Dana Chasin at 2020 Vision does a good job of encapsulating key issuesthat surface in the Democratic debates.
Let’s get this out first: most listeners will admit that the debates seem both too long and too short, as mentioned on Stephen Henderson’s Detroit Today program this Wednesday 1/15 morning. They are too short, because candidates are interrupted at the 30-second time limit and not allowed to develop nuanced, considered answers to questions. They are too long, because they go on for 2 hours. I’d add that they are problematic, because the media pundits have their own views of what creates energetic dialogue that makes good ‘copy’ for programming, versus the kinds of in-depth discussions about issues like climate change, health care, education, the Supreme Court, congressional oversight/checks and balances, tax policy, wealth inequality and income inequality, plutocracy and oligarchy, etc. that people want to hear.
One important distinction that Chasin notes for thinking about socio-economic programs is the distinction between means testing and universality. A means-tested program is generally available to lower-income people and often phases out and is capped at some income level beyond which it is no available. A universally offered program is one that is available to all, rich and poor alike. So the Earned Income Tax Credit is a means-tested program that is capped (too low, in my view), and Social Security is a universally available program (though there is a graduated payout scale and the funding formula caps pay-ins to the program at a ridiculously low level that means the rich pay only a pittance into the program)
It is good to read your posts again.
It is important to separate the price of healthcare as opposed to the real cost of healthcare. One is not the same as the other. A one JAMA Network article stated inpatient care is up 42% and outpatient care is up 25%. Doctors were 7% over the same period 2007 – 2014. Kocher and Berwick in “While Considering Medicare For All: Policies For Making Health Care In The United States Better” discusses that pathway to Single Payer and emphasizes the Jama Network findings for outpatient and inpatient care as the leading cause of increased healthcare insurance pricing and increased deductibles and copays.
The issue here is understanding costs in order to get to pricing. Most recently, our congressional rep (Slotkin) was touting the fact the House was able to remove exclusivity for drugs from the NAFTA bill. This was great! Except, a similar version reappeared in the House Budget bill for a longer period of time. As far as exclusivity, World Health Org says much of the risk adjusted costs can be recouped in 2-5 years median time period. ICER reviewed the pricing increases of 100 drugs, dropped 23 of them because their pricing increases did not exceed twice medical CPI, and review the top nine of the remainder. Two were dropped from the nine. Of the 7 remainder, not one could be found to have provided additional value to the patient, society, or the healthcare system to justify the pricing increase. Some the increases were dbl digit percentages.
So what is my point? To say we will be taxing you and eliminate prices of healthcare pricing to people is scary to them. Both are bad as witnessed by their complaints on rising insurance prices, etc. and no one likes to pay taxes. Much of this is wording but their is real value to looking at costs as opposed to pricing and accounting for when they are paid off. Bernie and Elizabeth should be emphasizing cost control which drive pricing with an emphasis on reducing exclusivity so as to increase competition. The legislation coming out of Congress such as Upton’s 21st Century Cures Act resulted in a huge give away to the healthcare industry.
I think I made my point.
The reason FDR made social security universal rather than means tested was to get middle class support. He was afraid if he made it means tested the middle class support for SS would fade away.
Think about all the jokes over the years about the woman wanting to keep the government’s hands off of her social security. t may be a joke but it is also for real and is exactly why FDR make it universal. Politically, it would be a massive mistake to make it means tested. The Republican opposition to SS would love you forever for winning their battle for them.