Documents don’t save democracy — people do. American democratic institutions are only as strong as those who fight for them in times of duress. This is one of those times, and this is just the beginning. It will be a long fight. To win it, Democrats and Republicans must set aside policy divides and unite in the defense of democracy.

The American Civil Liberties Union is preparing to engage in this defense of democracy, including learning from tools used by Bernie Sanders’ campaign. Reuters reports:

The American Civil Liberties Union is launching what it bills as the first grassroots mobilization effort in its nearly 100-year history, as it seeks to harness a surge of energy among left-leaning activists since the November election of Republican Donald Trump as U.S. president.

The campaign, known as PeoplePower, kicks off on Saturday with a town hall-style event in Miami featuring “resistance training” that will be streamed live at more than 2,300 local gatherings nationwide.

It will focus on free speech, reproductive rights and immigration and include presentations from legal experts, ACLU Executive Director Anthony Romero and “Top Chef” television star Padma Lakshmi.

Membership in the civil rights organization, which was founded in 1920, has tripled to more than 1 million since Trump’s election, the group says…

Suggested tactics, like the use of text messages as a mass mobilization tool, will mirror some of those employed by the insurgent presidential campaign of U.S. Senator Bernie Sanders, who mounted a surprisingly robust challenge to Hillary Clinton for the Democratic nomination.

“It’s completely unprecedented,” Romero said of the response since Trump’s victory. “People are wide awake right now and have been since the night of the election.”

Three Reports Demonstrate How It Was A Horrible Mistake For Democrats To Nominate Hillary Clinton

Since Hillary Clinton’s loss to Donald Trump, many Clinton supporters and partisan Democrats have blamed her loss on sexism, Russia, James Comey, and even Barack Obama. They repeatedly fail to acknowledge that the real problem was that Hillary Clinton was a terrible candidate who ran a terrible campaign. Of course the exact same thing could be said about Donald Trump, but when two terrible candidates are running, only one can lose, and Clinton was even more out of touch than Trump. With many Democrats failing to acknowledge why they have lost badly in 2010, 2014, and now 2016, and some even speaking of nominating Clinton again in 2020, it is important for Democrats to face reality. Three recent studies shed some light on the election.

While perhaps not the most consequential, the most interesting was an experiment to look at sexism performed by Maria Guadalupe, an associate professor of economics and political science, and Joe Salvatore, “a Steinhardt clinical associate professor of educational theatre who specializes in ethnodrama—a method of adapting interviews, field notes, journal entries, and other print and media artifacts into a script to be performed as a play.”

After watching the second televised debate between Donald Trump and Hillary Clinton in October 2016—a battle between the first female candidate nominated by a major party and an opponent who’d just been caught on tape bragging about sexually assaulting women—Maria Guadalupe, an associate professor of economics and political science at INSEAD, had an idea. Millions had tuned in to watch a man face off against a woman for the first set of co-ed presidential debates in American history. But how would their perceptions change, she wondered, if the genders of the candidates were switched? She pictured an actress playing Trump, replicating his words, gestures, body language, and tone verbatim, while an actor took on Clinton’s role in the same way. What would the experiment reveal about male and female communication styles, and the differing standards by which we unconsciously judge them?

…Salvatore says he and Guadalupe began the project assuming that the gender inversion would confirm what they’d each suspected watching the real-life debates: that Trump’s aggression—his tendency to interrupt and attack—would never be tolerated in a woman, and that Clinton’s competence and preparedness would seem even more convincing coming from a man.

While Salvatore and Guadalupe were surprised at the results, I was not. Audiences did not like the character portraying Hillary Clinton, even when played by a man. The entire argument based upon sexism, with Clinton supporters finding absurd ways to blame any disagreement with Clinton on sexism, has always been absurd.  This is especially true on the left, where many opponents of Clinton had initially backed Elizabeth Warren, and some wound up voting for Jill Stein. Those on the left who opposed Hillary Clinton also object to Bill Clinton and other DLC Democrats for similar reasons, regardless of gender. For many, the choice of a running mate as conservative as Tim Kaine was the last straw. There are many reasons to oppose Clinton based both on her policy positions and her gross ethical misconduct in using her position to exchange influence for wealth which have nothing to do with gender.

Wesleyan Media Project study elaborates on what I have discussed previously on how Clinton ran a poor campaign, including in states such as Michigan which cost her the election. They noted that Clinton’s loss came from states in which she did not advertise until the last week. When I did start seeing ads for Clinton in Michigan, I questioned the judgement of her campaign. While Trump was advertising with promises (regardless of whether he could keep them) of creating more jobs and a brighter future, Clinton’s ads were based upon personal attacks (even if valid) against Donald Trump. The Wesleyan Media Project study showed that  “Clinton’s message was devoid of policy discussions in a way not seen in the previous four presidential contests.” They found that this strategy may have backfired badly.

Throughout the campaign, Clinton gave little reason to vote for her beyond her gender and it being her turn. Her own negatives, both on her record and her character, despite the denials of partisan Democrats, where on a level comparable to those of Donald Trump. It is no surprise that third party candidates Jill Stein and Gary Johnson did three times as well against Clinton and Trump than they did against Barack Obama and Mitt Romney four years previously.

Finally, Huffington Post ran yet another article making a case that the letter from James Comey cost Clinton the election. Many factors were involved in the loss, and it is simplistic to blame it on a single factor, but to blame it on Comey is actually an admission that it was a mistake to nominate Clinton.  There would have not been a criminal investigation of Hillary Clinton if Clinton had not violated the rules regarding handling email, as documented in the State Department Inspector General report, and then go on to repeatedly lie about the situation. This included her lies about the initial FBI report.  Clinton’s statement that, “Director Comey said my answers were truthful” was the first lie listed by Glenn Kessler (listed in no particular order) in his listing of The biggest Pinocchios of 2016. Hillary Clinton’s frequent lies during the campaign negated any advantage she might have had over Donald Trump, who has also shown very little regard for facts or reality.

I argued before the nomination that it would be a mistake for Democrats to nominate Clinton in light of the email and Foundation scandals. Beyond the details of these scandals, this emphasized Clinton’s dishonesty. An argument might be made that the coverage of Clinton’s scandals distracted from discussion of the issues, except for the fact that Clinton’s own campaign avoided discussion of the issues.

The lesson here is that it was a mistake for the Democrats to nominate a candidate who acted improperly in her last major government position, including grossly violating the ethics agreement she entered into before being confirmed as Secretary of State, and was already distrusted by voters before the nomination.

Democrats were lucky to come as close as they did in the 2016 election with a candidate as weak as Clinton, and would have probably lost by a far greater margin if not for the many problems with Donald Trump. Running Republican-lite candidates have also cost them control of Congress and many state governments in the 2010 and 2014 elections. Democrats were in a strong position during the Bush years, but squandered this by moving as far right as the Republicans of circa 2002 on far too many issues, and engaging in exactly the same types of unethical behavior as they have attacked Republicans over. Democrats had an alternative in Bernie Sanders in 2016 who could have both motivated voters to turn out for him, and brought in the votes of many independent voters. By rigging the system for a more conservative candidate such as Clinton, and ignoring her major ethical failings, very likely cost Democrats both the White House and control of the Senate.

Discussing Obamacare Replacement With A Republican Congressman

House Republicans have finally released their plan to replace Obamacare. I have a lot of concerns about the plan, such as whether the tax credits will be sufficient for low income families to afford health insurance, and their attack on Planned Parenthood.

I am going to wait until I have a chance to look at the details of the plan to discuss it in depth, but for other reasons I have found it a good day to blog about health care. Hours prior to the release of the plan, I met with my conservative Republican Congressman, Bill Huizenga, along with a few colleagues, to discuss health care. I figured it would be futile to change the mindset of a conservative Republican, but when I received the invitation I also thought I should make the attempt to try to explain how health care really works. After all, there is zero chance of changing anyone’s mind if no attempt is made to persuade them. I was also appreciative that he was willing to meet with a group which strongly disagreed with him on the issue, while many Republicans around the country are reportedly hiding from their constituents.

The first time I spoke today I made a point of explaining how I am self-employed and have purchased health care on the individual market for my entire life. Therefore I could definitely state that high premiums and high out of pocket expenses, often cited as a failing of the Affordable Care Act by Republican, have always been a characteristic of the individual market–and are not something created by Obamacare.

Discussion got bogged down for quite a while over philosophical issues, especially when someone referred to health care as a right. Congressman Huizenga disagreed. While I managed to get out most of what I wanted to say today, in a conversation with multiple people present, sometimes the topic changed before I got a chance to speak. I didn’t get a chance until after the meeting while speaking to a colleague that I can understand a Republican’s position in not seeing health care as a Constitutional right in the same way as civil liberties specifically expressed in the First Amendment. After all, the Founding Fathers would have never conceived of health care being as expansive, and expensive, as it is now. However, regardless of whether you want to call it a right, access to affordable health care is both highly desirable, and something which is expected in a modern, advanced, industrialized society such as the United States. We should do it regardless of whether you want to label it a right.

The limited nature of assured coverage in the United States, compared to the rest of the world, was an underlying thought in many of our comments. It did come up that 1) the sick can show up to the Emergency Room and will not be turned away and 2) a significant portion of the Medicare population consists of the disabled. In typical Republican dodging of the issue, the Congressman at one point tried to claim that this does provide some form of basic health care as people can go to the Emergency Room. I pointed out that it is one thing to receive coverage in the Emergency Room, but this does not mean that people will receive necessary follow up medical care, especially for the types of chronic medical conditions I typically treat, such as diabetes, heart failure, and emphysema. Initial stabilization in an Emergency Room is both costly and not adequate health care. Plus an Emergency Room physician present pointed out that being seen does not mean patients do not receive large bills, which could be well beyond their ability to pay.

Congressman Huizenga responded that the disabled can receive coverage on Medicare, but I pointed out that people with chronic medical problems are not necessarily disabled, especially if they receive adequate medical treatment. Someone with diabetes, for example, can live and work for many years with the condition. However, without adequate care, twenty years down the road they are far more likely to develop problems such as heart attacks, strokes, and renal failure.

The Congressman’s philosophy on limited government (which, like most Republicans, is terribly selective, ignoring everything from infringements on reproductive rights to today’s revised anti-Muslim travel ban), also influenced his responses. Before his arrival I had discussed with others how market solutions have not worked well, with insurance companies having developed a business strategy based upon collecting premiums and then finding ways to deny care. Congressman Huizenga brought up irrelevant matters such as restrictions on choice present in Canada and other countries which Americans might not tolerate. The typical Republican scare stories. My response was simply that we do not have to adopt the restrictions which he mentioned, regardless of what other countries have done. One point I did not manage to get in was that in the United States, private insurance plans are often far more restrictive on the choices which patients and physicians can make than the government Medicare program is.

The physicians present generally saw Obamacare as an improvement over the previous system, but not going far enough, with Medicare for All being seen as a preferable solution. As a couple of us discussed afterwards, this is a far easier sell for physicians, who see first hand the amount of time and money wasted in having to deal with multiple different insurance companies, with  multiple different sets of rules. Plus this has the huge advantage of taking the astronomical profits received by the insurance industry, and using that money to actually provide health care. (Medicare for All was promoted by Bernie Sanders in the 2016 nomination battle, leading to politically-based opposition from Hillary Clinton.)

If Medicare for All is too hard a sell immediately, I, and others, suggested phasing it in. I also mentioned ideas such as the public option and the Medicare buy-in which were considered when the ACA was being written, but died when the two most conservative Senators voting with the Democrats (Joe Lieberman and Ben Nelson) opposed the ideas. Either would help with the high costs on the individual market.

The  higher cost for caring for older individuals, with some of that cost spread to the premiums of younger purchasers, is a major problem in health care coverage.  I doubt insurance companies even want to cover their older customers, who are responsible for the bulk of their costs. Either outright lower the Medicare age (even if gradually, such as initially to 50 or 55, and ultimately to around 40) or allow a Medicare buy-in.

After the Congressman left, his Legislative Director remained for a brief time and suggested that Americans would not go for expanding a government program such as Medicare. While a typical Republican thought, it does not hold up. I pointed out that we all do wind up on a government program, with most people going on Medicare at age 65. Not only are Americans failing to rebel at the though of going on Medicare at age 65, many look forward to the opportunity. Remember all those tea party protests with signs like “Keep Government Out Of My Medicare.”

My parting comment to Congressman Huizenga before he left was that Republicans must move beyond their anti-Obama rhetoric and actually address the problem. I related how for the past eight years I have often heard patients blame Obama for anything wrong with the health care system, even if it was over matters not even related to the Affordable Care Act. However, in early January, before Donald Trump even took office, I started to hear patients blame Trump for their healthcare problems. Republicans now “own” healthcare and must deliver.

I have my doubts as to whether the plan released today does deliver, but I do want to take a look at the details beyond what is in the initial news stories I have read.