A Bad Idea

        Bernie Sanders would be a disaster as POTUS. He is not a consensus builder at the personal level, as numerous current and former staffers will (and have) attest in private. He has been rather disparaging of the first Black president and continues to show his apparent inability to credit any Democrat who makes compromises in the name of getting something done. Sanders never cheered Obama’s Affordable Care Act — the closest America has come to universal coverage — as the political miracle it was. That’s because it was not the perfect single-payer plan residing in Sanders’ head.  Progress under Obama also refutes one of Sanders’ corollary points, that meaningful change is impossible without a revolutionary transformation that eliminates corporate power. Trump’s assault on Obama environmental issues, Dodd-Frank, and other reforms shows their value, largely ignored by Bernie.

      Sanders has also minimized much of what Obama did in dragging the US out of the second worst economic collapse in its history, choosing the anniversary of MLK’s death to do it in Jackson, MS.  "The business model, if you like, of the Democratic Party for the last 15 years or so has been a failure. People sometimes don't see that because there was a charismatic individual named Barack Obama. He was obviously an extraordinary candidate, brilliant guy. But beyond that reality..." For a candidate trying for broad appeal, this is almost terminally stupid! Responses included:  

 “Bernie Sanders dislike of Barack Obama's administration/policies is what connects him to Trump voters. That is what they can build a bridge on and it's deplorable and disgusting.”

“The hills are alive with the sound of white people explaining why it was OK for Bernie Sanders to travel to Jackson, MS and shit on Obama's legacy on the 50th anniversary of King's assassination.”

“Dr. Martin Luther King Jr warned us about white progressives like Bernie Sanders in his letter from Birmingham jail. On the 50th anniversary he decides it was appropriate to attack President Obama and belittle the work Democrats have done for America in 15 years. Shame on you.”

          He also has the burden of being a non-Democrat for most of his life and unlike his small state, the US Congress will not fawn over him to any degree. He would face the same issues as a Ralph Nader - the angry outsider who cannot build consensus. If you want four more years of Trump, nominate Sanders. A sidebar comment – this 76-year-old writer (me) has real concerns about a President who would be 79 the day he’s elected.

       As for those wild-eyed, enthusiastic, idealistic and, to a large extent, naive young Turks (and Turkettes) who chant "economic equality" as if Bernie could snap his fingers and create it, this is a display of political ignorance on the grand scale. The system, especially the financial sector, needs regulation, that is certain, and the 2008 bubble collapse proved it, but, the real needs of the nation - equal employment opportunities, health care, civil liberty levelling, environmental protection,  cannot be advanced, or even maintained, by destroying the processes which produce income for the vast majority of the nation. That dog simply won't hunt, as the UK proved decades ago. A simple explanation, which both AOC and Sanders apparently just don’t get, is at if you destroy the means of wealth production, there is no money to do the good things one wishes to accomplish.

        What seems to have been lost in the rhetoric is that concept that the first step towards economic inclusion for the individual is to learn to do something that someone will pay you to do. When we bemoan the condition of unemployable high school dropouts who have chosen ignorance and ergo possess no (legal) occupational skills, rather than address the individual failings from which they derive, we miss the point, don’t we? I saw this as a high school teacher.  Almost all motivated students who make an effort succeed in high percentages. Those who don’t, generally fail - school, and life in general.  One simply cannot legislate success or motivation.

       That said, and acknowledging that we all can’t be in the top 10%, (a statistical impossibility), it is reasonable to posit that anyone who works hard and competently at a legitimate job should be able to make a living wage. This isn’t a “Sanders” concept, but is endorsed by essentially all Democratic candidates, and even some Republicans with brains.

       Bernie is right on health care.... but making the changes we need simply will not occur by electing an angry old man who 535 elected officials, many of whom even on his own side of the aisle, don't like well enough to support. Sander’s home state of Vermont had to abandon hopes of creating its own single-payer plan. If Vermont, one of the most liberal states in America, can’t summon the political willpower for single-payer, it is almost impossible, or at most, incredibly difficult, to imagine the country as a whole doing it.

       The shift to a national health care system in the US, unless measured and enacted with a strong consensus, would be spasmodic and could, at least for some time, actually result in less effective health care delivery as insurers are legislatively forced out of the industry. In a nation where a huge driver of health care expense is grossly exorbitant drug pricing, the same issues exist. Would the Bernie supporters have the drug industry "nationalized?" (There actually is a partial fix, available to Congress - modify Part D to allow Medicare  to negotiate drug prices) True national health care can also mean, among other things, having doctors be national employees with fixed salaries as employees of the National Health Service. (see UK)

         So first, raise a generation of altruistic and motivated students who strive for medical school. Pay their tuition to Med School in exchange for a contract to perform public sector health care for (at least) a time certain. We have great difficulty getting Americans to do it now (what nationality are your doctors?), so think about how a governmentally mandated salary scale would further (de)motivate them. Top doctors would likely, as they have in the UK to some extent, gravitate to private hospitals and private practice, requiring either cash or private health insurance. Guess who would be left out of that mix?

        Single payer is demonstrably more efficient with respect to administrative costs,  yet harder to sell to medical providers, unless guarantees of reasonable compensations are in place. At present, the portions paid by Medicare as it exists,  are lower than medical providers would like, but Medicare supplements and secondary insurances can add to the total. In the absence of such second party payments, Medicare will have to come to some sort of concordance with providers across the spectrum of treatments and specialties regarding costs and compensations. This, by its very nature would be a long and contentious process.

        Donning the ruby slippers, clicking one’s heels and chanting “there’s no ‘ism’ like Socialism” isn’t a plan, it’s a fantasy. In a Constitutional system which places the power of the purse in the Congress, it is probably a fool’s errand, especially for an 80-year-old.