2020 Elections

[Anselm]

Sanders is even less my guy since I, personally, will be much worse off under most of the things he proposes while his proposed solutions won't fix the underlying problems for my fellow citizens.  The democratic Socialist countries are not appealing to me, in large part because I am living the American Dream in having started from a very modest beginning (lowest decile) and now being in the professional class (second highest decile and still climbing) with free time for my family and hobbies that includes reading lots of books and partaking of the local performing arts offerings.

You realize, of course, that it's all the stuff people call SOCIALIST that allowed you to move across social boundaries and enjoy the life you live, correct?

• The WPA probably built the electric, telephone and sewer systems in your region so you could have light bulbs and flush toilets at home.
• Labor unions so your grandparents and parents could have weekends and living wages and job security.
• Your family might even have relied on food stamps and Medicaid at some point to keep you fed and healthy.
• Free public education and affordable higher education were made available to you.
• Social Security so your grandparents didn't consume resources that your parents needed to support you.
• Medicare so that you aren't going broke keeping up with your own parents' health needs.
• Never mind all that radical stuff like votes for all citizens, not just white male property owners; environmental protection; blah blah blah.

Where did the money come from to pay for those things?  How is it determined who will pay for them and who will get the benefits?  This is my biggest problem with any government program, the way they they pick winners and losers.  I've known people in dire straits, including myself, who could not qualify for these programs.   One example is unemployment insurance.  If you sit on the couch and watch TV you get a check.  If you take one college class you are ineligible unless your job got shipped to Mexico under NAFTA and then you can go to college for free and get unemployment checks. 

[Parasaurolophus]

Why don't you see any hope for Buttigieg or Steyer?  I'm amused every time I read "Mayo Pete" and think, yes, Midwesterners want someone with minimal drama who is running for the office of commander in chief/diplomat in chief.  Mayo Pete is currently a strong second in actual delegates--the only metric that matters in June for an uncontested convention.

Buttigieg has a real, serious race problem. It's one that started under his mayorship, and one which he's been exceptionally poor at defusing (or, indeed: accepting). Consider, for instance, his rollout of his "Douglass Plan", half of whose "Black" supporters were in fact white, and for which he publicly claimed support from a number of prominent Black politicians who, it turns out, did not support his candidacy at all (the campaign emailed them the plan and said that unless they got a negative response, they'd assume positive support). That was a bad, unforced error. Stupid, but one can accept that this stuff sometimes happens. What boggles my mind is that he then did the exact same thing a second time just before Nevada. The result is that he polls at about 0% among Black people in South Bend, not to mention nationally. That's bad news for his candidacy.

But wait! He also polls at between 1%-5% nationally among Latinos! Now there's another path to victory! His outreach to Latino communities has been virtually nonexistent.

Those are serious problems for his candidacy. Maybe not fatal in and of themselves--though definitely red flags!--but when other candidates are doing a lot better on those scores, and when so many major ST states have significant minority voting communities, you have to conclude that he's in very bad shape despite currently being second in delegates. His best hope is probably a brokered convention, but that's not much to hang your hat on.

And I haven't even begun to talk about all the reasons why he sucks as a presidential candidate.


Steyer's a different story. I can't tell why he's in the race at all, except that some people stoked up his ambitions for grift. He's sunk a ton of money into the race (including Nevada; something like $172 million overall, and 43 million in NV, if memory serves), which is about half what Bloomberg's spent and almost five times what Sanders has spent (which itself is way, way more than any other candidate). But look at where it's getting him: nowhere. Short of pulling a ST surprise, his only hope seems to be a brokered convention, too. But who's going to pick him?

Neither Buttigieg nor Steyer is running a very good campaign on the ground. They're being out-organized, and it shows. And if you want to win the presidency...

[jimbogumbo]

To claim that Buttegieg is not running good ground campaign is simply ridiculous. The Iowa campaign was terrific, and so was New Hampshire. I think this is a good first effort, and if he puts in the work in the African American and Latino communities over the next four years he'll be a strong contender in 2024.

I favored Warren and Booker, and was depressed that Booker had to drop out. I liked Buttegieg once I got to know him, and Klobuchar. But, Klobuchar should have dropped out after Iowa; it was clear she couldn't win anywhere but maybe Minnesota and the Dakotas.

I've said since the beginning I wouldn't vote for another old man. (FTR, I'm 67). I'll probably sit out the general election if the nominee is any of Sanders, Biden or Bloomberg (Jesus, why is this even a possibility!). I'm in a state where unless there is a change in the Electoral process my vote will mean nothing.

[Parasaurolophus]

To claim that Buttegieg is not running good ground campaign is simply ridiculous. The Iowa campaign was terrific, and so was New Hampshire. I think this is a good first effort, and if he puts in the work in the African American and Latino communities over the next four years he'll be a strong contender in 2024.

I'm willing to walk my assessment back. The reason I gave it, however, is because Buttigieg has poured all his resources into the first four states, and of those, he poured most of his resources into Iowa. That paid off in Iowa, and the bump helped him a lot in NH, where he spent a fair bit of effort (but still significantly less). But his efforts in Nevada were a joke, and his efforts in South Carolina aren't much better. And remember, these are two of the four states into which he poured all of his energy. That kind of ground game can't go the distance, and significantly underperforms his fundraising assets and positive media exposure.

[jimbogumbo]

To claim that Buttegieg is not running good ground campaign is simply ridiculous. The Iowa campaign was terrific, and so was New Hampshire. I think this is a good first effort, and if he puts in the work in the African American and Latino communities over the next four years he'll be a strong contender in 2024.

I'm willing to walk my assessment back. The reason I gave it, however, is because Buttigieg has poured all his resources into the first four states, and of those, he poured most of his resources into Iowa. That paid off in Iowa, and the bump helped him a lot in NH, where he spent a fair bit of effort (but still significantly less). But his efforts in Nevada were a joke, and his efforts in South Carolina aren't much better. And remember, these are two of the four states into which he poured all of his energy. That kind of ground game can't go the distance, and significantly underperforms his fundraising assets and positive media exposure.

I almost completely agree. However, I'm pretty sure he wouldn't even be on the radar if he hadn't expended all kinds of his capital in Iowa and New Hampshire.

I don't think what happened in Nevada completely supports your assertions except about his support (none) in communities of color. He easily beat Biden in all but two Nevada counties, but one of those was Clark. There, he got thrashed.


He has made some nice connections with James Clyburn's family in South Carolina. Won't make a difference this time, but could in the future.

Sadly, I don't think he can ever win (at least in my lifetime) a statewide race in Indiana.

[Parasaurolophus]

Fair enough.

(And in the interest of full disclosure (if it's needed): I absolutely detest him, and hope he ceases to inflict himself upon the American electorate. Not that he will, and not that my Canadian opinions matter in the slightest!)

[pigou]

The problem with M4A isn't on the patient side: clearly a plan with no deductible, no co-pay, no co-insurance, and no networks is vastly superior for patients. And if you pay for it through general taxation, then it's going to get cheaper for the median household than paying for it via premiums. The problem is that assuming costs will stay the same when there's unlimited coverage is insane.

Take dental cleanings (will also be covered under M4A). There are no medical benefits to getting twice annual cleanings versus annual cleanings, even for high risk groups. But dental plans generally cover two, so dentists do substantial outreach to make sure people get their "free" cleaning. Many plans now offer 3 cleanings per year, and so dentists are scheduling those patients every 4 months -- again, with no known clinical benefits. But if you can have an assistant spend half an hour on a checkup and pocked $200, that's a pretty good deal and you're going to do more of it.

The same will happen in healthcare broadly (it already happens, but to a lesser extent). A plan with no co-pay means the patient doesn't pay any more for a $1,500 MRI than a $50 x-ray. For a $1,000/month brand name drug vs. a $100/month generic. For lower back surgery vs. therapy (no known clinical benefits in the vast, vast majority of cases). And the fact that there's no "network" means there is no way to exclude doctors and hospitals who continue to do the procedures that get them paid the most rather than that benefit their patients.

GoFundMe campaigns are often brought up as a thing that shouldn't exist. But if you look at what they're raising money for: it's primarily scam treatments that have absolutely no established medical benefits. There are lots of places that fleece patients who have nowhere else to go and insurance companies rightfully refuse to pay for them. But you can't prohibit people from spending their own money (or that of donors). There's already pretty widespread abuse of addiction recovery facilities, dialysis centers, etc.

Which is to say, it's definitely not that the current system is perfect and prevents abuses. Far from it: there's a lot of reform that really needs to happen (including an end to surprise medical billing, which just failed after lobbying from hospitals). But M4A is going to make a lot of these things much worse and doesn't have a path to actually saving costs. Insurance company profits are a laughable $50bn/year out of over $3,000bn in spending. Lower back alone is more than $100bn/year.

[Parasaurolophus]

All the M4A proposals involve price controls, including (and especially) on per-unit pricing. It wouldn't be doable otherwise.

[backatit]

Specifically in reference to your claim about gofundme efforts, the four I've seen this week have been for 1) insulin treatment for a Type 1 diabetic, 2) coverage for a friend who lost her job and insurance when she couldn't work due to sepsis, 3) a friend who is asthmatic and can't afford her inhaler, and 4) a friend who has neck cancer and needs help with supporting his insurance premiums because he'll be out of work due to treatments and will have to go on COBRA for his insurance. Most of those would directly be eliminated by M4A.

I may just have a particularly good friend group (although they are not particularly affluent- my family and friends tend to be more working class as I'm first-gen in college).

[ciao_yall]

Sanders is even less my guy since I, personally, will be much worse off under most of the things he proposes while his proposed solutions won't fix the underlying problems for my fellow citizens.  The democratic Socialist countries are not appealing to me, in large part because I am living the American Dream in having started from a very modest beginning (lowest decile) and now being in the professional class (second highest decile and still climbing) with free time for my family and hobbies that includes reading lots of books and partaking of the local performing arts offerings.

You realize, of course, that it's all the stuff people call SOCIALIST that allowed you to move across social boundaries and enjoy the life you live, correct?

• The WPA probably built the electric, telephone and sewer systems in your region so you could have light bulbs and flush toilets at home.
• Labor unions so your grandparents and parents could have weekends and living wages and job security.
• Your family might even have relied on food stamps and Medicaid at some point to keep you fed and healthy.
• Free public education and affordable higher education were made available to you.
• Social Security so your grandparents didn't consume resources that your parents needed to support you.
• Medicare so that you aren't going broke keeping up with your own parents' health needs.
• Never mind all that radical stuff like votes for all citizens, not just white male property owners; environmental protection; blah blah blah.

Where did the money come from to pay for those things?  Taxes. How is it determined who will pay for them and who will get the benefits? Voters.  This is my biggest problem with any government program, the way they they pick winners and losers. You are a voter. Lobby for change if you have better ideas.  I've known people in dire straits, including myself, who could not qualify for these programs.   One example is unemployment insurance. Consider yourself lucky.  If you sit on the couch and watch TV you get a check.  If you take one college class you are ineligible unless your job got shipped to Mexico under NAFTA and then you can go to college for free and get unemployment checks. That's the end result of choosing "winners" and "losers" and being all judgy about who deserves help instead of having flexible benefits available.

[pigou]

All the M4A proposals involve price controls, including (and especially) on per-unit pricing. It wouldn't be doable otherwise.

Medicare already negotiates prices for inpatient and outpatient care, just not for prescription drugs. And private insurers generally tie their reimbursement rates to that of Medicare. For prescription drugs, there's already only a couple pharmacy benefits managers that negotiate drug prices on behalf of insurance companies -- unlikely that the government could get that much more in savings. But prescription drugs are about 10% of health care spending, so even if you somehow got that down by 50% (not even remotely possible), that's enough to bring us back to the health care costs of... 2018. Things weren't great then either.

Even so, no amount of negotiation is going to bring the cost of an MRI down to that of an x-ray, and hospitals and doctors will always make more money with more specialized care. And a surgeon is still going to make more money when performing a surgery than telling their patient to try therapy for 3 months first. What we really need is a mechanism that makes it in the financial interest of a physician to do an x-ray when that's good enough and to save MRIs for when they're needed. But a M4A system is almost surely going to make such a mechanism politically impossible.

The UK sort-of gets it done by having most physicians as government employees and having state-run hospitals. But if you look at their salaries, there's no way that'd fly in the US: nobody is going to go through med school to make $50,000 a year when they could take their bio degree and go into a biotech startup or pharmaceutical company instead. It's not even sustainable in the UK, which has been relying on doctors from Eastern Europe for years and that supply is drying up, too. If you look at what matters most -- the growth of health care costs -- then the UK is really just a few years behind the US. This isn't a problem any system has solved, because it's actually hard.

For what it's worth, I came across a cool paper a couple years ago that compared the price of veterinary care in the US vs. other countries. This is a case where none of the systemic differences that explain differences in prices for human health care apply. And it basically looks exactly the same: the US is spending much more per capita on pets, too.

I may just have a particularly good friend group (although they are not particularly affluent- my family and friends tend to be more working class as I'm first-gen in college).

It's hard to get good data on it, but it's overall not looking good: https://arstechnica.com/science/2018/10/hundreds-of-health-crowdfunding-campaigns-are-for-sham-treatments/

There are obviously people who fall through various cracks -- not least when the states they lived in failed to expand Medicaid and so they're stuck too rich to qualify for public insurance, but too poor to receive insurance through the ACA. Just to be clear: I'm not opposed to additional reforms that increase access to care.

[polly_mer]

You realize, of course, that it's all the stuff people call SOCIALIST that allowed you to move across social boundaries and enjoy the life you live, correct?

Why must people automatically go to an inaccurate label instead of looking at the tradeoffs between individual government actions, as I already wrote?

• The WPA probably built the electric, telephone and sewer systems in your region so you could have light bulbs and flush toilets at home.

Yes, that's the infrastructure I wrote about being a good use of public funds.

• Labor unions so your grandparents and parents could have weekends and living wages and job security.

I come from farmers who don't really do weekends, wages, or job security.  I worked my ass off for years in school where again weekends weren't really a thing.  As a member of the professional class, I don't work 9-5, but instead work until the work is done.

• Your family might even have relied on food stamps and Medicaid at some point to keep you fed and healthy.

Nope, again, that farmer thing means I have helped the family in many ways since I was knee-high-to-a-grasshopper including flat out labor during harvest and hunting season.  You could make a case for farm subsidies as being a targeted tax-funded program under which I have personally benefited as someone on a small family farm in some lean years.

• Free public education and affordable higher education were made available to you.

Yes, I believe I wrote in support of public education for those who can benefit.  Because I come from an excellent public school system in a rural area, I know that not everyone will/can benefit from even an excellent education available.  Humans are diverse and interesting that way.

• Social Security so your grandparents didn't consume resources that your parents needed to support you.

Nope, the culture of marrying young and having children right away means I was an adult before most of my grandparents were old enough to collect.  My great-grandmother lived with us when I was small because that was the way to ensure she was taken care of.  Likewise, the grandmother who was old enough to collect was supported by my family in various ways including taking food, sewing clothes, and other material benefits since money was tight and Social Security isn't nearly enough.

• Medicare so that you aren't going broke keeping up with your own parents' health needs.

At multiple times during my adult life, I have sent money to various family members to ensure that they don't sink entirely under a bad couple of months.  I am currently supporting parts of 4 households because I am a professional success and can afford to do so.  Taking away my personal extra capacity means all those folks will be worse off.

• Never mind all that radical stuff like votes for all citizens, not just white male property owners; environmental protection; blah blah blah.

Not socialism so I'm unclear why this item is on the list.



I have definitely benefited from the US having tax-supported public goods like infrastructure, schools, roads, libraries, environmental protection laws, good police protection in stable communities, and a strong military.  I'll grant that currently we're spending a lot of money on health-administrative-activities that would be better spent on health-care.

No one running as a Democrat is against those things.  Thus, Sanders doesn't stand out as a fabulous choice to avoid losing very important things that aren't really even at risk under Trump no matter how loudly some folks keep saying it.  However, since Sanders' plans are all expensive, I worry a lot about someone who has stated that people like me are the enemy and we don't need to have our earned stuff.  Asking us to continue to pay for the good of the country is one thing; taking away our extra capacity to help our families, friends, and communities as we see fit is quite another thing.

[polly_mer]

Why don't you see any hope for Buttigieg or Steyer?  I'm amused every time I read "Mayo Pete" and think, yes, Midwesterners want someone with minimal drama who is running for the office of commander in chief/diplomat in chief.  Mayo Pete is currently a strong second in actual delegates--the only metric that matters in June for an uncontested convention.

Buttigieg has a real, serious race problem. It's one that started under his mayorship, and one which he's been exceptionally poor at defusing (or, indeed: accepting). Consider, for instance, his rollout of his "Douglass Plan", half of whose "Black" supporters were in fact white, and for which he publicly claimed support from a number of prominent Black politicians who, it turns out, did not support his candidacy at all (the campaign emailed them the plan and said that unless they got a negative response, they'd assume positive support). That was a bad, unforced error. Stupid, but one can accept that this stuff sometimes happens. What boggles my mind is that he then did the exact same thing a second time just before Nevada. The result is that he polls at about 0% among Black people in South Bend, not to mention nationally. That's bad news for his candidacy.

But wait! He also polls at between 1%-5% nationally among Latinos! Now there's another path to victory! His outreach to Latino communities has been virtually nonexistent.

What percentage of the people who are likely to vote are <racial group of your choice> and how are they geographically distributed in the US?  One does not need to get the overall popular vote to be the candidate.  If one 100% <racial group of your choice> precinct is lost while several other precincts are won, that's mathematically likely to work out in terms of delegates and then again in terms of a general election.

I disbelieve the assertion that Buttigieg has not done outreach to Latino communities since his Twitter feed has had Spanish tweets for a year that are campaign talking points.  I live in a Hispanic-majority region and I see national ads along with local signs and bumper stickers.  I find that amusing since our primary usually is irrelevant since it's so late in the season and has very few delegates.  That's why the Bloomberg and Steyer ads stand out since we usually don't get too many political ads in the local market for national candidates.

Thus, I again have to wonder how the polls are done and whether they are truly representative or whether they were convenient for people who still have a landline or are in big enough cities that polls on the street of people who have a specific skin tone are not representative of "everyone" with that skin tone.

[marshwiggle]

You realize, of course, that it's all the stuff people call SOCIALIST that allowed you to move across social boundaries and enjoy the life you live, correct?

Why must people automatically go to an inaccurate label instead of looking at the tradeoffs between individual government actions, as I already wrote?

It recently occurred to me that people on the left who use the term "socialism" as also people most concerned with prohibiting the use of "offensive" language. Maybe if they can be convinced that many people find the term "socialist" offensive, they may be convinced to change it for a better term so people can actually hear what they are talking about.

(And as a Canadian, who favours things like national healthcare, I am offended by being called a "socialist", because I am NOT.)

[mahagonny]

You realize, of course, that it's all the stuff people call SOCIALIST that allowed you to move across social boundaries and enjoy the life you live, correct?

Why must people automatically go to an inaccurate label instead of looking at the tradeoffs between individual government actions, as I already wrote?

• The WPA probably built the electric, telephone and sewer systems in your region so you could have light bulbs and flush toilets at home.

Yes, that's the infrastructure I wrote about being a good use of public funds.

• Labor unions so your grandparents and parents could have weekends and living wages and job security.

I come from farmers who don't really do weekends, wages, or job security.  I worked my ass off for years in school where again weekends weren't really a thing.  As a member of the professional class, I don't work 9-5, but instead work until the work is done.

• Your family might even have relied on food stamps and Medicaid at some point to keep you fed and healthy.

Nope, again, that farmer thing means I have helped the family in many ways since I was knee-high-to-a-grasshopper including flat out labor during harvest and hunting season.  You could make a case for farm subsidies as being a targeted tax-funded program under which I have personally benefited as someone on a small family farm in some lean years.

If there are any farmers reading, Polly_Mer is a respected scholar, member/architect of this online community and proud advocate of the 'pulling yourself up by your bootstraps' slogan. She's against government programs that subsidize people that a few bleeding heart activists think are in meritorious position, such as farmers. OK with you?