Monday, January 18, 2016

Voting for Bernie, Hoping for Hillary

Here's how rational Mad Dog is:  He is voting for Bernie in the NH primary but hoping Hillary wins the nomination.

Voting with the heart, but hoping with the head.

During last night's debate, one exchange solidified Mad Dog's shift in thinking Hillary would make the better President:  Bernie laid out the case for a single payer, Medicare for all--it would cost less overall; it would include the 29 million still not covered; it would simplify a byzantine system. It would be fair and fair is nothing our American health care system ever has offered. 

But Ms. Clinton responded with the straightforward realist's response: Even when we had both houses of Congress and the Presidency, we could not get the single payer option attached to the ACA. Not even as an option.  The votes simply were not there.  There simply were not then, are not now, will not be in the foreseeable future enough votes for Medicare for all. 

As Paul Krugman points out in today's NY Times, there are simply too many people with too much to lose in this fight. All those people with Cadillac policies through their work places are doing better than Medicare would do for them, and Medicare is a very good insurance, just not the best possible. So, it's not fair--you work for General Electric and all your prescriptions are covered; you work for General Aquatics and you have huge copay's. 

There is also the problem of transition. You've got millions of people who are providers who have borrowed for medical and nursing schools, invested in loans, taken the risks of signing office leases, equipment leases, who would fear going belly up financially if Medicare for all slammed in and cut compensation. All those doctors with huge student loans, all those doctors with 10 year leases on office space which puts them on the hook for millions of promised payments. The web of finance and borrowing which supports the current doctors, nurses, hospitals, offices, free standing clinics would wobble under the earthquake of such a revolution.

And that is the nub of it: Bernie really is talking about a revolution and Hillary is talking evolution. 

Even Medicare began small, and got added to incrementally, year after year, until most of the kinks were ironed out. 

Even if Bernie can win, would Mad Dog really want revolution, at this stage in life?

It's the old case of the thrill and seduction of someone who sets you dreaming and gets your heart pounding vs the quiet realization that once that night is over and you wake up in the morning, there is still real life to lead.

No comments:

Post a Comment