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Clinton, Finally Forced to Confront a Single Payer Advocate in Debate, Can’t Win on Policy, Falls Ba

Clinton, Finally Forced to Confront a Single Payer Advocate in Debate, Can’t Win on Policy, Falls Back on Demagoguery and Distortion


LAMBERT STRETHER: Most of the post-Democratic debate analysis has focused Clinton’s response to Sanders’ challenge on her Wall Street ties; a response that was, to put it charitably, confused. There has been little focus on her exchange with Sanders on health care which, from a pure public policy standpoint — that is, leaving aside corruption — is arguably more important. So, despite DNC Chair Debbie Wasserman Schultz’s successful suppression of viewership, the debates really are doing what they are supposed to be doing: Allowing voters to compare and contrast the candidates. Now, we remember from 2014 that Clinton, despite her lofty claims to an evidence-based approach to policy, refused to even mention single payer in two back-to-back major speeches on health care. So let’s see how she did in the debate on this topic, when faced with Sanders, a single payer advocate. Spoiler alert: Badly. First I’ll take a look at the debate transcript, and then I’ll take a quick look at the Sanders plan. Spoiler alert: Not all one might wish.

The Debate

To the transcript! Sanders comes first, so I’ll pick his performance apart first. Then Clinton brings the demagoguery. (Recall that the debate location was held at Drake University in Des Moines, Iowa, the first caucus state in 2016. That will become important in one of Clinton’s responses to Sanders.)

NANCY CORDES: Back to healthcare by popular demand. First to you, Senator Sanders. You prefer to scrap ObamaCare and move to a single-payer system, essentially Medicare for all(1). You say you wanna put the private insurance companies out of business. Is it realistic to think that you can pull the plug on a $1 trillion industry?(2)

BERNIE SANDERS: It’s not gonna happen tomorrow. And it’s probably not gonna happen until you have real campaign finance reform and get rid of all these super PACs and the power of the insurance companies and the drug companies.(3) But at the end of the day, Nancy, here is a question. In this great country of ours, with so much intelligence, with so much capabilities, why do we remain the only (UNINTEL) country on earth that does not guarantee healthcare to all people as a right?(4)


(1) A CBS analyst just treated “single payer” “Medicare for All” as a not-insane policy proposal. That’s called dragging the Overton Window left (which has been my sole criterion for success from a Sanders campaign).

(2) The “health insurance industry” is not, following Veblen, an industry; unlike health care, it creates no value; it is wholly parasitic and should not exist. “One does not improve a tapeworm; one removes it.” Pragmatically, I grant it’s not possible for anybody to answer Cordes’s question in those terms on national television, even on a Saturday night in Des Moines, but Sanders doesn’t even address it (though Clinton, in another sign of inattention or confusion, doesn’t call him on that). Somebody on the Sanders team needs to figure this out, because people will have noticed, and the question will come up again.

(3) Tactically, Sanders keeps hammering Clinton on corruption. Strategically, “these are our demands” is always a good thing to be able to say. However, at least to Sanders, the missing agency in “happen” can only be a movement outside the party structure, which he doesn’t mention here (and only mentions elsewhere). To be fair, time constraints are clearly a concern for all the candidates; CBS ran the debate well, and didn’t let them filibuster.

(4) A rhetorical question (in fact, Anacoenosis /ˌænəsiːˈnoʊsɨs/ a figure of speech in which the speaker poses a question to an audience in a way that demonstrates a common interest.). And a powerful one, especially because Clinton can’t ask or answer it. However, Sanders — and we all love Bernie, but some of us love a killer instinct, too, especially in debate — might have driven the knife home by adding something like “and this is a question I would like Secretary Clinton to answer.” (If Sanders wants to pick up a few seconds for this, he can eliminate “at the end of the day.”)

SANDERS: Why do we continue to get ripped off by the drug companies who can charge us any prices they want? (1) Why is it that we are spending per capita far, far more than Canada, which is a hundred miles away from my door, that guarantees healthcare to all people? (2,3) It will not happen tomorrow. But when millions of people stand up(4) and are prepared to take on the insurance companies and the drug companies, it will happen and I will lead (5) that effort. Medicare for all, single-payer system (6) is the way we should go. (APPLAUSE)


(1) I don’t know the Drake audience, but I’m not sure that’s the most effective appeal to students, despite the obvious villainy of Pharma. Sanders’ appeal to basic fairness probably works. It’s also, when you think about it, ridiculous that putting young adults on their parents’ health insurance policies is treated as some sort of policy triumph. Surely it’s on a par with young adults living in their parents homes because they can’t afford to move out?

(2) Presumably, then — thanks to the work of Michael Moore? — everybody in the audience knows that Canada has a health care system that guarantees health care to all, gutted the private health insurance business, and successfully bent the cost curve. So Sanders doesn’t have to unpack the detail.

(3) I’m surprised Sanders doesn’t bring in the $500 billion a year in cost savings; that’s real money, even today. This would have insulated him against any claim of reckless extravagance. In the event, Clinton made no such claim.

(4) Here Sanders adds the missing agency.

(5) Mark “I will lead” for later.

(6) As a wonkish side note, single payer advocates have gone round and round about whether “single payer” or “Medicare for All” is the right phrase. “Single payer” accurately describes the system; “Medicare for All” is a better selling point (despite its increasing infestation by neo-liberal rent seekers). Here Sanders simply yokes both phrases together. That’s probably the way to go.


NANCY CORDES: Secretary Clinton, back in– (CHEERING) Secretary Clinton, back in 1994, you said that momentum for a single-payer system would sweep the country. That sounds Sandersesque. But you don’t feel that way anymore. Why not–

HILLARY CLINTON: Well, the revolution never came (1). (LAUGHTER) And I waited and I’ve got the scars to show for it (2). We now have this great accomplishment known as the Affordable Care Act. And– I don’t think we should have to be defending it amount (sic) Democrats. (3) We ought to be working to improve it and prevent Republicans (4) from both undermining it and even repealing it.(5)


(1) First, the policy failure is nothing other than a failure of leadership (see note (5), supra) in 1994; note how the lack of agency in “never came” airbrushes this away. It seems foolish to reproduce the failures of more than twenty years ago today. Second, I can’t help but think that “the revolution” is, in Clinton’s mind, a subconscious allusion to Ira Magaziner’s Time magazine cover, captioned “Peaceful Revolutionary,” since Clinton chose Magaziner to lead her own (butchered) health care reform effort. Third, this a sharpened version of the usual Democratic trope that this or that policy isn’t “politically feasible.” However, Democrats who make that argument can be relied upon never to have made the slightest effort to make the policy politically feasible; among such Democrats, in health care policy, Clinton.

(2) Well, no. The people who suffered or died without health care due to lack of universal coverage can be said to have scars. Clinton has the very best of health care; no scars at all.

(3) A demagogic appeal to party tribalism. Five years after ObamaCare was passed, 50% of those eligible but unenrolled have run the numbers and concluded it’s a bad deal for them (NBER). ObamaCare faces a death spiral. How is any of this defensible, especially when lives are at stake?

(4) Another demagogic appeal to party tribalism; how is ObamaCare to be “improved,” if not by making coverage universal? Clinton doesn’t say. She doesn’t even mention “my plan.”

(5) Why would passing an effective single payer Medicare for All plan be less effective than continuing to tinker with ObamaCare? FDR said: “It is common sense to take a method and try it. If it fails, admit it frankly and try another. But above all, try something.” Last I checked, FDR was also a highly effective Democratic partisan. So why can’t Clinton adopt FDR’s common sense attitude?

CLINTON: I have looked at– (APPLAUSE) I’ve looked at the legislation that Senator Sanders has proposed. And basically, he does eliminate (1) the Affordable Care Act, eliminate private insurance, eliminates Medicare, eliminates Medicaid, Tricare, children’s health insurance program. Puts it all together in a big program which he then hands over to the state to administer.

(1) Another demagogic appeal. In substance, as we shall see, Clinton’s description of the Sanders proposal is accurate. However, Clinton does two things. First, she begins with the effective use of anaphora (“eliminate… eliminate… eliminate…”) to convey the impression to the beneficiaries of each individual program that their benefits will be taken away (“eliminated”), and finishes by characterizing the universality of the Sanders program as “a big program” (as if the programs Clinton lists were not, in the aggregate, big). I grant that Clinton’s first tactic can be effective; “I’ve got mine” really is a powerful appeal, especially to somebody who’s managed to scramble to safety in some part of our terrible system. However, I’d argue that “I’ve got mine,” in the context of electoral politics, implies “now you get yours,” which is both unworthy of a genuine Democrat and airbrushes away the very possibility of “standing up” together for something better. Second, “big program” is a right-wing dog whistle for “big gummint,” again unworthy of a genuine Democrat.

CLINTON: And I have to tell you, I would not want, if I lived in Iowa, Terry Branstad administering my healthcare.(1) (APPLAUSE) (CHEERING) I– I think– I think as Democrats, we ought to proudly support the Affordable Care Act, improve it, and make it the model that we know it can be–

(1) Here’s why Clinton’s point appeals to the audience in Iowa. From the Des Moines Register:

Three Democratic senators will ask federal officials Wednesday to reject or delay Gov. Terry Branstad’s controversial effort to privatize management of Iowa’s $4.2 billion annual Medicaid program.

The state’s Medicaid privatization effort has been the subject of multiple challenges, including allegations that the companies picked to manage the program engaged in unethical and possibly illegal competitive bid practices. The Iowa Hospital Association has also filed a lawsuit, challenging the bid process as illegal.

Branstad’s administration must get permission from the Centers for Medicare and Medicaid Services to go forward with the plan. Mathis and Sens. Pam Jochum of Dubuque and Amanda Ragan of Mason City will meet with CMS officials Wednesday.

Dozens of providers weighed in on the plan during a conference call Tuesday with CMS, warning federal officials of concerns about contracts, unanswered questions and a general lack of notification to Medicaid recipients about the changes.

Branstad spokesman Ben Hammes accused Democrats of playing politics. Hammes noted that the governor last week met with U.S. Health and Human Services Secretary Sylvia Burwell and “remains confident” that Iowa’s plan will be approved and implemented on Jan. 1.

And here’s why Clinton’s point is pure demagoguery, even leaving aside another appeal to party tribalism. First, the Branstad plan can only be implemented if HHS Secretary Burwell — a Democrat — approves it. (Sanders might usefully have put in the shiv by saying something like “Secretary Clinton, will you join with me in demanding that Secretary Burwell reject Branstad’s plan?”) Second, Clinton sets up an opposition between (#1) ObamaCare, whose program design allowed 22 states to refuse Medicaid coverage to their citizens altogether, to the Sanders plan, where (#2) Branstad would at least be required to deliver Medicare to all, and under Federal supervision. Granted, I don’t like Door #2 all that much (see MORE AT LINK), but surely imperfect universal coverage is much better than no coverage for poor people in 22 states?

WEE Will Always Have Paris! November 20-22, 2015

The Threadmaker (me) is bushed. This has been a week of exhaustion, for some reason.

But not to worry! No matter how awful it gets, we'll always have Paris!

War has a way of serving as the Waring blendor(tm) of lives....mixed, chopped, pureed, crushed. Nobody (well, maybe the war profiteers) gets out of War unchanged, and not changed for the better, either.

In Casablanca, that classic tale of "the problems of three little people (that) don't amount to a hill of beans in this crazy world" Paris was Rick and Isla's safe haven, the golden memory to warm many a cold and lonely night. But now, today, Paris is the nightmare, torn apart by violence by the people Paris took in for charity's sake.

Let's take a review of Paris: the good, the bad, the ugly, the past, present, and maybe even the future. Because we have to have Paris, to have a West. We need all the accomplishments of our civilization to get us through a bunch of long, cold and lonely nights.


PARIS: 1932

Do the Kochs Have Their Own Spy Network?


Five years ago, when The New Yorker published my piece “Covert Operations,” about the ambitious and secretive political network underwritten by the billionaire industrialists Charles and David Koch, the Koch brothers complained mightily about the story’s title, protesting that there was nothing at all covert about their political activities. Since then, the two have embarked on an impressive public-relations campaign meant to demonstrate their transparency and openness. But today, the Politico reporter Kenneth Vogel came out with a blockbuster scoop suggesting that the brothers, whose organization has vowed to spend an unprecedented eight hundred and eighty-nine million dollars in the 2016 election cycle, are more involved in covert operations than even their own partners have known.

After culling through the latest legally required disclosures, Vogel unearthed a new front group within the Kochs’ expanding network of affiliated nonprofit organizations—a high-tech surveillance and intelligence-gathering outfit devoted to stealthily tracking liberal and Democratic groups which Politico calls the “Koch Intelligence Agency.” The sleuthing operation reportedly includes twenty-five employees, one of whom formerly worked as an analyst for the Central Intelligence Agency, and follows opponents by harvesting high-tech geodata from their social-media posts.

According to Vogel, the effort is so secretive that very few people know of it even within the Kochs’ own sprawling political operation. Housed with other Koch nonprofit organizations in a bland office building in Arlington, Virginia, the outfit is managed by a limited-liability partnership called American Strategies Group, LLC. The company is part of the Kochs’ main political group: a circle of ultra-conservative donors called Freedom Partners Chamber of Commerce, which describes itself as a “business league” and so claims that it can legally hide the identities of its members.

Reached for comment, James Davis, the spokesman for Freedom Partners, described news accounts comparing the organization’s operation to espionage as “inaccurate.” Davis said, “Like most other organizations, Freedom Partners has a research department that benchmarks our efforts against other organizations.”


Explaining "democratic socialism" NPR: MARKETPLACE

by Nancy Marshall-Genzer Wednesday, November 18, 2015 - 10:09

PODCAST AT LINK AND MORE: http://www.marketplace.org/2015/11/18/elections/explaining-democratic-socialism

If you ask 10 different people what they think democratic socialism is, chances are you’ll get 10 different answers.

We reached out to the Sanders campaign, but didn’t hear back.

So, I asked two political science professors to define democratic socialism.

Samuel Goldman, an assistant professor of political science at George Washington University, told me it was, “achieving collective control of the economy.”

And Andrei Markovits, a professor of political science at the University of Michigan, said democratic socialism is an attempt to create, “a property–free, socialist society.”

So everything is communally owned.

Senator Sanders has touched on democratic socialism in stump speeches, like this one in Iowa last month:

“When you call your fire department or the police department, what do you think you’re calling?" Sanders asked the crowd. "These are socialist institutions.”

That Sanders attempt to use fire and police departments to define democratic socialism does not sit well with Professor Markovits.

“If he were to write this on an exam for me? That’s an F,” Markovits said.

Sanders has also cited Denmark as a place where democratic socialism has worked.

That gets a rise out of Professor Goldman. With apologies to Shakespeare, he said there’s something rotten in Sander’s assertions about the state of Denmark.

“I would not call that socialism,” he said.

Or even democratic socialism. Professor Markovits agrees. Ultimately, Markovits said, there’s no private property at all under democratic socialism. He said it doesn’t exist in Denmark or anywhere else, and is an unattainable goal.

In new shock poll, Sanders has landslides over both Trump and Bush NOV 11


In a new McClatchy-Marist poll, Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) leads Republican candidate Donald Trump by a landslide margin of 12 percentage points, 53 to 41. In the McClatchy poll, Sanders also leads former Florida Gov. Jeb Bush (R) by a landslide margin of 10 points, 51 to 41. The huge Sanders advantage over Trump is not new. In the last four match-up polls between them reported by Real Clear Politics, Sanders defeated Trump by margins of 12, 9, 9 and 2 percentage points. The huge Sanders advantage over Bush is new. In previous match-ups, the polling showed Sanders and Bush running virtually even, with Bush holding a 1-point lead over Sanders in most of the polls. Future polls will be needed to test whether the huge Sanders lead over Bush in the McClatchy poll will be repeated in future polling or whether the McClatchy poll is an outlier.

It is shocking that the data suggests that Sanders has a lead over Trump that could be so huge that he would win a landslide victory in the presidential campaign, with margins that would almost certainly lead Democrats to regain control of the Senate and could help Democrats regain control of the House of Representative — if, of course, the three polls that show Sanders beating Trump by 9 to 12 points reflect final voting in the presidential election. It would be equally shocking if future polling shows that the Sanders lead over Bush remains at landslide margins.

For today, there are two issues these polls present. First, the national reporting of the presidential campaign completely fails to reflect Sanders's strength in a general election, especially against Trump, and against Bush as well. Second, and perhaps more important, Sanders's strength in general election polling gives credence to the argument I have been making in recent years, that American voters favor progressive populist positions which, if taken by Democrats in the general election, would lead to a progressive populist Democratic president and far greater Democratic strength in Congress.

It is a fallacy argued by conservatives and, in my view, inaccurately parroted by the mainstream media, that Sanders and other liberals take positions that are far too "left." The polling shows, issue by issue, and increasingly in general election match-ups of Republicans running against Sanders, that it is the left, not the right, which has the upper hand with American voters.

Budowsky was an aide to former Sen. Lloyd Bentsen (D-Texas) and former Chief Deputy Majority Whip Bill Alexander (D-Ark.). He holds an LL.M. degree in international financial law from the London School of Economics. Contact him at brentbbi@webtv.net.

Obama: I didn’t appreciate how weak the presidency is until I was president


One big thing Barack Obama has learned about being president? The job isn't as powerful as you might expect.

In a new interview with Bill Simmons at GQ, which is well worth reading in full, Obama explains that he "didn't fully appreciate" how "decentralized power is" in the US political system until he took office.

That is, to get anything done, he had to spend a ton of his time trying to persuade other people. Here's what he told Simmons:

OBAMA: What I didn’t fully appreciate, and nobody can appreciate until they’re in the position, is how decentralized power is in this system. When you’re in the seat and you’re seeing the housing market collapse and you are seeing unemployment skyrocketing and you have a sense of what the right thing to do is, then you realize, "Okay, not only do I have to persuade my own party, not only do I have to prevent the other party from blocking what the right thing to do is, but now I can anticipate this lawsuit, this lobbying taking place, and this federal agency that technically is independent, so I can’t tell them what to do. I’ve got the Federal Reserve, and I’m hoping that they do the right thing—and by the way, since the economy now is global, I’ve got to make sure that the Europeans, the Asians, the Chinese, everybody is on board." A lot of the work is not just identifying the right policy but now constantly building these ever shifting coalitions to be able to actually implement and execute and get it done.

Of course, that's right — on a great many issues, the president isn't the policy-wonk-in-chief, he's the coalition-builder-in-chief. And without a strong enough coalition, he can't get his way. This is true on issue after issue — from gun control to the cap-and-trade bill to immigration reform.

This is a common realization that presidents have after taking office. Indeed, it's so common that political scientist Richard Neustadt wrote a book about it decades ago, in which he made the famous argument that at its heart, "Presidential power is the power to persuade."

Now, Neustadt didn't just mean that the president has to rely only on convincing people with the power of his words. Instead, the president is engaged in a long bargaining give and take with all of those actors Obama listed. The president's position, prominence, and powers provide many advantages in that process. Still, of course, presidents often fail to get their way — and even when they do get what they want, they feel like they're working awfully hard at it. Neustadt quotes President Harry Truman complaining:

"I sit here all day trying to persuade people to do the things they ought to have sense enough to do without my persuading them. ... That's all the powers of the President amount to."


Is it my imagination, or is it awfully quiet on the other side of the primary?

Not that I'm complaining, mind you. I just thought if the rest of you see that, maybe the supporters of She who must not be maligned are having second thoughts.

Five Charts Tell You How You Feel


Forget the blood work and the scale—how healthy do you feel? It seems the answer depends on where you live.

According to data from the "Health at a Glance 2015" report from the Organisation for Economic Co-operation & Development, when adults in OECD member countries were asked to rank their self-perceived health status, nearly 90 percent of New Zealanders pegged their health as good or very good, compared with just 35.1 percent of South Koreans.1

What makes people in one country feel healthier than their cross-border neighbors? The charts below show whether such factors as a country's average fruit consumption or smoking rate appear to be factors.

Note: In Israel, respondents only had two choices of answers—good/very good or bad/very bad. Respondents in all other countries also had the option of answering "fair," which many did.
Source: OECD

A fruitful diet

If a larger share of a country's adult population reports including fruit in its daily diet, its residents are also more likely to report feeling good or very good. Chile and Finland, the two reporting countries with the lowest fruit consumption, fall well below the OECD average for feeling like a million bucks. And then there are the puzzlers. South Korea comes in slightly above the OECD fruit consumption average, but its residents still don't feel so good about their health.


Gene Amdahl, IBM Designer Who Founded Rival, Dies at 92

Source: Bloomberg News

Gene Amdahl, who helped IBM usher in general-purpose computers in the 1960s and challenged the company’s dominance a decade later with his eponymous machines, has died. He was 92.

He died on Nov. 10 at Vi at Palo Alto, a continuing care retirement community in Palo Alto, California, his wife Marian Amdahl said in a telephone interview. The cause was pneumonia, and he had Alzheimer’s disease for about five years.

Amdahl shepherded the design of the IBM Series/360, the first computer system not built for a specific purpose and one that offered modularity, interoperability -- software made for one machine could run on another -- and the use of cheaper third-party peripherals. Announced in 1964, it made IBM the king of mainframes, closet-sized data crunchers, by expanding the market to everyday businesses such as airlines and carmakers from a user base limited to government offices and universities.

“That architecture has endured for 50 years,” Mike Chuba, an analyst who has followed the industry for more than three decades at Stamford, Connecticut-based Gartner Inc., said in a 2014 telephone interview. “Most credit-card transactions will go through a mainframe at some point.”

Read more: http://www.bloomberg.com/news/articles/2015-11-12/gene-amdahl-ibm-computer-designer-who-founded-rival-dies-at-92

CDC: New estimate suggests more children have autism than first thought



The government has a new estimate for autism -- 1 in 45 U.S. children -- but other federal calculations say the developmental disorder is less common. The latest figure released Friday is one of three estimates that the Centers for Disease Control and Prevention gives for autism based on different surveys; the most rigorous one gives a lower estimate of 1 in 68 children. The new number is from a survey of parents of 13,000 children, who were asked last year if their child were ever diagnosed with autism or a related disorder. The lower CDC estimate is from researchers checking health and school records for more than 47,000 children.

The 1 in 68 will still be treated as the best estimate, said Michael Rosanoff, director of public health research for the advocacy group Autism Speaks. But the new number supports a belief that 1 in 68 is an underestimate, he added. Estimates of how common autism is have been steadily increasing. In 2007, the CDC estimated 1 in 150 children had autism.

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