Thursday, December 15, 2016

"Next Gen" US Health Care Delivery Reshaping: In Which We All Learn (From EmptyWheel), That "Wonk Harder" Is Not The Answer...

I have been looking for a more than a bit, for something like this. Someone really smart, willing to synthesize all that might be learned from the Election Day results, with an open, and accepting mind. It took me a tick, but I should have thought of EmptyWheel, first. I have trusted her instincts, since Dick Cheney's first lies in office, post 9-11 (circa 2002). And you should too. What she has posted this morning achieves all that I had hoped, and more, in terms of starting in on the road-map -- a data-driven roadmap, for us -- the loyal opposition -- going into 2017, and beyond.

Do go read it all -- but all she writes rings wise, and true (especially the middle two paragraphs, below):

. . . .[Here's] something that got discussed during passage [in 2010], but not in as much detail: the degree to which the two-tiered method of expansion, with some getting Medicaid and some getting subsidized [less desirable] insurance, would poison the perception of the law, because the working poor would get fewer benefits than people who were or believed to be not working.

"I really think Medicaid is good, but I’m really having a problem with the people that don’t want to work," she said. "Us middle-class people are really, really upset about having to work constantly, and then these people are not responsible. . . ."

This has long been the basis for (often GOP-stoked) opposition to government support in the US, the resentment that others are getting more, a resentment that often gets radicalized via stereotypes about welfare queens. . . .

Luckily, being completely out of power, Democrats have another alternative besides just "wonk harder." Since Republicans will already in in the difficult position of taking away benefits, Democrats can make that much harder — and play to what we’ve learned from the roll out of ObamaCare — by calling for what they should have called for in the first place: something that moves us towards true universal care, rather than just aspirationally universal insurance coverage. Not only is that what Kentucky voters appear to want, but it is a more efficient way of providing health care. Implement it via subsidized Medicare (well-loved because it is universal) buy-in, I don’t care. But this is the opportunity for Democrats to turn the Republicans’ attacks on ObamaCare on their head, and make the policy much smarter at the same time. . . .

Do go read it all -- as I say. It actually yields some pretty compelling ideas for how to move forward -- with an open mind. Stay warm and safe, one and all. That even includes those quoted in the embedded article, in Kentucky, who wrongly perceive that they are getting shafted -- in some ill-defined way. Namaste -- and Onward!


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