Bernie Sanders' state single payer provision is far superior to Dennis Kucinich's

[ProSense]

Of course, Kucinich just wants his way:

AMY GOODMAN: Congressman Kucinich, President Obama says that the Senate bill does include single-payer language. He was talking about a provision by Senator Bernie Sanders which would allow states to use federal money to set up a single-payer system years down the road. What do you think of that?

REP. DENNIS KUCINICH: Well, it provides for a waiver; it doesn’t grant the waiver. And it takes effect 2017. But by then, we’ll already have a system in place that will be very difficult to move out of. And it doesn’t cure the attack that insurance companies can make on state plans using the Employee—the ERISA Act. And so, my amendment that was passed in committee would have protected states from illegal challenge by insurance companies. The Sanders amendment doesn’t do that, so you still have the problem that, no matter what reforms are enacted, can be knocked out. I mean, I talked to the President personally about this. I’ve met with the President three times on this bill. The White House knows my position.

link

His provision simply offers a waiver and no other support for states. And here is the reason Pelosi likely pulled it:

(2) the State single payer system shall operate in the State instead of the public health insurance option or the National Health Exchange.

<...>

STATE SINGLE PAYER SYSTEM.—The term ‘‘State single payer system’’ means, in connection with a State, a non-profit program of the State for providing health care—

PDF

So an immediate waiver, no funding, no federal support and no national plan can operate in the state. That's pretty damn risky.

The state-based single payer strategy

"Quite frankly," Sen. Bernie Sanders said today, "we don't have the votes for single payer." That's not much of a surprise, but Sanders did outline another strategy for single payer that some liberals might want to think about. "Right now," he explained, "we have language in the bill that says that states that want to go forward with single payer can do that." He's talking about the Waiver for State Innovation, which allows states to go their own way if they have a plan that will achieve the goals of the bill at a lower cost. You could imagine a state -- say, California, where the legislature has passed single-payer bills before only to see them vetoed by the governor -- using that provision to implement a single-payer system.

Sanders thought this the best strategy going forward. "I believe the way we move to single payer in this country is to let one state like California go first," he said. And before some of my conservative readers decide this is a liberal trapdoor in the middle of the bill, the provision could be used to develop a much more conservative approach to universal health care. In fact, it's a legislative expression of the GOP's third plank for health-care reform: "Give states the tools to create their own innovative reforms that lower health-care costs."

The health-care reform bill will create a basic, near-universal system across the country. If individual states think they can do better, they're welcome to try. And if they succeed, you could imagine those reforms spreading quickly to other states, too.

More on Sanders' provision:

Sec. 1332. Waiver for State innovation. Beginning in 2017, allows States to apply for a waiver for up to 5 years of requirements relating to qualified health plans, Exchanges, cost-sharing reductions, tax credits, the individual responsibility requirement, and shared responsibility for employers. Requires States to enact a law and to comply with regulations that ensure transparency. Requires the Secretary to provide to a State the aggregate amount of tax credits and cost-sharing reductions that would have been paid to residents of the State in the absence of a waiver. Requires the Secretary to determine that the State plan for a waiver will provide coverage that is at least as comprehensive and affordable, to at least a comparable number of residents, as this title would provide; and that it will not increase the Federal deficit.

PDF

SEC. 1332. WAIVER FOR STATE INNOVATION.

<...>

(3) PASS THROUGH OF FUNDING.—With respect to a State waiver under paragraph (1), under which, due to the structure of the State plan, individuals and small employers in the State would not qualify for the premium tax credits, cost-sharing reductions, or small business credits under sections 36B of the Internal Revenue Code of 1986 or under part I of subtitle E for which they would otherwise be eligible, the Secretary shall provide for an alternative means by HR 3590 EAS/PP which the aggregate amount of such credits or reductions that would have been paid on behalf of participants in the Exchanges established under this title had the State not received such waiver, shall be paid to the State for purposes of implementing the State plan under the waiver. Such amount shall be determined annually by the Secretary, taking into consideration the experience of other States with respect to participation in an Exchange and credits and reductions provided under such provisions to residents of the other States.

PDF

The provision also addresses coordination with Medicaid and Medicare.

[rockymountaindem]

1. I have to say, this is the first thing you've posted that makes me like this bill

since I guess I have to agree with Sanders that a state-by-state route might be the best, or only, way to single payer. I keep seeing a lot of posts about how it's moving forward in CA, PA, CO and elsewhere. I still think mandates and subsidies for private insurers are a horrible idea without a public option at the federal level, but leaving the window open for states to do what they want (hint hint, California) is good. Thanks for letting me know about this.

[Cleita]

2. Yeah, our federal government is sold out to the industry.

I think we will have to do it state by state. Actually, Bernie once suggested that we try different systems in different states to find out which one worked the best. I'm sure single payer, with no insurance companies allowed to cover basic health care, would win hands down for covering everyone with quality health care for the least amount of expense. I hope California finally gets it through once we get rid of our big Republican obstructionist, Arnold.

[rockymountaindem]

3. Would once and future Governor Brown sign that into law? n/t

[Cleita]

4. I'm certain he would. Our legislature has passed single payer in both

houses twice and Arnold has vetoed it twice. I'm certain the legislature would pass it again and it is being submitted again and hopefully Arnold will be gone by the time it's time to sign it into law. I'm sure Jerry Brown will win with no problem. Californians are fed up with Republican fucked up government.

[patrice]

5. Senator Sanders is a light in the darkness.

[Armstead]

6. Bernie's my hero -- But why 2017?

[RaleighNCDUer]

7. My question exactly. nt

[krawhitham]

27. to keep the CBO score low

[harun]

53. How could the impact the CBO score when we have no idea

what type of system a state might choose to implement?

[Hawkowl]

8. Canada started like this

I believe this is the way Canada's single payer system started. I think Alberta was the first province to go single payer and then the rest of the country caught on.

[Spazito]

21. You are right re starting this way in Canada but the province was...

Saskatchewan under the leadership of Tommy Douglas.

[Name removed]

9. Deleted message

Message removed by moderator. Click here to review the message board rules.

[mzmolly]

10. Yep. And Barbara Boxer has pointed this out as well.

:hi: Thanks Prosense.

[Oregone]

11. Are you passionate about Single-Payer health care, or just smearing Kucinich the Democrat?

Perhaps Ive misunderstood you, but Ive seen you trashing single-payer advocates for the last year just as much as you've been trashing Kucinich. Maybe Im wrong, but it seems like this bill is but just another political football you are tossing around to make a cheap argument on the internet. Once I get over that hump, itd be easier to comment on the actual content.

[FrenchieCat]

12. What I have noticed about the Kill the Bill Faction,

is they never discuss honestly what is good about this bill.
They only do drive by with their insults,
which belies their true agenda.


They should read about Sec. 2718 as well....
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x221735

me thinks some folks haven't even gotten close to reading the bill at all,
and if that is so, that would be sad; to advocate against something
without truly knowing what it does and doesn't do.

[vaberella]

18. Of course. They do what republicans do.

Spout all the bad about it and how it doesn't do this or that. Or they unrec threads that do promote some of the good measures.

[Dappleganger]

52. Agreed! nt

[mzmolly]

57. Agree! They're both full of talking points and not much analysis. We have "death panels" or

"corporatist sell out". It's insane.

[andym]

13. Both Bernie's and Dennis' amendments are useful

Single-payer done right is probably the best outcome, and to get the whole country there, it will be useful to show how well single-payer works at a state level first. There's nothing like showing Americans that something actually works in America and that one group (for example, Californians, should single-payer pass and be funded) is benefiting.

I really hope that Rep Grayson's Medicare buy-in in also seriously considered. I really think it could go a long way to setting the stage for single-payer (since it will increase the number of people who trust the government to provide an essential service).

[mzmolly]

56. Agreed. But Bernie isn't demading we do XYZ or else,

immediately.

[eridani]

14. 2017 is NOT better than right now, period n/t

[vaberella]

17. No it's not. But it's better than NEVER. Which is what Kucinich is making you bank on.

He's had his measure for single payer in the house for YEARS. Are we getting that?! YEARS! For almost 7 years the legislation for Single payer has been in the house and NOTHING. And if the measure starts in another 7 years it's a problem? When the single payer legislation hasn't even gotten as far as the house for a vote. And would die a quick death making it not even worth voting on. This is something, not nothing.

[eridani]

51. What is relevant now is his ERISA waiver, not HR 676 n/t

[ProSense]

22. Hint:

"instead of the public health insurance option or the National Health Exchange."

Wonder why Kucinich's amendment gained the support of 13 Republicans in committee?

Right now, what's to stop a Republican governor from requesting (not applying, but requesting) the waiver just to opt out of the national plan?

No support, no funding, just a desire.

[eridani]

50. Republicans are gung-ho for state's rights on general principle

Also, the Senate bill leaves regulation entirely up to states, so it's just a matter of your state government's whims as to whether any changes are implemented.

[PHIMG]

15. The single payer activists I talk to disagree with you

But don't let that stop you from bashing Kucinich. Your agenda is clear.

[cali]

38. disagree with the OP on what precisely. Please elaborate on what all

these advocates say and please tell us who they are so that we know they're more than rhetorical devices. thank you kindly.

[vaberella]

16. The whole aspect of a state following single payer is not discussed on DU.

Because people think the bill is shit. When if they thought about it. If this bill makes it through they can organize and work to get their state to adopt single payer as the measure is set in law. ugh....but who cares. all is shit for them on DU and Kucinich.

[IndianaGreen]

19. Obama is opposed to single payer, and he doesn't want public option

It doesn't matter what Dennis or Bernie want, Obama will block it.

[Name removed]

20. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Bluenorthwest]

23. How many people suffer and die for that 2017 date?

Seven years from now, we might be able to start making a fix to that which will be far more broken. Why wait? Why 2017? Why?
And of course, Bernie is not a Democrat. Dennis is. I see many here bashing Dennis, who has no Democratic primary rival. I assume they favor the Republican, as they bash the Democrat in an election year, over and over and over again. Lather, rinse repeat.
If you manage to defeat Dennis, you will have elected a Republican. Which seems to be the objective. What other objective could there be? More than 20 House Democrats are voting no, yet you only mention Dennis. Over and over and over. The only end you could achieve is the election of a Republican. But that is the choice you make. Over and over and over.

[ProSense]

24. What?

The provision is part of reform.

How may people will suffer waiting for Kucinich to get his way?

[IndianaGreen]

25. No public option will be allowed on the reconciliation bill

No amendments will be permitted.

Don't you keep up with the news?

[Jennicut]

26. Dennis does not deserve to lose his seat. It is just that Bernie Sanders seems

less obstinate to me, less all or nothing. Therefore, he is actually getting something done, no matter how small it may seem at the moment. Canada's health care system started with one state making changes. Now, the United States is much bigger (and more conservative). But all it takes is a small opening to make some progress in many states.
I think DK is not as effective as Bernie but I don't dislike him. Some here are frustrated with him but we don't want to see a good liberal defeated. At least I know I don't. Anyway, that is up to the people in his district to decide, isn't it?

[Bluenorthwest]

28. Well this is election year, and he has no primary rival

and it is past the filing date, so those who are on the attack have to understand that the only alternative is the Republican. So singling out Kucinich among many Democrats saying they will vote no, so many times are doing so for a reason. The others don't seem to 'frustrate' them. Just Dennis. Who is up for reelection, who speaks for a better bill, whose only opponent in November will be the Republican. And yep, the people in his district will decide. But as for me, I'll be supporting the Democrat in that district with my voice and what money I can find, most certainly not giving aid to the Republican. This is election year. From Primary to General Election, I was an Obama loving tee shirt wearing Party guy. On the phones and on the streets. Kucinich has no primary rival from our Party. So trashing him beyond sharing an opinion has to be questioned for objective. What can be gained by this? Other than losing a seat to the Republicans?
No really. What can be gained? What do you imagine comes from this? I have seen people on DU say they'd rather a Republican have that seat, so it is good to hear you are not among that mindset. I love Bernie as well, but he is not a Democrat. Perhaps he is correct on that one too, where Dennis is wrong?

[Jennicut]

29. I do not have that mindset at all. Any Rethug is worse then any Dem be it

ultra-leftist to Blue Dog although a liberal Repub that was something like a Lincoln Chafee I could make a case for over some blue dogs.
I am frustrated by various politicians in our party from time to time, including Obama. I think the obsession with DK is that he is the easiest person to get behind or trash because there is not in between in his views. It makes him a lightening rod. I am disappointed in some of his tactics or his votes but the man is trying to do some good for the country. I really don't get the obsession DU has had for the last few days here as we don't need his vote for the bill in the House if Pelosi has managed to break up the Stupak coalition.

[ProSense]

30. You're right,

a Republican is worse than any Dem. That doesn't stop people like Jane Hamsher and critics of the Democratiic Party from claiming that there is no difference.

Kucinich became a lightening rod, not because he plans to vote no, but because he declared he is willing to be the vote that kills the bill.

[Jennicut]

31. Jame Hamsher is an idiot, in my honest opinion.

And not effective, like Kucinich.

[Bluenorthwest]

33. But this is election year. The choice is binary. Hamsher is

a blogger. There will always be critics. You are a critic. Hamsher has nothing to do with this. This is about pushing against the sitting Democrat in election year, over stuff that bugs you personally. I find that to be so petty. You are talking to someone who supported Obama, even as Obama refused to support equality, because he was the nominee. Obama voted with Frist and Company on the Teri Schaivo bill. We could have made a huge stink about that stupid vote. A vote he cast.
In politics, the only person who can safely split hairs is bald.

On election eve, do you intend to be shouting about Hamsher, and offering up your arguments against the Democrat?

[ProSense]

34. This is a bit hypocritical

"This is about pushing against the sitting Democrat in election year, over stuff that bugs you personally. I find that to be so petty."

Blanche Lincoln is a sitting Democrat.

Previously, you stated: "I have seen people on DU say they'd rather a Republican have that seat..."

Now you say, "Hamsher is a blogger. There will always be critics. You are a critic. Hamsher has nothing to do with this."

If you're giving Hamsher a pass as a blogger, why aren't you willing to give random posters on DU a pass?

[Bluenorthwest]

35. Try to keep up here. I'm not 'giving a pass' to anyone

It was YOU being called out for, as you are doing again here, dragging non related subjects to the floor. Hamsher? You brought her up, as if she had to do with what we are saying. I did not comment on Hamsher. I commented on you. Your tactics.
You have no idea what I think of Hamsher. She's not the subject. You got called out for trying to throw her up as distraction. You brought her up, as if critics in politics are new or rare. As if you yourself are not a constant critic. I have nothing to say about her, because I am not familiar with her work in politics.
Bringing up non related elements to avoid being criticized yourself is bogus in the fist degree. Calling me a hypocrite for not playing your smoke screen name shouting game is rude.
What is your objective in this? Just tell us. Everyone asks you why, and you shout Hamsher. We are asking you. Why do you do this, over and over and over again. Will you stop it at some point? At what point?

[ProSense]

36. She was brought up to illustrate the point you made

"You have no idea what I think of Hamsher. She's not the subject. You got called out for trying to throw her up as distraction. You brought her up, as if critics in politics are new or rare. As if you yourself are not a constant critic. I have nothing to say about her, because I am not familiar with her work in politics."

Why so defensive?

"What is your objective in this? Just tell us. Everyone asks you why, and you shout Hamsher. We are asking you. Why do you do this, over and over and over again. Will you stop it at some point? At what point?"

What the hell are you talking about? Who is we? I was responding to the point you]

[Bluenorthwest]

37. I do not argue in circles

About people I've never read. You don't answer direct questions. It is just rude and dull, and this is it for that. Just no point.

[ProSense]

39. "About people I've never read."

You are the one using Hamsher as a distraction. First of all, I mentioned her in response to another poster, not you.

You chimed in with "Hamsher is a blogger. There will always be critics."

So you evidently are fully aware of who she is.

In fact, since I prefaced my comment with "people like," Hamsher is only relevant to the point because she is among that group.

[freddie mertz]

32. Dennis Dennis Dennis.

Why?

[IndianaGreen]

40. Because they hate what he represents, the progressive wing of the party

that has refused to be seduced by Obama's sweet and lying words that he really cares.

[ProSense]

41. Says a Clinton fan. Obama promised a public option

and Kucinich promised single payer. Was Kucinich lying?

[freddie mertz]

43. Why do you hate single-payer? nt.

[ProSense]

44. "Bernie Sanders' state single payer provision is far superior to Dennis Kucinich's"

More than 30 million people want what Kucinich now enjoys. More than 40,000 people's lives depend on it.

[freddie mertz]

45. I support single payer. I don't support the mandate legislation.

Contrary to what your endless interventions infer, this is not a thought crime.

Isn't it about time that you recognized this FACT: That your relentless badgering on the issue does absolutely NOTHING help your cause.

Indeed, I am pretty certain that in this context, your "contributions" only contribute to a hardening of positions and to resentment in the face of the constant assault from your keyboard.

If you really cared about convincing anyone of anything, you would tone it down a few decibels.

[ProSense]

46. Drivel. n/t

[freddie mertz]

47. Agreed. Your OP is drivel. So let's kick it up again!

[Cha]

42. Good for Vermont's Senator Bernie Sanders!

A Team Player playing for the best Team.

[freddie mertz]

48. Actually, he is an Independent Socialist. But he does his best, it is true.

[karynnj]

49. Does Kucinich want his legacy to be that he was the vote that denied comprehensive HCR?

That WILL be his legacy if he is a deciding vote and votes no.

There is NOTHING else he has done in his career that would have had greater effect.

[LatteLibertine]

54. I like that Grayson

has been seeking to pass a separate measure that will at least allow folks to buy into medicare.

[mzmolly]

55. This is how Canada moved into single payer

health care. I simply can't understand a no vote on this legislation.

[treestar]

58. That is good

States don't have the limits of problems of the federal government. That majority that wants single payer is concentrated is the Blue states, which is why the federal government can't do it.