Bruce Levine's picture

    Appealing for Healthcare Consensus--From Patchogue to Pasadena

    I grew up in a town called Patchogue, and although I haven't lived there for forty years it will always be my hometown.  Patchogue is about 60 miles from Manhattan, and so it was and continues to be bit too far from the city to be a commuting town.  

    Much of Patchogue is Trump country, and I often find myself with some, but few like-minded thinkers when it comes to the fitness of the president to serve.  And, until the election, after repeated admonishments from my more rational spouse, I was basically silent -- with Patchoguians -- about my firm views on Donald Trump and what he represents.  I do get a chuckle out the talking heads, however, when they speak of separate bubbles of Americans.  I have no doubt I am far from the only Clinton voter whose life-long acquaintances believe in Donald Trump. 

    Since the election, I have been far less circumspect with my hometown family about the president.  And yet I tread carefully.  I do this for a number of reasons  Many of the folks I know voted for Obama, and did so twice, and so whatever happened in November is complicated. How do I tell Gina (we've been friends since the 60s) what to do after she lost her beloved nephew in Afghanistan last year?.  Gina's nephew Louis had returned there for another tour of duty because of the limited opportunities he had on returning home.   And what do I say to Bruce (not this Bruce), whose son joined the marines at 18, stayed until he was 32, did four tours in Iraq and Afghanistan, and is now enrolled in community college because he cannot get a job?

    Still, post-election, I cannot stay silent, and I have resorted to social media to appeal to the fundamental goodness that I believe with all my heart exists in just about everyone. And so I search for consensus where I believe it can be reached. My recent focus is healthcare, and below is what I posted on Facebook this morning, and hopefully my introduction will help to explain how I approached the issue with my Patchogue peeps.

    This is my 10-point proposal that I posted this morning, and I present for your consideration and critique:

    ​1. Healthcare is a critical issue to every American.

    2. Some people think government should help provide universal access to health insurance, and others think that government should provide universal insurance coverage. There are good faith arguments to support both positions (aka a lawyer's dream and a nightmare for others).

    3. There is nobody, absolutely nobody, that I have read or spoken with or heard from, who believes that Obamacare is perfect, and some folks think it's worse than simply less than perfect.

    4. I hosted a couple of discussions on FB over the last week that corroborate my firm belief that one thing we should not do is rush to make changes--just because of campaign promises.

    5. Simply put, "repeal and replace" is not a healthy way to change healthcare.

    6. Moreover, it is not true, I submit, and dangerous to accept, that Obamacare is imploding. We have time.

    7. It is bipartisan, apolitical, and the right thing to do, for everyone to call their representatives to say this one simple thing: "I don't love Obamacare, or I can't stand Obamacare (however you feel), but if we're going to change healthcare one way or another, please don't rush."

    8. This goes for Democrats too, and to my brothers and sisters in the Democratic Party, here's what I think. I understand that there are reasons to argue that Republicans, who for years called for "repeal and replace," should stew in their own hypocrisy. But that and $2.75 get you on the subway. This is healthcare, and none of you out there think that Obamacare should continue as is. That means that even Democrats need to roll up their sleeves--certainly at some point. That's what I'm going to say to my representatives.

    9. I don't think this is about the president. I think he wants to be able to say something was done, and he doesn't have a dog in this hunt. It's entirely transactional for the president on many issues, and healthcare is one of them.

    10. So this is on Congress, not the president--at least not at this point. Lots of you folks who usually vote Democrat but supported Trump should keep this in mind. "Repeal and replace" is a Republican concept that predates President Trump and his adoption of that theme in the campaign. Please don't believe that "giving the president a chance" to do what he was elected to do means letting Congress play politics with the health of our kids and grand kids.

                                                        **************************************

    Penny for your thoughts.  Thanks.

    Comments

    I think my biggest criticism of my ten points would be the way I tried to nuance the role of the president. Yes, Congress is the genesis of the "repeal and replace" mantra, and yes the president doesn't really care about much and just wants to take credit for change, AND yes the president has now taken the lead in the campaign to falsely discredit Obamacare.


    Bruce... I side with Josh...

    As I posted in this Dag thread ...

    Indivisible Rising - on Fri, 02/17/2017

    And here is Josh today March 14, 2017, 7:53 PM EDT

    Time to Apply The Pressure

    --snippet--

    Here's the key. No one wants to be the last one holding on for an unpopular or dead bill. The more electeds pull their support, the more perilous the situation gets for those holding on.

    There are any number of reasons why this is true. If the bill goes down, you want to say you were always against it. If an unpopular bill goes through and everybody in the party supported it, at least then you have all the party machinery and all the forces of partisanship making the case for the vote. If you supported the legislation but the party abandons it, you're really on your own in your next reelection fight.

    What this all amounts to is that the political pressure against repealing Obamacare is working. Senators see the consequences in their states and are either moving into opposition to Trump care or getting skittish. The more those people (and the same applies to those getting cold feet in the House) are confirmed in their opposition, the better. Just as important, the more move into that camp the more intense the pressure gets on those that remain. More pressure to cave and more bad electoral consequences down the road.

    It's not impossible at all now that Obamacare will either not be touched at all or amended in very limited ways. If that happens, not only is that great for those who retain their health insurance, it is also disastrous politically for the GOP. Republican base voters have turned out in three straight elections around a unifying message of repealing Obamacare. If they can't make that happen with full control of the entire government it will turn the party's wings against each other and be profoundly demoralizing to its voters.

    Just as important, for a President victory begets victory and power. And vice versa. Of all President's Trump capture on his voters, a huge amount is tied up in his claim to be a man of action, someone who gets things done. If he can't manage this, it will hurt him a lot.

    What it all comes down to is that if you want people to retain their coverage and want the GOP to have a shattering 2018, now is the time to pour on the energy. Grassroots pressure is working. And it's effectiveness is growing because of that.

     

    ~OGD~

     


    moved comment

     

    I have run into enough Longue Eyeland and Westchesta type Trump fans that I feel your pain. They seem to be a special type difficult to figure out, not exactly Staten Island GOP. It's like they have risked the bet of their entire houses that having an anti-politician in the oval office is the last best chance to rectify everything.

    So I can't be of much help with your brave quest, haven't much of a clue what would work for them that would involve politicians.

    The only thing I can think of to contribute. Keep in mind that though those of us who have been forced for one reason or another to try to understand it, that health insurance is indeed complicated, no joke, and nasty boring wonk stuff, and most have not been forced to try to understand it as they have the luxury of leaving that pain to their employer. So whatever wonk argument you might make, they don't get.

    But what I have found that such people often do get, especially if they have had any experience accessing a serious amount of health care in the current system: the profit motive does not belong in the practice of medicine. (I.E., it's a profession; would you trust an accountant that did so? or, would you trust a doctor working on contingency?) Then to say: Republicans believe the profit motive will make for better medicine and a better health care system, and that they build that into any laws they pass on the subject.

    Edit to add: it might also help if you admitted that you think Trump was being genuine about thinking he could easily produce something that would be better than Obamacare, that he himself has now admitted that he has discovered it is a might more complicated than commercial real estate, and that he is being forced to go along with what the GOP House is proposing through a combo of political contingency causing lack of time to investigate the whole thing. I suspect it's probably important not to impugn Trump's motives here, because he is still seen as the anti-politician by them. It should be more along the lines of him being duped by the House GOP? It might even be helpful to mention that he should be listening more to the governors, because it is the federal and state congressional bodies that are really seen as "the swamp" by this time of Trump fan?


    You might want to hold your horses a bit, the White House gang might still turn against the bill or force a change  in it, see the breaking I posted here:

    http://dagblog.com/comment/235242#comment-235242

    It's really tough doing any advocacy without limiting it to wonkery when everyone involved has extreme political motives.


    Option D -he's lazy as fuck and waiting for someone else to do something he can take credit for.


    Yea, but his supporters are good with that PP lol.


    Not so good. Alternatives for Obamacare are a disaster - PR & practically. Despite a decade of demagogueing, no one thought they'd ever be required to put real legislation on the table.

    If it were something only the poor & powerless would pay and suffer for, it might fly.


    I suspect it's probably important not to impugn Trump's motives here, because he is still seen as the anti-politician by them. 

    Thanks AA, I know this is a bit of an awkward effort on my part, but I'm also seeing people doing all kinds of things in response to the shocking election of Trump.  My three older ones and their contemporaries are making contributions, and demonstrating, and generally becoming more conscious of what has happened, and more importantly what may happen.

    But there are other worlds (bubbles).  I cannot tell you how many union folks, the rank and file, were committed big time to Trump, to the point where it's just really stooopid.  No strength here, and not appropriate for me in many cases, to tackle that at a personal level.  My "compromise" is  that folks know how I  feel, I make no secret about it, and life goes on.

    Then there is the Jewish angle, which I could write about and make a far less boring post for some people round these partz--I seem to recall a certain affinity for "Jew on Jew" battlin'.  But the truth is, in defiance of my Rabbi (who among other things has gotten himself arrested in support of immigrants in the last month), who admonishes us repeatedly that we look stupid when we lose our humility, I have broken off relations with any Jewish acquaintance, including two good friends, dear friends (one who I often wrote about on here), because of what I consider in my heart to be a sin, i.e. how does a Jew with our history vote for a man like Trump?  The answer is it is inexcusable for a Jewish person in my mind to have voted for Trump.  And there are nasty people in this group.  (See, e.g. David Friedman, soon to be US Ambassador to Israel).  Indeed, I was trying to figure out all kinds of ways to write down the experience I had for the first time last week--I was called a KAPO, a Nazi collaborator, by a fellow Jew.  In all the years I have battled with folks here and at other left of center sites, nobody, absolutely nobody, has ever called me Nazi or Kapo.  My heavens, folks would get banned for that kind of stuff, even in the wild wild dagblog tundra.  The experience stabbed my heart like no knife could.

    But the Jewish angle in my life, while something I've written so much about, doesn't touch my roots in Patchogue, where I literally was one of the "house Jews" in the hood.  And so I'm working it, first as a shocked and angry supporter of the losing candidate and ultimately tempered by recognizing the complexities of the support for Donald Trump in the hearts and minds of so many.  I don't know if it matters, and I recognize that.   I do know that there is almost no more "fake news" being posted, and the red-baiting or sleaze-baiting of anti-Trump demonstrators has ceased.  And the "snowflake" stuff melts on impact. But folks just don't let go of a Trump, and they're in a "give the guy a chance mode," but I guess right now I'm satisfied using whatever credibility I've accumulated over 50 years to focus on the disconnect between the Donald Trump they see and want to believe in like a kid wants so badly to continue to believe in Santa Clause, and what Donald Trump and those around him have in store for the white working class supporters of Donald Trump.


    I really enjoyed reading all that you shared here, Bruce. You probably have divined that I am simply a sucker for learning about any of this type "subculture" stuff. Disheartening to hear that it's all been so hurtful for you.

    From my angle, there is great hope here, though:

      I do know that there is almost no more "fake news" being posted, and the red-baiting or sleaze-baiting of anti-Trump demonstrators has ceased.  And the "snowflake" stuff melts on impact.

    Say to me that the freedom of the press thing, it is working. And capitalistically, too! The old style journalism rising from what was starting to look like a grave. Trump propaganda/spin = not selling. I have read analysis that has convinced me that a major part of Trump's squirrelyness is due to that, because he had been deluded all his life that he could manipulate the media to his wishes and he is finding himself failing at that now. If he can get used to that, he may settle down and act more rational, so the "give him a chance" thiing, I do not consider it totally irrational. He might even deliver on some promises. Most people in this country now instinctively get propaganda or as it is called in our culture "P.R." Yes, it does mean that many of those who voted for him wanted some of the nasty things he promised, and that's the whole other problem. But baby steps are better than nothing, I think we can be assured that a dictatorship is not coming our way.


    Thanks AA, it's not been too painful, really.  And, to date, ain't nobody telling us to get out or anything like that.  Lots to be thankful for even as we begin to sense the fragility of so many things that we take for granted.

    P.S. And, yes, as I've gotten older I have learned that baby steps can still be useful.


    Hope with next generation. . .my son here in DC (note the sarcasm in my message in response to the meme at the time that the DC marchers were a vulgar lot), and my three older ones with some aging curmudgeon in the sleet and rain, demonstrating with HIAS (Hebrew Immigrant Aid Society), in support of immigrants and refugees.  


    The last three articles I posted on the other thread make it clear that this is going to drag on for a long time and there are going to be a lot of changes to what the House put forth but they can't do nothing, either. So unfortunately, you don't even know what you are arguing against.

    The strongest dissatisfaction seems to be with letting the older pre-Medicare age demographic pay a lot more (and that, I would argue, is not the least of which because that demographic gets out and votes in mid terms.).Second is how it handles Medicaid. So the whole thing really has to be rejiggered, because the last thing the GOP as a whole wants to end up with is a more expensive system than Obamacare, and that's what they'd get if they just tinker on those two points.

    And the Russia thing is going to pull a lot of air from Senate rooms right now.


    And note that except for his hardcore base, the president is not getting a bye on the current House plan  Fox Poll showing 35/55 approval v. disapproval of president's handling of healthcare.  It's one of those hot messes.


    hey I bet you contributed to that disapproval rate! take a bow! wink


    Yes, seismic shift out of aging Patchoguians!


    Keep at it, you can get every single one. There's a lot of good arguments for Republican type thinkers against "repeal and replace" in this Politico piece and certainly against the House bill:

    http://www.politico.com/magazine/story/2017/03/cbo-health-care-congressional-republicans-214905

     


    AA, I'm glad you're taking this post seriously, because I wrote sincerely believing that each of us can in our own way make a difference.  I'm going to share with you a private message I received from someone I've probably not seen in decades, and it blew me away and it's kept me going since.  This is what I woke up to on the morning of February 6th:

    Good morning Bruce. I wanted to point out an observation that I have made in recent weeks but I didn't want it up for public debate so forgive the clandestine format. I read your posts and look forward to seeing them most every day. The fact is that your comments on these very critical subjects are so well thought out and spoken in a clear, understandable way. You speak without venom but your genuine concern is apparent without reducing yourself to speaking in a derogatory manner to those who may not agree with you. The reason I am focusing on the way you project yourself is that we need people such as yourself who can explain to people the seriousness of what is happening with the only agenda being to educate the many many many people who are not well versed and are embarrassed to say it. These people are so angry because they clearly get the gist of what is going on but not necessarily what they can do about it. This rant (sorry Bruce) I am guilty of is just a thinly veiled attempt to encourage you to continue educating many people including myself at times, on how to get in front of this mess in such a way that people still want to learn more about what it is they can do by understanding that they have power. If you Dave ______ and Tim _____ sat down and brainstormed I think alot of people would toss in their hat at many different levels. Not trying to get all Kumbaya on you, well maybe just a little. Think Norma Rae on a much more specific way. People NEED to really understand clearly the ramifications of his actions and THEN they have to understand the power they have and how to use it in the most effective way so their voices can be heard. I'm rambling on but I think it is vital for every person who knows that some of the actions that have been taken this past few weeks is reprehensible and YES everyone has a voice so lets help them to do that in the most effective way possible. Thanks for listening.

    AA, can you believe that she thanked me for listening?  The salient point is that I do believe in doing what I'm doing here, not that it is anything profound, but that it is an example of one of the little things that each of us can do--and why the hell not?  Heck, it beats arguing about Israel. :)   And those of us, like so many of us here, who can put a sentence of two together, might be in the position to put that ability to good use--on FB, some other forum, or heaven forbid, in face to face encounters everywhere people talk about stuff.

    P.S.  [Deleted this because I was concerned about the possibility, albeit remote, that what I wrote could be used to identify the person who wrote the above without her permission. Nothing substantive.] 


    Yes it is beautiful, that is exactly the way to describe it.

    Makes me want to yammer a bit more on this specific topic: helping people understand health insurance in this country is a mitzvah for a Jew and should be worth like 10 years indulgence for a Catholic! Cause trying to figure it all all out is like spending more time in purgatory already!

    My dirty little secret: I'm far from a fan of Obamacare Romneycare (if you think of it that way, the whole Obamacare lite thing makes more sense, as the GOP caused significant changes to what Obama & Dems wanted), but it's better than nothing. To just have the the pre-existing condition thing solved was worth all of the rest. And delving into these issues often gives me a headache. I was forced to do it from more than a few major personal circumstances.  But now: if more people are educated through all of this, maybe we'll end up with something better!!!  What I am starting to think: that from all this angst, that really could happen before I die. wink


    this one is good, too, for some of the points he makes, for inspiration. It's a conservative talk show host in a NYTimes March 15 guest op-ed, especially where he gets into how he differs with Trump voters:

    https://www.nytimes.com/2017/03/15/opinion/erick-erickson-dont-try-to-fix-obamacare-abolish-it.html


    there are plenty of other results in that Fox poll that are interesting too, like:

    When asked about Trump's tweeting habits, just 16 percent of voters said they approved. Half of voters disapprove of the president's tweeting and 32 percent "wish he'd be more careful" with what he tweets.

    and

    A majority of voters, 54 percent, disapprove of the president's revised travel ban, and just 34 percent think the order makes the country safer.

    and

    On immigration, 41 percent approve of how the president is dealing with the issue

    and

    just 33 percent approve of how he is dealing with U.S.-Russian affairs.


    Those are interesting findings.  I wonder, still, and kind of think it is the case, that underlying all of those numbers is a solid, as yet immovable base of say 35 to 40 percent of the American public.  


    Boston Globe columnist Joan Vennochi writes this morning about the futility of changing the hearts and minds of the president's most ardent base, and takes a few shots at bleeding hearts like yours truly. Apparently the column was prompted by the behavior of anti-Trumpster at her mom's funeral.  She writes:

     

    Walking out of church, I stopped to hug a relative I seldom see and thank her for attending. As the casket was being lifted into the hearse, she segued to the subject she said she really wanted to talk about: the anti-Trump letter-writing campaign she had joined and the urgent need to declare the president mentally unfit.

    ...............

    I agree with fellow Globe columnist Alex Beam: Get used to Trump. He’s not about to self-deport out of the White House and, for now, impeachment is a liberal pipe dream. Meanwhile, he’s delivering on campaign promises his opponents find hateful. But until Trump backers come to hate Trump policies, the wailing from the other side is little more than Shakespeare’s sound and fury. Rather than signifying nothing, however, all that noise signifies something very specific to Trump backers: Trump Derangement Syndrome. And there’s some truth to it.


    Trump has his 40% base. Democrats need to target the other 60%. Trump supporters will not be moved by separating children from their mothers, voter suppression, destruction of the environment, etc. They may even tolerate losing health care if they feel less worthy groups are being harmed more.


    I can't argue with this reasoning at all RM.  There is another dimension though, which is where I've come from more often than not, that seeks to separate the loyalty to the man to the policies being proposed in Congress.  It's kind of like what is happening with the whole healthcare debate, for better or for worse and we'll see.  


    But he's not delivering on his promises and only trying hard on immigration so far. There will be no health insurance for everyone anytime soon and there will probably not be a wall. Etc.

    And a note for rmrd: Fox's own poll basically puts the hard core supporters at 1/3, not 40%. This is really no change for decades, 1/3 of our population is always vehemently anti-Dem and conservative in various ways.. And note that even half of them don't like some of his behavior like the tweeting! (Comes to mind this makes a lot of sense since part of that 1/3 are social conservatives who wouldn't cotton to Trump's more "heathen, sybaritic" side, as one writer I read put it.) The winning this time was strategically accomplished with GOTV of those who normally don't, not by changing the nature of the country itself. Polling even by Fox shows things haven't changed on that front.

    Edit to add: I  happen to think these demographics that were the same for decades are going to change in the future as boomers die. Millenials will be different one way or another.


    Gallup poll from 1/20/17 to 3/8/17 puts Trump's approval at 42%. There is a racial difference with 67% of white men without college degrees supporting Trump while only 13% of blacks support Trump.

    http://www.gallup.com/poll/205832/race-education-gender-key-factors-trum...


    People give a new president benefit of the doubt, especially so in this case, Independents with a president that is not a party faithful, even if they didn't vote for him might agree with some things he promised, and hope for the best. The Fox poll link's lede is that he has just lost 5% in approval, the end of benefit of the doubt is kicking in. I think the media's strong stand against all his shenanigans has effected that rather quickly.


    The Fox poll puts Trump approval at 43%

    http://www.foxnews.com/politics/2017/03/15/fox-news-poll-trump-approval-...

    Fivethirtyeight puts the approval at 43.8%

    https://fivethirtyeight.com/

    There is no argument.

     


    P.S. On immigration, it behooves everyone to remember that this issue is special in that it crosses a lot of party and ideological lines, i.e., it's not the case that all liberals are pro-immigrant and all conservatives anti-immigrant. "The wall" thing had a lot of appeal across many lines.

    Health insurance is turning out that way too and keep in mind what he promised on that. It is actually not irrational to think that a billionaire businessman might be able to fix what politicians could not on that front. Where people got fooled is thinking he would have a brain for policy. Perot got a lot of votes for the same reason, I am sure, I watched all the debates on topic and Perot was selling "this is not rocket science, we can fix it."


    Impeachment or resign, I don't care which. Heart attack works too. Trump is continually in violation of the emoluments clause, and has colluded with the Russians both to throw an election, reveal the opposing party's strategic property, as well as to circumvent a presidential executive order. I've seen much less obvious pipedreams in my life. Make Trump live in his pressure cooker - he has thin skin and will eventually fold like a cheap suit. Even a few Republicans are coming around. It will only grow.


    Trump admits that the current healthcare bill hurts people in the counties who voted for him much harder than the counties that voted for Hillary. He says the bill will be adjusted.

    http://www.huffingtonpost.com/entry/donald-trump-health-care-bill_us_58c...


    I think he is going to try to keep what he thinks are his promises to those who voted for him, because their adoration is the air he breathes. I also suspect he may not be competent enough to do that, especially to work to effect it with Congress. If he can't, he will spin it as such and he will believe his own spin.

    The point: he is going to continue to pander to them. And what he thinks they want may be wrong. But it's genuine pandering, to a minority of the population. Clearly he is not going to ever try to be president of "all the people" because he thinks "all the people" are off the track of making America great again. They'll thank him later in the history books. It's not cynical rich guy stuff (he just happens to think rich guys are smarter than politicians and bureaucrats.) I listened to parts of his rally speech yesterday. He wants to go back to Rosie the Riveter, you could tell he really believes that whole shtick, it's what inspires him to do what he's doing. He wants to see factories churning out planes one a day, the U.S. blowing everyone else away, on topa the world.


    there is this great couple of lines in the article I just posted on the Trump/Ryan thread, just really pegs what we've got in Trump and the GOP Congress:

    In theory, Trumpism follows the tradition of the European right, which combines nationalism with support for the welfare state. In practice, Trumpism relies on Donald Trump, who is many things to many people, and the Republican Party, which rejects nationalism (apart from the interventionist sort) and seeks to shrink the welfare state.


    In practice, Trump follows the practice of Berlusconi, Francois Fillon, and other super-wealthy pompous ethics-challenged purveyors of faux populism.

    Lock him up.


    Berlusconi is a useful comparison except where you get to the part where he keeps getting re-elected.

    Lock him up.

    Keep in mind this thread is to help Bruce with winning over Trump voters to reasonable, non-lunatic policy choices. Making him a martyr: not so good? Frustrate him till he quits?


    Starting to look to me like the whole liberal media wants to help with your project!

    The G.O.P.’s Great Health-Care Betrayal

    Paul Ryan’s bill would transfer billions of dollars from older, rural Trump voters to counties that voted for Clinton.
     
    by Abigail Tracy @ The Hive @ VanityFair.com, March 14, 2017 11:17 am

    Most excellent help for your project, as only a master at 'splaining can do:

    Does Donald Trump know what the GOP health bill does?

    Ezra Klein March 17, 2017, 5:30 p.m. ET

    Maybe not.

     


    Robert Samuelson @ WaPo makes a good case that the use of Medicaid for the long term care of elderly who are already on Medicare is the major expense screwing up the whole system and things would be much better is that were fixed and we owned up to "we're paying for nursing home care whether we like that or not". That the division of care for the elderly between Medicare and Medicaid is artificial silliness because Medicare didn't want to cover nursing homes. That if elderly care was all federal, and not split, the states would have little problem covering the rest that need Medicaid. Yes of course this screws all the extra responsible people who have purchased long term care insurance. How many of those does anyone know?

    Politico notes that Paul Ryan made a related statement the other day (whether he thinks it is related or not, it is.) Doh. No brainer


    I think people like you helped get this consensus:

    Only 17% of Americans support 'Trumpcare' in new poll

    word of mouth started by trusted menschen can go far, take a bow


    Coming to this almost two weeks later I was struck   to read you still believe in the fundamental goodness of most people.

     I guess I don´t . And haven´ t for a while  Reading that you do  caused me to at least be more open to the possibility that´s true.  


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