I grew up in a *very* rural neighborhood. I see you did as well, so I’m sure you’d agree that there are a number of reasons why hospitals are struggling. And you hit on one of them: specialty clinics. If you get cancer, you’re not going to Bumfuck General. Because the best doctors do not choose to practice in rural…

This is more like one of you advocating for a program based on eminent domain or newborn-abolition (in which blacks are born free, importing or making new slaves is illegal, and, generally, manumission is mandatory) and the other is advocating abolition by rounding up every person of color and shipping the whole…

M4A unrealistic. It literally works everywhere else in the industrialized world

“A huge part of the issue is that Red states are more homogenous in both their demographics and their interests than Blue states- which makes ideological unity a lot easier.”

I’ll hear arguments that those systems are completely alien because the insurance companies over there tend to be nonprofit, as if that’s somehow more different than not having insurance (and also not having cost sharing, even though that’s also the international norm, or utilization control, even though that’s…

Wait.... “both sides of the aisle have agreed on” ....has something happened in the last week and I just missed it because the Republicans are still by and large fighting tooth and nail to repeal the ACA, any lipservice they give to “universal care” is just that given that they’ve never even presented a rough outline…

Like I said, they are more interested in convincing people not to vote for Democrats than to inform their readers. I guess because its an easier and better way to get clicks.

I think a big issue is that people here don’t actually want a better system, just a radical change slogan. That’s why the lose their minds when you mention Bismark systems even though those systems vastly outperform Canada.

what you judge “minimally acceptable in 2008" wasn’t acceptable enough to make it into the ACA in 2010 so perhaps you should reassess your own judgment about what is or is not politically possible. I certainly wouldn’t say maximal M4All is impossible but it is definitely unlikely and I don’t see the path forward, so…

Most would want M4A and then start getting scared at the cost.

Well, that would be a better way of putting it, but perhaps one shouldn’t instantly jump to the framing “ I want to extend free health insurance to undocumented immigrant” That’s not a political strategy reasonably calculated to result in expanded health coverage for anybody.

Yes, so the well thought out plan is for getting Senate pickups in Texas, Arizona, Iowa, Ohio is maximalist versions of “medicare for all” and “abolish ICE” is that right?

Which is what makes Medicare for All a useful pipe dream. It pushes farther forward which grants room to give concessions while still ending up better than where we were before.

Appease the majority of the public with substantial programs and they will vote for you.

One important factor is that Libby doesn’t seem all that interested in talking policy to her readers but mainly to convince people to not to vote for Democrats.

Even with control of every branch, the reality is that the Democratic Party is a party of diverse factions that has only ever held a majority in the modern era by building a coalition that is also ideologically diverse. Until the progressive platform is demonstrated as politically viable outside of Democratic…

Cool. Now get 60 Senators. 

It would also speed up the paper-documentation collection they’ve been painfully attempting, I imagine.

Get 60 seats or GTFO. Until then don’t tell me what is or is not a pipe dream.

Out of curiosity, would characterize Medicare for All as a “useful pipe dream”? I’m still not clear on the degree to which you all understand how unlikely it is that, regardless of who wins next year, there will be a functioning, universal, single-payer health care system in this country at any point over the next two…