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Edited by Mrph1 on Nov 30th 2023 at 11:03:59 AM

Mio Since: Jan, 2001
#109226: Jan 20th 2016 at 5:09:28 PM

[up]The politics seems like more of a deal breaker to Krugman then the numbers. And frankly, even if the numbers aren't fully correct it's still more information and more of a plan then most of the presidential landscape has offered including Hillary.

I don't know. I just think he is being unnecessarily harsh on Sanders for no real reason other then he's afraid a republican getting the presidency, which I think is not as likely as he thinks.

NativeJovian Jupiterian Local from Orlando, FL Since: Mar, 2014 Relationship Status: Maxing my social links
Jupiterian Local
#109227: Jan 20th 2016 at 5:31:29 PM

More information about a plan that won't work isn't a positive thing.

Really from Jupiter, but not an alien.
TheyCallMeTomu Since: Jan, 2001 Relationship Status: Anime is my true love
#109228: Jan 20th 2016 at 5:45:38 PM

If Sanders is running on shifting the Overton window by being a leftist version of Republican candidates, it basically makes Krugman's "Cult of Centrism!!!" arguments go up in smoke.

LSBK Since: Sep, 2014
Ogodei Fuck you, Fascist sympathizers from The front lines Since: Jan, 2011
Fuck you, Fascist sympathizers
#109230: Jan 20th 2016 at 6:23:55 PM

His plans do, unfortunately, seem to function somewhat on voodoo math.

But universal healthcare would be a titanic shift on the economy. Hundreds of thousands of jobs lost on the now-irrelevant insurance cos, with only a fraction of that going to expanded bureaucracy in DHS. Employers who had to pay for health benefits suddenly have free money to play with: will that go into people's pockets, would it go to executive pay, could that money be captured to subsidize the new program by itself? Where would the savings come from due to everyone having coverage and being able to get preventative care, presumably preventing a lot more sickness? Would demand for services increase due to greater access, or decrease due to more preventative care?

We can map other countries' experiences with universal health care to get some of these ideas, but most of them got it long enough ago that the health care landscape would be broadly different.

JackOLantern1337 Shameful Display from The Most Miserable Province in the Russian Empir Since: Aug, 2014 Relationship Status: 700 wives and 300 concubines
Shameful Display
#109231: Jan 20th 2016 at 7:25:49 PM

[up][up][up] Arguing that a plan is economically non viable and cannot be passed is far from appealing to the "cult of centrism."

I Bring Doom,and a bit of gloom, but mostly gloom.
Fighteer Lost in Space from The Time Vortex (Time Abyss) Relationship Status: TV Tropes ruined my love life
Lost in Space
#109232: Jan 20th 2016 at 7:35:51 PM

Ya. Centrism would be saying that Tea Party Republicans should have their opinions taken seriously regarding the healthcare system because we should give each side an equal voice in the debate.

edited 20th Jan '16 7:42:37 PM by Fighteer

"It's Occam's Shuriken! If the answer is elusive, never rule out ninjas!"
NativeJovian Jupiterian Local from Orlando, FL Since: Mar, 2014 Relationship Status: Maxing my social links
Jupiterian Local
#109233: Jan 20th 2016 at 7:44:42 PM

If Sanders is running on shifting the Overton window by being a leftist version of Republican candidates, it basically makes Krugman's "Cult of Centrism!!!" arguments go up in smoke.
I'm not entirely sure what you mean by that. The cult of centrism is the idea that political observers (particularly the media) like to blame both parties for everything, even if that's blatantly not the case. The general example is that, during Obama's administration, the Democrats have been willing to compromise in order to pass legislation, while the Republicans (and particularly the Tea Party) have not.

The Democrats want black, the Republicans want white, so the compromise position would be grey. The Republicans refuse to accept grey, they want white. The Democrats offer light grey. The Republicans refuse: they want white. The Democrats offer really light grey, basically white with a little shading to it. The Republicans still refuse, demanding white or nothing. Since the Democrats can't pass legislation without the Republican Congress, and the Republicans can't pass legislation through the Democratic veto, no legislation is passed.

The cult of centrism blames both parties equally for this, despite the Democrats doing damn near everything they can to make the Republicans happy, short of doing exactly what the Republicans want for nothing the Democrats want in return.

I'm not sure what Sanders shifting the Overton window left has to do with that.

Really from Jupiter, but not an alien.
Shawnsummer7 Since: Jan, 2016 Relationship Status: Yes, I'm alone, but I'm alone and free
#109234: Jan 20th 2016 at 7:59:03 PM

[up] Well, then it looks like we won't have a lot of legislation done for a while whether Bernie's elected or not (being Captain Obvious here). Same goes for Hillary.

I do hope he wins though because at least if he's elected, even though he may not get the stuff he wants done, we'll at least have someone in there with the inclination to get those things done.

We'll only start getting stuff like universal health care and free community college (which speaking as a young person, I really hope happens) when the Democrats control Congress again, and we'll have learned the lesson that trying to compromise with the Republicans is a futile effort.

Hopefully more people recognize that Congress is arguably even more important than the presidency and vote more in those elections. Part of the political revolution.

PotatoesRock Since: Oct, 2012
#109235: Jan 20th 2016 at 11:41:11 PM

Of what I understand, under Ryan, Republicans are beginning to accept more relative greys, but Ryan's still kind of relatively in a fairly precarious position overall?

Hopefully more people recognize that Congress is arguably even more important than the presidency and vote more in those elections. Part of the political revolution.
Again, that's Sanders' position: Him taking the presidency is meant to be a beacon. A lighthouse. A relative call to arms for Democrats to take Congress, Statehouses. Judiciaries. Governorships.

edited 20th Jan '16 11:42:33 PM by PotatoesRock

Demonic_Braeburn Yankee Doodle Dandy from Defective California Since: Jan, 2016
Yankee Doodle Dandy
#109236: Jan 21st 2016 at 1:19:57 AM

Ryan is one of the few Republicans who has cred with with both Tea Party and Establishment Republicans. It'll be interesting to see how long that lasts.

The same day Oregon Governor Kate Brown called the takeover of the Malheur National Wildlife Refuge “absolutely intolerable”, more militiamen from around the country drove in truck by truck to join the cause.

Any group who acts like morons ironically will eventually find itself swamped by morons who think themselves to be in good company.
Greenmantle V from Greater Wessex, Britannia Since: Feb, 2010 Relationship Status: Hiding
V
#109237: Jan 21st 2016 at 5:22:05 AM

@ Sanders: Reading an article that Krugman linked that shows the basic details of Sanders' Health Plan:

Sanders calls his plan "Medicare for all." But it actually has nothing to do with Medicare. He's not simply expanding Medicare coverage to the broader population — he makes that clear when he says his plan means "no more copays, no more deductibles"; Medicare includes copays and deductibles. The list of what Sanders's plan would cover far exceeds what Medicare offers, suggesting, more or less, that pretty much everything will be covered, under all circumstances.

Bernie's plan will cover the entire continuum of health care, from inpatient to outpatient care; preventive to emergency care; primary care to specialty care, including long-term and palliative care; vision, hearing and oral health care; mental health and substance abuse services; as well as prescription medications, medical equipment, supplies, diagnostics and treatments. Patients will be able to choose a health care provider without worrying about whether that provider is in-network and will be able to get the care they need without having to read any fine print or trying to figure out how they can afford the out-of-pocket costs.

Sanders goes on to say that his plan means "no more fighting with insurance companies when they fail to pay for charges."

To be generous, it's possible that Sanders is just being cynical in his wording, and what he means is that under his plan, individuals have to fight with the government rather than private insurers when their claims are denied.

But the implication to most people, I think, is that claim denials will be a thing of the past — a statement that belies the fights patients have every day with public insurers like Medicare and Medicaid, to say nothing of the fights that go on in the Canadian, German, or British health care systems.

What makes that so irresponsible is that it stands in flagrant contradiction to the way single-payer plans actually work — and the way Sanders's plan will have to work if its numbers are going to add up.

In other words, what Sanders intends is more wide-ranging than the NHS probably ever covered. And there are some other questions:

The real way single-payer systems save money isn't through cutting administrative costs. It's through cutting reimbursements to doctors, hospitals, drug companies, and device companies. And Sanders gestures toward this truth in his plan, saying that "the government will finally have the ability to stand up to drug companies and negotiate fair prices for the American people collectively."

But to get those savings, the government needs to be willing to say no when doctors, hospitals, drug companies, and device companies refuse to meet their prices, and that means the government needs to be willing to say no to people who want those treatments. If the government can't do that — if Sanders is going to stick to the spirit of "no more fighting with insurance companies when they fail to pay for charges" — then it won't be able to control costs.

The issue of how often the government says no leads to all sorts of other key questions — questions Sanders is silent on. For instance, who decides when the government says no? Will there be a cost-effectiveness council, like Britain's National Institute for Health and Care Excellence? Or will the government basically have to cover every treatment that can be proven beneficial, as is true for Medicare now? What will the appeals process be like?

This might sound technical, but it's absolutely critical. Sanders implies everything will be covered because he knows how important that question is to people. But everything won't be covered. So who decides, how do they decide, what gets covered, and what doesn't? Without knowing that, it's impossible to say whether a particular single-payer system is a good idea or a really, really bad one.

Quite.

Another crucial question is whether Sanders envisions the possibility of exit inside his system. Technically, a single-payer system is a system with, well, a single payer. Private insurers are outlawed — otherwise, it would be a multi-payer system. But the term is often used more loosely than that, and many systems that get mentioned during discussions of single-payer, like the French system, include various kinds of supplementary, private insurance that people generally purchase.

The role of private insurers matters because it drives the government's bargaining power. If drug companies either sell to the government or they go out of business, then the government can get better prices. The problem there is obvious, though: What do people do if the government doesn't cover a treatment they need? But if there are private insurers selling add-on policies to wealthier Americans, then drug companies can deal only with them, and the government's negotiating power wanes.

Remember, even with the NHS, Private Health still exists in addition to the basic treatment provided by the NHS. Sometimes NHS Hospitals offer Private Care, and certainly most Doctors do Private work on the side.

Another question Sanders's plan doesn't answer but is crucially important: How do you guarantee physical access to medical care? Right now hospitals charge Medicaid one price, Medicare a somewhat higher price, and private insurers an even higher price. If the entire system is squeezed down to Medicare pricing, a lot of hospitals are going to close. How will Sanders keep that from happening? Or will he let it happen, even if it means people in rural areas need to drive hours for care?

The easy rejoinder to this is that this is just a campaign proposal, and these are details that can be worked out in the legislative process. I disagree. Sanders is proposing a huge, disruptive reform here — he owes the public answers to the most central, obvious questions about how that reform would work. Perhaps more importantly, he also needs to show that he's at least aware of the difficulties of a single-payer system and has realistic ideas for managing the transition.

Keep Rolling On
Fighteer Lost in Space from The Time Vortex (Time Abyss) Relationship Status: TV Tropes ruined my love life
Lost in Space
#109238: Jan 21st 2016 at 5:34:17 AM

[up] Exactly this. Sanders must be accountable for his "magic asterisks" if he wants his plan to be taken as anything other than pie-in-the-sky liberalism of the worst kind.

"It's Occam's Shuriken! If the answer is elusive, never rule out ninjas!"
FFShinra Since: Jan, 2001
#109239: Jan 21st 2016 at 6:34:32 AM

This does not give me confidence about him.

Fighteer Lost in Space from The Time Vortex (Time Abyss) Relationship Status: TV Tropes ruined my love life
Lost in Space
#109240: Jan 21st 2016 at 6:37:59 AM

Frankly, I've been worried ever since I first heard his stump speech that he wasn't going to be keen on providing details of his plans, but I held out hope that it would be possible to pin him down on them at some point. I figured that there had to be actual numbers somewhere, that he or some of his staff had done the homework and it was being held back for reasons of political timing. Now I am starting to doubt that, and it makes me sad.

If I'm going to risk it all on a moon shot, I'd like to know that there is some empirical substance behind it.

edited 21st Jan '16 6:39:22 AM by Fighteer

"It's Occam's Shuriken! If the answer is elusive, never rule out ninjas!"
carbon-mantis Collector Of Fine Oddities from Trumpland Since: Mar, 2010 Relationship Status: Married to my murderer
Collector Of Fine Oddities
#109241: Jan 21st 2016 at 6:45:31 AM

There's a sort of parallel to Trump there I think. Making politically outlandish claims to get more fringe-sided votes without having any clear plan to actually implement it. Even if the worst happens and Herr Trump reigns, I don't see any way in hell half of the nuttery he's spouting would actually be realized (looking at you, Mexican Maginot Line).

Fighteer Lost in Space from The Time Vortex (Time Abyss) Relationship Status: TV Tropes ruined my love life
Lost in Space
#109242: Jan 21st 2016 at 6:50:24 AM

Well, it happens that the things that Sanders advocates have a lot of substantive analysis behind them in the econo-blogosphere, and could make a very significant difference in our national prosperity if implemented well, but I just don't think that he's talking to any of those folks on a regular basis. If he is, he's keeping it a close secret.

There are parallels in that both Trump and Sanders are running insurgent, populist campaigns based on specific hot-button issues for their respective support bases, and, unfortunately, in that both seem to be ignoring the practical realities of implementing their ideas.

"It's Occam's Shuriken! If the answer is elusive, never rule out ninjas!"
Aszur A nice butterfly from Pagliacci's Since: Apr, 2014 Relationship Status: Don't hug me; I'm scared
A nice butterfly
#109243: Jan 21st 2016 at 7:01:49 AM

See, it is better to live in a country so politically and internationally irrelevant that I can afford to just not vote for the crazy chavez wannabes and look at the U.S politics with a shrug of "I would vote for crazy old grumpy grandpa cuz he is funny" instead of having to be informed and intellectual and shit

...and then we third world people wonder why we end up so fucked up economically tongue

It has always been the prerogative of children and half-wits to point out that the emperor has no clothes
Fighteer Lost in Space from The Time Vortex (Time Abyss) Relationship Status: TV Tropes ruined my love life
Lost in Space
#109244: Jan 21st 2016 at 7:03:12 AM

I can't really dignify that with a serious response; you already said everything necessary.

"It's Occam's Shuriken! If the answer is elusive, never rule out ninjas!"
carbon-mantis Collector Of Fine Oddities from Trumpland Since: Mar, 2010 Relationship Status: Married to my murderer
Collector Of Fine Oddities
#109245: Jan 21st 2016 at 7:03:48 AM

One thing that Sanders is proposing that I can seriously get behind-

Prohibit the United States from agreeing to provisions in international trade deals that would raise drug prices in the United States or extend the monopoly period when a brand name drug company has no generic competition.

I haven't heard any other candidates touch this issue. Seems to be something largely ignored because it doesn't really directly affect anyone with any political power but severely affects the poor (myself included). note 

Fighteer Lost in Space from The Time Vortex (Time Abyss) Relationship Status: TV Tropes ruined my love life
Lost in Space
#109246: Jan 21st 2016 at 7:04:28 AM

I can't disagree with that, but it's not a sexy topic for the national political stage, unfortunately. Like I said, there are many ideas that are part of Sanders' platform that I support, either broadly or specifically, but unless he presents a credible overall macroeconomic agenda, I can't vote for him just on the basis of those ideas.

edited 21st Jan '16 8:47:00 AM by Fighteer

"It's Occam's Shuriken! If the answer is elusive, never rule out ninjas!"
FieldMarshalFry Field Marshal of Cracked from World Internet War 1 Since: Oct, 2015 Relationship Status: THIS CONCEPT OF 'WUV' CONFUSES AND INFURIATES US!
Field Marshal of Cracked
#109247: Jan 21st 2016 at 7:14:05 AM

I've heard quite a few people go to Canada to get medical treatment carbon, yes, that's how bad you Yanks made it, that people are going to CANADA, eh

advancing the front into TV Tropes
Greenmantle V from Greater Wessex, Britannia Since: Feb, 2010 Relationship Status: Hiding
V
#109248: Jan 21st 2016 at 8:49:19 AM

[up] Then again, to turn it around, how often is the NHS not in the news?

Keep Rolling On
Fighteer Lost in Space from The Time Vortex (Time Abyss) Relationship Status: TV Tropes ruined my love life
Lost in Space
#109249: Jan 21st 2016 at 8:50:29 AM

The way I see it is that any system is only as good as the people running it, and both Canada and Britain (never mind the rest of Europe) have had governments in place for many years whose leaders see it as their goal to tear down the trappings of socialism and replace them with "market solutions" in true neoconservative style. It's no wonder that dysfunction would arise in those services as a result.

edited 21st Jan '16 8:50:50 AM by Fighteer

"It's Occam's Shuriken! If the answer is elusive, never rule out ninjas!"
JackOLantern1337 Shameful Display from The Most Miserable Province in the Russian Empir Since: Aug, 2014 Relationship Status: 700 wives and 300 concubines
Shameful Display
#109250: Jan 21st 2016 at 4:25:20 PM

Well we'd have to see how the NHS operated in it's "glory days" and compare it with how things run today.

I Bring Doom,and a bit of gloom, but mostly gloom.

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