Medicare for All?

It's obvious that Bernie's "Medicare for All" bill is not about to become law, but that doesn't make it an exercise in futility.  It is a means for ambitious Democrats to define themselves as progressive, not slaves to the party establishment.

The single greatest obstacle to national health insurance is not Republican or industry opposition – it is employer provided health coverage.  As long as most Americans have that, they will not be especially concerned for those who do not; so public pressure for national health insurance never will be sufficient to bring about change.

There must be a means to transition from employer provided insurance to public insurance – and the most direct route begins with allowing employers to purchase Medicare for their workers.  This "free-market" approach would put a government-run program in direct competition with private insurance.  Profit-free, Medicare should have a competitive advantage; and by introducing younger, healthier participants into its insurance pool, Medicare should become more economically viable.  The new money in the system also would make the prospect of future cuts in benefits or increased premiums less likely.

The impact on the private insurance industry would be gradual, as employers switched over.  Since Medicare is far from a "Cadillac" plan, many employers also would shop private markets for supplementary, further softening the impact on the industry.  Over time, there would be plenty of public pressure to improve the coverage that Medicare offers, and to offer Medicare as an option in the ACA insurance markets.

Once a majority of Americans already are covered by Medicare, it would be far easier to find support for universal coverage, paid for by a combination of individual and business taxes.  Here in the USofA, "creeping" socialism is the only kind that ever wins the race.

Economic Outlook

Although the Times still is publishing an extra section to cover election "news," and a lot of young people in urban centers haven't figured out that you're supposed to organize and get active before bad things happen, the dust is beginning to settle.

Somebody seems to have assured Wall Street that our next president will not be starting any trade wars, so the markets have stabilized.  Given Tr*mp's anti-regulatory instincts and the promise of even more tax advantages for the rich, a bit of a bull market certainly isn't out of the question.  Economically, it looks like Republican-as-usual on the horizon.

The narrow Republican majority in the Senate means that Obamacare, such as it is, will be safe for a while — although steady defunding seems inevitable.  In a way, it's a shame: the total elimination of Obamacare could pave the way for genuine national health insurance down the line.  The biggest beneficiaries of the ACA were those newly qualified for Medicaid, and it's pretty clear that letting market forces determine health spending continues to be unworkable.

I wonder how successful Tr*mp can be in moving expensive infrastructure projects past the deficit hawks.  They even might balk at a substantial expansion of border controls.  Forget the "wall" altogether: if there is any real progress towards seizing remittances to Mexico, invest in virtual currency exchanges — or, perhaps, organized crime cartels.

The biggest damage will be done to the fight against climate change — but even there, it seems to be too late to save the coal industry.  Hopefully, though, the industry's last gasps won't be a prelude to our own.