Housekeeping

 

I should really let you all know that I'm in a much better state, getting regular physical therapy and recovering well, though I've got a long way to go. My grievance with the hospital now boils down to just one item, their catastrophic inability to communicate, which I guess is a form of the "administrative burden" Brad DeLong was writing about (the day after my accident, as it happens) :

Pamela Herd & al.: Administrative burden as a mechanism of inequality: ‘Ask anyone about their interactions with government, and chances are you will get an earful about a seemingly Kafka-esque experience that they or a family member has faced trying to access vitally important social rights such as health care, income support, unemployment, and food assistance, or a fundamental political right….

Administrative burdens have the odd combination of being both grindingly familiar to us as individuals, and largely unattended as a matter of policy analysis, design, and practice…. One explanation for this failing is the fragmented discourse around them, siloed both across and within academic disciplines and policy areas…

The hospital never in fact abandoned me, they just never let me know. I wasn't getting PT right away because I wasn't expected to be ready for it until considerably later (most patients are too broken to start exercising for at least a couple of weeks; I was ready, in fact, as they could have found out if they'd been paying attention, but they were treating a fictionally average patient). There's a whole series of follow-up visits going on into October I have to attend, but they didn't tell me in advance, just started scheduling them and calling me when that was done. All the medical personnel are very nice, encouraging, and happy to tell me what they know (which is of course limited by the "team" approach; I finally had an appointment this morning with the "Dr. John Muller" who undislocated my finger but never entered my brain, but he still didn't show up—it was an extremely pleasant young woman called "Dr. Miller" that examined me and sent me on my way).

It is, as DeLong's reading suggests, a form of the enforcement of inequality. We commonly think of administrative burden as a rightwing issue, complaints about excessive regulation, and the suffering of businessmen forced to furnish proof that they're not robbing the public or endangering their workers, but it falls more on the disadvantaged, who can't hire the assistance they need to emerge from the process successfully and experience it not as too much paperwork but as sheer neglect: 

My view is that administrative burdens do not vary much across different types of interactions with the government—but that means that you are f***ed if you cannot afford to buy expertise to figure out how to minimize the burdens, or if you find yourself in a place in your life where you have to have a lot of interactions with a lot of different arms of governments. And federalism is an absolute killer.

Thus it is not a mechanism that raises inequality so much as a burden that existing inequality makes much heavier on the poor than on the rich—that insulating themselves from government-imposed administrative burdens is another one of the things the rich can and do buy with their money.

Something I've been too prosperous to experience in recent years (not entirely: I've had some bad and mystifying tax issues connected with Social Security) but remember from my youth and bouts with unemployment insurance and food stamps (back when there were actual stamps) and student loans, in pathetically small amounts (low four figures), that somehow took me decades to pay.

Now I'm past the actual horror I wrote about a weekend ago, I'm taking it as an opportunity to think about these matters, and kind of glad of the experience.

Public Options

 

After I was taken from the subway station where I'd fallen down a flight of steps and broken my left femur to a well-known East Side hospital a couple of weeks ago (saga here, here, and here, I stayed in the intensive care unit while they were readying me for surgery and then got moved to an ordinary unit after the surgery was done, and was dismissed a couple of days after that, in what felt like a rush job. I had to coordinate my exit myself, via text, with various family members, and negotiate the wheelchair ride to outside with nurses who had mostly disappeared, get dressed (another nurse brought me a pair of sweat pants, my leg being much too swollen to fit in the jeans my son brought from home), and nobody seemed available to answer any questions about what the rest of my life was going to be like, or even the next few days. Then, as the kids and I waited for their mother to show up, the wheelchair-wallah got antsy—it was taking too long, and he was afraid of getting in trouble for keeping the wheelchair—with me sitting in it—too long. He suggested I should get out and stand there with my new walker, or maybe if I got too tired I could sit down on one of the 18-inch round stone objects with which the pavement was dotted, which I obviously couldn't.

So I ended up surrendering, and standing to wait for my ride to show up, which was maybe not so bad (not as bad as the horror of getting into and out of the car with the kids trying to swing the leg into position). I'll never know if the guy was reprimanded for bringing the chair back late, maybe even fired, for all I know, or if his anxiety was merely irrational, as it seemed.

It's a week since then, and the whole experience is taking on a different complexion in my memory, starting from that spot and working backwards (so that the apparently harmless events of the early part are seen to foreshadow the abandonment at the end), than it had at first, in a way that's maybe relevant to some ideas that have been floating around the Tubes in the last few days. 

Everybody I interacted most with—the nurses and physical therapists—was kind, competent, and respectful, but these relationships weren't very stable; few lasted longer than a shift, day or night. The others were still more fleeting, especially in the upper orders, social workers and doctors, of whom I never met one twice, never got a name or an offer to call, never got an effort to connect (except one of the anethesiologists, they always have a sense of humor), and at the top of the hierarchy groups of four or five from which no individuals emerged at all, except a chairman charged with the job of speaking for them, a "team", and where they mostly gave me the neurological test (name, birthdate, and "where are you?" "what year is it?"). I finally lost my temper with one of them: "What are you, tourists?" That chairman took it courteously, explained that they were the "Trauma Team", monitoring my case, and that they thought I was ready to leave. I apologized and thanked him, but I feel funny about it now.

Could it be?

A nice column by Paul Waldman at WaPo ("How this crisis could help us get to health-care reform") asks a question I've been thinking about a little bit, whether the pandemic crisis might not stimulate us in in the US to do something about the inequities of our health care system. It's easy for rightwingers to say that socialized medicine in Italy and Spain is proving just as ill equipped to handle the logistic demands of the thing as our marketized approach is, but what can't be denied is that we're going to have a much harder time paying for it, as Waldman says:

untold numbers of people are going to get huge bills from being treated for covid-19. Insurance companies made a big deal about waiving cost-sharing for coronavirus tests, but if you get it and have to get treated, you could still face thousands of dollars in costs, especially if you have a high-deductible plan of the kind that has proliferated in recent years.

The number of people facing those costs will be enormous. As bad as the virus has gotten in some other countries, that’s one thing their citizens don’t have to worry about.

For the Record: Two Warren Topics

Cherokee Freedmen, undated, via Mid-Continent Public Library.

Wanted to try giving Roger an answer here:

I have never understood this 'controversy.' At all.

— Roger Matile (@rmatile1) January 19, 2020

Fast-forward to her political career, conservatives unable to believe a woman could be a distinguished legal scholar suggest she's a fake who benefited from affirmative action because her bio said she was Native American. Same schmucks who doubted Obama wrote for Law Review.

— Dopes 'n' Babies (@Yastreblyansky) January 19, 2020

For the Record: M4A

I feel as if I may have been getting confusing lately on the subject of health care coverage, speaking positively about a "Medicare For All" model I've never liked that much, but then you have to ask, compared to what?

For instance, compared to the chaos that will commence if the Supreme Court finds for the plaintiff in Texas v. Azar (for which we should be getting a ruling from the Fifth Circuit Appeals Court sometime fairly soon) and the entire Affordable Care and Patient Protection Act is voided overnight, we won't have any ACA around to improve, and Medicare For All looks pretty good. Not that it's at all likely to happen. It would be a worse economic disruption than hard Brexit, and John Roberts wouldn't let it happen. And I don't think he could lay down some kind of structured settlement in which the ACA is gradually disassembled rather than being wiped out instantly; he'll just have to find it's constitutional, which is not that much of a stretch, because it clearly is constitutional.

Two Cheers for Brooks

Well, two restrained cheers for David Brooks ("If It's Trump Vs. Warren, Then What?"): He's wrong about Warren in general, but he's right that he wouldn't want to vote for her if he understood what she was up to, and he's right that, if Trump and Warren are the nominees, he should vote for her nevertheless, for reasons that I think are pretty solid:

Politics is downstream from morality and culture. Warren represents a policy wrong turn, in my view, but policies can be argued about and reversed. Trump represents a much more important and fundamental threat — to the norms, values, standards and soul of this country.

I'd like to return the favor with an inverse pledge, but it's really hard to imagine a Democrat against whom I'd vote for, say, Willard Mitt Romney or even William Weld, because Democrats don't run like Trump. If Rod Blagojevic got nominated, I'd know he has a pretty bad reputation, but he has a sense that these institutions exist outside of him. If Jared Kushner or Ivanka Trump was to run as a Democrat, I'd easily vote for Weld, but that's not going to happen either. Nor is empty-eyed cult member Tulsi Gabbard, for that matter. Nobody like that is going to get the Democratic nomination. Ever.

Everybody makes fun of Democrats for being obsessed with "electability", but it's true we always look for a candidate who only tells lies for a good reason and doesn't have a dangerous personality disorder. We're not going to nominate somebody like Blagojevic for the presidency, or even like Reagan, let alone Scrooge McAsshole and his brood of ducklings. We won't even nominate Steyer or Bloomberg. It might be interesting to ask why Republicans are so careless about electability and still exist as a party. They have such objectively horrible people at all levels, from Mitch McConnell to Matt Gaetz and Duncan Hunter, people you really wouldn't want to let in your house, and yet they carry on.

Designed to Lose

Ten-minute drawing by Bonnie-Hop/DrawCeption, November 2016.

Piggybacking on Steve's post yesterday on the new Trump Justice Department policy on the Affordable Care Act—and the ongoing appeal process over the December ruling by federal judge Reed O'Connor of Fort Worth in a suit brought by 18 Republican state attorneys general announcing that the whole law, including mandatory coverage for pre-existing conditions, coverage of children up to age 26 on their parents' policies, regulations requiring insurers to give some kind of value for money, and health insurance for some 17 million people through the Marketplace and expanded Medicaid programs, is invalid—

That was OK with President Chucklehead, of course, who thinks consequences are for little people—

President Donald Trump was quick to take a victory lap, and pressed Senate Majority Leader Mitch McConnell, R-Ky., and the presumed incoming House Speaker Nancy Pelosi, D-Calif., to fix the problem. The president tweeted Friday night: "As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions. Mitch and Nancy, get it done!"

—but the DOJ announced it would be defending part of the law, though not the pre-existing conditions part, presumably under the advice of lobbyists for insurers anxious to get around the Obama regulations against junk insurance that doesn't cover much of anything.

Now they've changed their minds and decided not to defend any of it at all, which seems like a pretty weird move from the political standpoint; healthcare is the most important issue on voters' minds, and they like what the ACA provides, though most of us really wish there was more of it. They showed it pretty clearly in the November elections, too, as seemed instantly clear the day after the elections:

The Rightness Lag

Via.

David Brooks has changed his mind ("The Case for Reparations"):

Nearly five years ago I read Ta-Nehisi Coates’s Atlantic article “The Case for Reparations,” with mild disagreement. All sorts of practical objections leapt to mind. What about the recent African immigrants? What about the poor whites who have nothing of what you would call privilege? Do we pay Oprah and LeBron?

But I have had so many experiences over the past year — sitting, for example, with an elderly black woman in South Carolina shaking in rage because the kids in her neighborhood face greater challenges than she did growing up in 1953 — that suggest we are at another moment of make-or-break racial reckoning.

Then he calms down a bit. He's got the theological idea, which I really do, no snark, appreciate, that systemic racism is a sin, for which white society needs to atone, but he's more interested in Christian confession and absolution for himself than Jewish atonement and repair for the victims: looks like it's not the money that he expects to do the job, but the process of talking about it:

Reparations are a drastic policy and hard to execute, but the very act of talking about and designing them heals a wound and opens a new story.

It'll make him feel all tingly, as David Brooks might say. So that's nice, and better than what his friends have done with the Universal Basic Income idea (used it as an excuse for planning the devastation of the social safety net), but it's pretty Brooksish in the end, and I'm not swooning.

Also it occurs to me that at the beginning of the week he seems to have read something about the Sanders "Medicare for All" proposal with "mild disagreement" and "all sorts of practical objections" and concluded that it was an "impossible dream". Does this mean that sometime in 2024 he's going to decide that it needs to be done, or at least discussed, after he has a conversation with an elderly diabetic who's been condemned to death by the price of insulin?

Come to think of it, wasn't it around 2008 that Brooks decided George W. Bush had made some "bad calls" at the beginning of the Iraq war? (He was applauding the "courageous and astute" 2007 surge)? Is Brooks installed with some kind of five-year rightness lag?

Cross-posted at No More Mister Nice Blog.

Trump has an opinion

USA Today did choose a picture that made his fist look especially tiny. Photo by Nicholas Kamm/AFP/Getty Images.

In USA Today today, an op-ed by some dude using this silly pseudonym:

Donald Trump: Democrats 'Medicare for All' plan will demolish promises to seniors

Donald J. TrumpPublished 3:15 a.m. ET Oct. 10, 2018

The Democrats want to outlaw private health care plans, taking away freedom to choose plans while letting anyone cross our border. We must win this.

I don't know who really wrote it, but that gratuitous lie "while letting anyone cross our border"—if Democrats really did have an open borders policy, which they certainly don't and are not likely to, what relationship would it have to health insurance policy?—is authentically Trumpy, isn't it?

AOC v. VDH

Giovanni de Min. Spartan women wrestling, fresco, 1835-36. Villa Patt, Sedico, via .scclub.  

Victor Davis Hanson denounces the educated classes for the enjoyment and edificaton of the unlettered readership of the National Review:
T

rumpism is sometimes derided as an updated know-nothingism that rejects expertise and the input of credentialed expertise. Supposedly, professionals who could now save us tragically have their talent untapped as they sit idle at the Council on Foreign Relations, the economics Department at Harvard, or in the offices of the Brookings Institution — even as Trump’s wheelers and dealers crash and burn, too proud, too smelly, or too ignorant to call in their betters to come in and save Trump from himself.

But do the degreed classes, at least outside math, the sciences, engineering, and medicine, merit such esteem anymore?

You can tell by his plain, colloquial language that he's a hardscrabble man of the people himself, at ease with chainsaws.

Trouble in Mind

Revised and Updated

Senator Hatch "has a rough time" with renewing the Children's Health Insurance Program.

.@SenOrrinHatch on CHIP: “I have a rough time wanting to spend billions and billions and trillions of dollars to help people who won’t help themselves – won’t lift a finger – and expect the federal government to do everything.”

Unbelievable. https://t.co/4VHROvIL8X

— Jenny Wilson for UT (@JennyWilsonUT) December 2, 2017

About $14 billion a year, and it's true small kids are shamefully slow on paying their medical bills like "I think Daddy takes care of it right?"

Everybody—starting with Joe Scarborough!—took this a little bit out of context, I'm sorry to say. What Hatch said, as reported in The Guardian, is this:

Monsignor thinks it would be better to change the subject

Concerned cat. Uncredited photo from Washington Post.

Well, we've got a request from Monsignor Ross Douthat, Apostolic Nuncio to 42nd Street, which is ("The Health Care Cul-de-Sac") would everybody please stop talking about health care?

sometimes, when a party has spent most of a year producing health care bills that excite almost nobody and that even the senators voting for them can’t effectively defend, it’s worth stepping back and thinking about our national priorities.

This goes for both parties: not only the stepping-on-rakes Republicans, but the suddenly single-payer-dreaming Democrats.

I wouldn't say those Republican health care bills excite almost nobody: somebody must be excited over the thought of getting rid of the Obamacare brand, or the employer mandate, or above all the concept of eliminating Medicaid as a federal program, or these things wouldn't keep coming back again and again from their zombie graves.

On the other hand, it's still less accurate to say the Democrats have spent most of a year producing unexciting health care bills that the Senators voting for them haven't been able to defend. Democrats have spent some time working on drafts of bills nobody's had a chance to vote on, inspiring various degrees of excitement, including the Sanders "Medicare for All" proposal launched on September 13 with endorsements from a really startling number of Democratic Senators including Tammy Baldwin, Elizabeth Warren, Kirsten Gillibrand, Al Franken, Patrick Leahy, Jeanne Shaheen, Mazie Hirono, Brian Schatz (though he's offering a bill of his own as well), Kamala Harris, and Cory Booker, and more, as well as 60% of the Democratic caucus in the House, and a public that may have gone back to its longstanding desire for government-guaranteed universal health care after giving up on it while we were waiting for the PPACA to come into effect—

Foils! Cursed Again!

Via SevenDaysVT.

Bernie Sanders is pushing hard for a single payer healthcare plan - a curse on the U.S. & its people...

— Donald J. Trump (@realDonaldTrump) September 14, 2017

...I told Republicans to approve healthcare fast or this would happen. But don't worry, I will veto because I love our country & its people.

— Donald J. Trump (@realDonaldTrump) September 14, 2017

Is this the sound of thinking, in some respect? What does Trump think is going on here? How does he think things happen? What does he think might require him to use his veto power, that wouldn't have happened if the Republicans had succeeding in getting a something through the Senate? Is the single-payer proposal a kind of asteroid homing in on America, through Bernie's diabolical will, that the Senate Republicans could have deflected by quick action? But it's not really a problem because Trump can deal with it now?

Does he think the Republican failure to pass one of their stupid Repeal 'n' Replace bills means the Republican majority will now be forced to pass a single-payer plan against their own will? Does he think, a little less crazily, that because of their failure voters will ineluctably give us a Democratic Congress next year, which will ineluctably pass that Berniecare bill, forcing Trump to veto it, which he wouldn't but for the lucky fact that he loves our country?
 
Is it a real curse? Like, "I, Bernie, ask the powers of Evil, Hecate, Eris, and Dis, to inflict the horrors of single-payer upon the wicked Americans!" "No!" cries Trump, "Never, you hate-filled monster, not while I'm alive!" What universe does he come from, and how can we get him back there?

Annals of Derp: The Infinite-Deductible Plan

Updated in tribute to the late Kenneth Arrow

Image from 25 Cognitive Biases.

Shorter Bret Stephens, "A Price for the G.O.P.'s Health Care Insanity", June 30 2017:

A colonoscopy will cost you $372 in Australia and $3,059 in the US, so obviously the problem in America is insurance, as Kenneth Arrow crisply explained in 1963, because nobody's going to shop around for the best price on their hip replacement if the Blue Cross is going to be paying for it anyway. Thus the Affordable Care Act is a colossal failure, so the Republicans should stop trying to repeal and replace it and instead double the limits on health savings accounts. I am not a crank.

No, that problem isn't insurance, because Australians don't shop around for the best deal on a colonoscopy either. They can't, because the government controls prices for medical services, as part of the operation of its publicly owned and funded Medicare system of universal health insurance, as do the other cheaper countries Stephens references, Spain, UK, and New Zealand. Thanks to these and other countries, we know a lot more about this now than Kenneth Arrow did in 1963, although Arrow knew a whole lot more than Stephens does, see below. Controlling health costs requires an active government effort, which is why the US is always dead last in doing it even as it provides mediocre care.

Update: Kenneth Arrow, who died last February, was the Nobel-winning economist who demonstrated from the model-theoretical standpoint in his 1963 paper that health care is a special case for which a laissez-faire market approach is "intolerable", and that government is obliged to step in, most likely acting as insurer, to make up for this. Krugman cited him in 2009 to warn against making the Obama plan too market-oriented. For Stephens to be quoting the work in defense of a system where everybody pays cash is like quoting Galileo to prove the Sun revolves around the Earth. I can't imagine what he thought he was accomplishing.

Stephens really does make that psychotic break from denouncing the death-spiraling Obamacare in the usual distorted terms to saying the Republicans should stop trying to do anything about it:

Legislative Leaping

Desperados of Richardson High School in the Texas State Capitol. From The Statesman.

So Majority Leader McConnell had to abandon his bill, as I expected he would, and send the troops off to their recess, while he and his elves theoretically work to rewrite the thing into a form that can pass after Independence Day, and the pandits aren't expressing much doubt that it can be done, referring to McConnell's "slush fund" of something over $300 billion in money that the bill theoretically saves the government, according to the CBO score, which could be used to pay for the traditional Christmas tree lights and ornaments with which legislation like this is festooned to get votes from the recalcitrant legislators.

I'm not changing my mind, mainly because I think Medicaid expansion is a much bigger deal than is widely understood—according to Times reporting picked up this morning by BooMan, it wasn't those prima donna dramatically wavering Republican Senators like Heller and Collins who really stopped the vote this week, it was Republican governors working a plan they'd been devising since February to preserve Obama's new Medicaid, and there's more to it than this week's defeat; in theory, a plan for some "moderate" group to work out a bipartisan proposal. Yeah, I'll believe that when I see it, but I don't see in the meantime how McConnell comes up with anything that overcomes these obstacles. (In Kansas in April, the utterly Republican legislature almost passed Medicaid expansion over the governor's veto—they were just three votes short of the two thirds they needed.)

The other day, lawrence090469 commented on my predictions of death for the bill:

Required Reading

Rafflesia in Sabah, East Malaysia.

Why I Hate the New York Times, the Rafflesia of media-criticism blogging as I call it, after the Southeast Asian jungle flower that produces its huge and spectacular single bloom once every ten years or so, has just shown up with four months of material, and just as the Rafflesia smells like a corpse, the piece is as funny as hell, if you read it with attention: "How to Resist Trump" as the writers of the Times conceive it.

For instance, by not marching too much, the way the women did at the beginning of the regime:

Those ladies meant well, but they didn’t know what they were doing. “This movement focuses on the wrong issues…. Marchers…were marching under the conventional structure in which the central issues were clear.” That was their first mistake, according to known marching tactics expert David Brooks: Never march in a framework in which the central issues are clear. 

Or by being civil:

For the record

Screenshot from a YouTube video, 1.MOST IMPORTANT MCQ POINTS FOR PASS AUSTRALIAN MEDICAL COUNCIL (AMC) CAT EXAM, credited to "John Smith".

@tedlieu @Monkeyfister1 @realDonaldTrump Jeez, Congressman. He doesn't want to call it #Trumpcare until he finds out what's in it. Which will be never. #TooMuchWork

— Yastreblyansky (@Yastreblyansky) May 7, 2017

Of course the Australians have better healthcare than we do --everybody does. ObamaCare is dead! But our healthcare will soon be great.

— Donald J. Trump (@realDonaldTrump) May 5, 2017

For example, I like the fact that AUSTRALIAN GOVERNMENT DIRECTLY PAYS 83% OF ALL THE COUNTRY'S MEDICAL COSTS.

— Yastreblyansky (@Yastreblyansky) May 8, 2017

You going to get Ryan to write a bill that does that?

— Yastreblyansky (@Yastreblyansky) May 7, 2017

Handout or protection racket?

Via.

Blogfriend Ten Bears comments on yesterday morning's post:

They're beaten. Like Social Security and Medicare/Medicaid, the Affordable Care Act is now the "law of the land" and we will indeed be "living with it for the foreseeable future."

A government handout to the insurance industry.

An industry that, notes commenter Tom Riker, "insures millions of people. That includes the Medicaid expansion, helping millions more. That stabilizes the finances of rural hospitals..." And that employs something like 530,000 people, which is a lot of people to throw out of work at one blow in a revolutionary change in the management of the economy. And 40-odd percent of which is nonprofit companies. The ACA contains mechanisms to increase the nonprofit side but Republicans in Congress gutted them, as I tell you all the time.

The for-profit companies don't regard it as much of a handout, either, because of the caps it puts on profits. Eighty cents out of every dollar they take in in premiums must be paid out in claims, thanks to the ACA (that's the minimum medical loss ratio), 85 cents in the large group market that ensures most of us with jobs (and all the overhead has to be paid out of what's left over, before anything gets to the shareholders), and thanks to the list of ten essential health benefits they're no longer allowed to sell the kind of "skinny" plan designed to never pay out any claims at all. They especially don't like the exchanges of the individual market, which is why they're pulling out of them or trying to create monopolies, county by county.

It's not so much a handout as protection money, where the insurers are the gangsters running the street of health care and can fuck you up if you try to do something in their territory. And they don't seem to think it's enough.

Oh snap: Postscript

Image via Giphy.

Thomas P. Friedman ("Can the U.S. Win This Election?"), better known as Thomas L. Friedman, Mystax Mirabilis, hopes Congress goes Democratic in an overwhelming way, so Clinton will be able to push through some Republican policy:

we have to hope not only that Hillary Clinton wins the national election but also that Democrats retake at least the Senate, so she has some real leverage to forge trade-offs with a more sane G.O.P. to start fixing things: putting in place common-sense gun laws, like restoring the Assault Weapons Ban, requiring universal background checks and making it illegal for anyone on the terrorist watch list to buy a gun; borrowing money at near-zero interest rates to rebuild our infrastructure; replacing some income and corporate taxes with a revenue-neutral carbon tax to stimulate more clean-energy production; fixing Obamacare; and implementing sensible immigration reform and responsible tax and entitlement reforms.

The bigger Clinton’s margin of victory, the less dependent she’d be, I hope, on the left wing of her party, and the more likely she’d work with Republicans, as she vowed during the last debate, by “finding common ground, because you have to be able to get along with people to get things done in Washington.”

I'll stick with that old-fashioned kind of logic, thanks, where the consequent is kind of attached to the antecedent, and the better the Democrats do the more ability they'll have to implement the Democratic platform, and the less power the Republicans have the more things can get done in Washington without them.

Don't know where Tom is hoping to get those votes for a carbon tax, revenue-neutral or otherwise, other than the despised "left wing of her party"; for Republicans, it's the worst of all possible tax hikes and permanently off the table, and Clinton herself has not been very supportive. The Sanders forces were unable to get her to sign on for it and had to make do with a deliberately ambiguous declaration that

Economic downturns kill people. With cancer.

Architect David Adjaye's rendering of the projected Gahanga International Children's Cancer Center near Kigali, Rwanda, where health insurance is mandatory (with zero premiums for the poor). Via De Zeen. 

And government-run health care systems prevent it. A study by Mahiben Maruthappu, Johnathan Watkins, et al. reported in The Lancet this week found in a study of cancer outcomes in 75 countries from 1990 to 2010 that

Unemployment rises were significantly associated with an increase in all-cancer mortality and all specific cancers except lung cancer in women. By contrast, untreatable cancer mortality was not significantly linked with changes in unemployment. Lag analyses showed significant associations remained 5 years after unemployment increases for the treatable cancer class. Rerunning analyses, while accounting for UHC [Universal Health Care] status, removed the significant associations. All-cancer, treatable cancer, and specific cancer mortalities significantly decreased as PEH [Public Expenditure on Health] increased. Time-series analysis provided an estimate of more than 40 000 excess deaths due to a subset of treatable cancers from 2008 to 2010, on the basis of 2000–07 trends. Most of these deaths were in non-UHC countries. 

Let's just say that again.