2020 Democratic Primary

[Salome]

As someone from a country that does, indeed, have a National Health Service which is struggling heroically to protect us from the covid-19, I'm afraid I'm going briefly to decline that suggestion.

Surely you don’t mean to say that countries with UHC are also dealing with crisis? But I have it on such good authority that UHC magically fixes all problems and anyone that thinks otherwise just wants poor people to die. How confusing.

Next you’ll tell me that people living in counties with UHC making $13/hour pay taxes.

He has expressed concerns about the transition period and said that he would have to be sure that nay law passed protected people during that time. He has NOT said that he would veto any M4A plan.

But taking it out of context is all they have. Otherwise they’d have to look at what he actually said — about how he’d veto any plan that removed existing protections and care from people — and admit there’s absolutely nothing controversial about it.

 

[Veritable Quandry]

And I will just add that in both of their plans, Biden and Sanders, like most people discussing healthcare in America, are solving the wrong problem.

Granted, access to coverage is an important issue. The costs of deductibles and copays is also a national embarrassment and a barrier to care for many Americans.

But what people need is not coverage, it is actual healthcare. And our system has been built on the assumption that not everyone gets healthcare. If we gave everyone access to coverage today, our healthcare system would still be a gigantic clusterfuck. The time it takes even for people with good insurance to find a GP and make appointments would become infinitely worse with expanded coverage.

Our healthcare system is overloaded with specialists and under staffed with primary care physicians. We don't graduate enough people going into what is the among lowest paying areas of medicine despite the critical importance of it. And if you can increase the number of doctors, they are in the wrong places. Consolidation, competition, the influence of HMOs, and cost of infrastructure has left much of our healthcare in very large hospital complexes clustered in urban areas. Rural clinics are in financial distress, squeezed by local poverty and the high cost of services. Big centers are more efficient but smaller clinics and hospitals are far more accessible.

Biden's plan includes some increase in funds for rural hospitals and clinics. I have not seen that mentioned in Sanders' plan. Neither address training or incentives for primary care physicians or mental health professionals. Both leave the healthcare delivery system intact, creating bottleneck to access that there is no incentive to fix.

Fucking around with M4A and Obamacare is just moving the deckchairs on the Titanic. We need doctors and clinics for people to access if that increased access is to become meaningful.

 

[Salome]

Fucking around with M4A and Obamacare is just moving the deckchairs on the Titanic. We need doctors and clinics for people to access if that increased access is to become meaningful.

Exactly this. Which is why we have to look at fixing healthcare in the context of fixing many of our other cultural problems and not pretending that fixing the economics or mechanics solves the problem. For example, a huge part of fixing healthcare (and social security) is tied to immigration. Which is why creating a purity test for any candidate based only on their UHC plan is so destructive.

 

[Innula Zenovka]

Next you’ll tell me that people living in counties with UHC making $13/hour pay taxes.

Not sure what $13/hour really equates to, but, broadly speaking

In the UK, the tax system is based on marginal tax rates. That means it’s worked out as a percentage of income you earn inside certain thresholds – you don’t pay the same amount of tax on everything you earn.

As an employee:

• you pay 0% on earnings up to £12,500 for 2019-20
• then you pay 20% on anything you earn between £12,501 and £50,000
• you’ll pay 40% Income Tax on earnings between £50,001 to £150,000
• if you earn £150,001 and over you pay 45% tax.

How Income Tax and the Personal Allowance works | MoneyHelper

Understanding how Income Tax and Personal Allowance works can seem confusing at first. Learn how much you should pay in England and Northern Ireland.

www.moneyadviceservice.org.uk

Minimum wage here is £8.21/hour if you're 25 and over, which is $10.16 or thereabouts, so if someone works a 7 hour day, five days a week, that's £287.35, which means you'd start to pay tax after working for 44 weeks, I think.

More significantly, though, there's a separate National Insurance tax:

There is a threshold (called the primary threshold) and if, as an employee, your income falls below this you do not need to pay any contributions. For 2019/20 this threshold is £166 a week or £719 a month.

The actual amount of Class 1 NIC you pay depends on what you earn up to the upper earnings limit, which is £962 per week or £4,167 per month for 2019/20.

For 2019/20 the weekly rates of Class 1 NIC for employees are as follows:

On first £166	Nil
On income between £166 and £962	12%
On amount above £962	2%

NIC for employees | Low Incomes Tax Reform Group

Most employees pay National Insurance contributions (NIC) before they get their wages. On this page, we explain NIC issues that you might come across

www.litrg.org.uk

Though we don't have to worry about health insurance, and we do have better social benefits than do people in the US, though that's not much of a contest, and in many cases our benefits are still clearly very inadequate. But, in comparison, I'd far rather try to live on social welfare benefits in the UK than in the USA, even though it would be miserable.

 

[Essence Lumin]

Not sure what $13/hour really equates to, but, broadly speaking

It comes to about $23000 / year after taxes.

 

[Salome]

Not sure what $13/hour really equates to, but, broadly speaking

About $27k US of which about $15k is taxable on just federal taxes. My $2800 number was off a bit because I was thinking Warren plan but saying 10%. Basically a 4% increase would be $600, but all reasonable economists think taxes would have to go up much higher to change us over to M4A all at once. More practically speaking it would be 10-25% which is $1500-$3000 ish. Assuming we don’t have to also implement something like VAT to go along with it which always disproportionally affects the poorer working class. But the point is that saying a $1k max deductible is a huge barrier while avoiding the increased tax burden proposed by other plans is dodgy.

Though we don't have to worry about health insurance, and we do have better social benefits than do people in the US, though that's not much of a contest, and in many cases our benefits are still clearly very inadequate. But, in comparison, I'd far rather try to live on social welfare benefits in the UK than in the USA, even though it would be miserable.

No question, but we have to change a lot of cultural issues on the path toward getting there, unfortunately. Which doesn’t help when one candidate pretends their plan fixes all the issues simply and everyone else is just a greedy establishment dupe that doesn’t care if people die.

 

[Essence Lumin]

My figure was based on this.

$27,000 【 Income Tax Calculator 】 Texas - Salary After Taxes

 

[Salome]

 

[Innula Zenovka]

About $27k US of which about $15k is taxable on just federal taxes. My $2800 number was off a bit because I was thinking Warren plan but saying 10%. Basically a 4% increase would be $600, but all reasonable economists think taxes would have to go up much higher to change us over to M4A all at once. More practically speaking it would be 10-25% which is $1500-$3000 ish. Assuming we don’t have to also implement something like VAT to go along with it which always disproportionally affects the poorer working class. But the point is that saying a $1k max deductible is a huge barrier while avoiding the increased tax burden proposed by other plans is dodgy.


No question, but we have to change a lot of cultural issues on the path toward getting there, unfortunately. Which doesn’t help when one candidate pretends their plan fixes all the issues simply and everyone else is just a greedy establishment dupe that doesn’t care if people die.

I completely agree.

While I think a universal, state funded, public health service is an unmitigated good and can't understand why it's at all contentious in the USA, it's a hugely complex and expensive undertaking, which raises all manner of problems and challenges which we've been trying to get right ever since the NHS was founded in 1948 and still haven't fixed to everyone's satisfaction, so the idea that any candidate's ideas can have much relationship to what would eventually transpire is fanciful, at least to my mind.

I wish Couldbe Yue was watching this thread -- she has direct personal expertise in how complicated NHS funding and management are, and I'm sure she'd confirm it's way, way more complex than we think it is to deliver a high quality public health system, free at the point of delivery, to patients based solely on their clinical need.

 

[Salome]

so the idea that any candidate's ideas can have much relationship to what would eventually transpire is fanciful, at least to my mind.

Yes. Just like the ACA didn’t end up looking like what Obama and Dems idealized. It will always be an evolution. Our system is deliberately designed to prevent broad, sweeping change in short amounts of time and force all parties to compromise. Of course, we’re also dealing with a minority party that has gamed the system to control everything, a hostile foreign effort to aid that cause, TYT/Intercept faux progressive fuckery, and the delightful heritage of white nationalism based cultural barriers.

What we can actually advance following each phase of sabotage is ... well, I wish I drank more.

 

[danielravennest]

Maybe we can learn something about the value of cooperation and safety nets. Maybe.

During the Great Depression farm and electric power cooperatives got their start. So did credit unions, which are bank cooperatives. When times are hard, people get together out of necessity.

 

[danielravennest]

THis has happened since you got your information.

Biden suggests he would veto 'Medicare for All' over its price tag

"I would veto anything that delays providing the security and the certainty of health care being available now," Biden said.

www.cnbc.com

March 10th, the date of the story, is like a lifetime ago in terms of this pandemic. There were 994 cases then, vs 214,000 in the US today. I would say that anything he said back then has been overcome by events. By the time whatever they do for a national convention happens, it will be even more irrelevant. Everyone in politics will have to change their positions to reflect the realities of what has, and what will happen over the next few months.

To give a random example, all those people who will be unemployed afterwards, perhaps 20% of the workforce, will lose their work-based health insurance. So any plans that were made prior to March, based on assumed coverage levels and cost of filling the gaps, will go right out the window. You seem to be implying that Biden said something once, and won't change based on events. I don't think that's fair or realistic.

 

[Essence Lumin]

March 10th, the date of the story, is like a lifetime ago in terms of this pandemic. There were 994 cases then, vs 214,000 in the US today. I would say that anything he said back then has been overcome by events. By the time whatever they do for a national convention happens, it will be even more irrelevant. Everyone in politics will have to change their positions to reflect the realities of what has, and what will happen over the next few months.

To give a random example, all those people who will be unemployed afterwards, perhaps 20% of the workforce, will lose their work-based health insurance. So any plans that were made prior to March, based on assumed coverage levels and cost of filling the gaps, will go right out the window. You seem to be implying that Biden said something once, and won't change based on events. I don't think that's fair or realistic.

Could be but he could have written his current health page on his website as though nothing has happened.

 

[Cristiano]

 

[Aribeth Zelin]

I just can't watch another old white man [even if he's Jewish] override a black woman. It says a lot, but what it says is, at some level there is a level of either racism, misogyny or just plain bad manners. I mean, I've seen him talk to other media figures and I don't remember him being quite so rude to say, Colbert....

 

[Sovereignty]

Yes. Just like the ACA didn’t end up looking like what Obama and Dems idealized. It will always be an evolution. Our system is deliberately designed to prevent broad, sweeping change in short amounts of time and force all parties to compromise.

I'd compare the healthcare issue to getting the Civil Rights Act passed in 1964. LBJ was helpful in overcoming the filibuster in the Senate, but it still happened at the cost of putting real teeth in the legislation. It was a compromise. From what I read, the teeth followed in succeeding years. (Also, it passed with a much less dysfunctional Congress--i.e., Republican Party with current party allegiances--than we have now.)

Putting my ignorance on display--Apparently, previous attempts at passing civil rights legislation were stymied by filibusters raising the question: why not get rid of the filibuster? The option to change Senate rules to disallow filibusters has always been there. I think it only requires getting the rule change to the floor and then a simple majority vote. In that sense the constitution allows faster change, but the senators (not the constitutionally mandated system) are always against it. I'd guess their reluctance lies in knowing that one day the majority will become the minority.

I also suspect the real rub is in getting the rule change to the floor, just as today McConnell prevents legislation passed by the House from ever reaching the Senate floor. Again, that is part of the Senate rules, and it apparently puts tremendous power in the hands of very few people. These people might be motivated to retain their power by not doing anything to rock the boat.

Who becomes majority leader? The senator best at retaining political power.

Bottom line--It seems to me that the inaction of the Senate [on civil rights was] is largely based on the desire to retain power. Keep the filibuster for when you are not the majority, and as majority leader don't rock the boat (go against your party's majority). The R's obsequious loyalty to Trump is based on this principle. It is not the system but the desire for power that slows change.

Odd. The desire for power keeps people from using that power except to maintain power.

I would be pleased if anyone who knows more/better can remove my weasel words or clarify/correct what I've said. Maybe they would just add more weasel words. lol

Disclaimer--I see blaming the system as a way of letting people avoid responsibility. In reality it might be a glass half full/empty sort of thing. Do you want to emphasize taking responsibility or not?

 

[Innula Zenovka]

I just can't watch another old white man [even if he's Jewish] override a black woman. It says a lot, but what it says is, at some level there is a level of either racism, misogyny or just plain bad manners. I mean, I've seen him talk to other media figures and I don't remember him being quite so rude to say, Colbert....

Nevertheless, she did an excellent job of repeatedly cutting through his attempts to change the subject and bringing him back to her question -- she just would not let him dodge it.

 

[Anya Ristow]

March 10th, the date of the story, is like a lifetime ago in terms of this pandemic. There were 994 cases then, vs 214,000 in the US today. I would say that anything he said back then has been overcome by events. By the time whatever they do for a national convention happens, it will be even more irrelevant. Everyone in politics will have to change their positions to reflect the realities of what has, and what will happen over the next few months.

He repeated his opposition to single payer on MSNBC yesterday.

 

[Lady Darnk Juniorette]

He repeated his opposition to single payer on MSNBC yesterday.

Shhh! Biden can do no wrong you frothing maniac!!!

 

[Cristiano]

Nevertheless, she did an excellent job of repeatedly cutting through his attempts to change the subject and bringing him back to her question -- she just would not let him dodge it.

He was irritating to watch. He clearly did not want to answer the question, but she would not relent.