Do You Think That Trump Is The Only One Motivated By Corruption In The Battle Over Drug Prices? Wake Up

Medicare-for-All Will Never Pass And Drug Prices Will Remain High Until Pelosi And Wendell Primus Are Gone From Congress

The public-- Republicans, Democrats, Independents, non-voters-- everyone wants cheaper drug prices, but the prices continue to rise. The public wants Congress to do something about it. But nothing-- a whole lot of nothing-- is getting done. PhRMA charges what the market lets them get away with. As Sam Baker pointed out in Politico over the weekend, "the most expensive drug in the world-- a gene replacement therapy that treats spinal muscular atrophy-- came to market earlier this year, with a sticker price of $2.1 million in the U.S. That drug is a groundbreaking new therapy, but prices also continue to rise for old, familiar products that people depend on every day-- most notably, insulin

This week, the House is going to vote on a very modest and unsatisfactory bill that Pelosi has been pushing and that progressives are embarrassed over. Trump prefers Chuck Grassley's Senate bill, which McConnell isn't thrilled with and which the right won't vote for. To pass it, it would take a lot of arm-twisting of conservative Republicans that Trump will never do, plus all the right-of-center and moderate Democrats. And then it would have pass the House. Big PhRMA opposes all the bills-- especially the effective one, H.R.1046 that Lloyd Doggett (D-TX) introduced and is backed by 127 Democratic co-sponsors. Doggett's bill is the only one that would crack down on PhRMA and it is being backed by Democrats from progressives like AOC (NY), Barbara Lee (CA), Ro Khanna (CA), Pramila Jayapal (WA), Raul Grijalva (AZ), Ayanna Pressley (MA), Jerry Nadler (NY), Ilhan Omar (MN), Katie Porter (CA), Jamie Raskin (MN), Ted Lieu (CA), Rashid Tlaib (MI), Andy Levin (MI), and Jan Scxhakowsky (IL) to even some of the most cowardly conservatives like Charlie Crist (Blue Dog-FL), Elissa Slotkin (New Dem-MI), Max Rose (Blue Dog-NY), Dan Lipinski (Blue Dog-IL), Abigail Spanberger (Blue Dog-VA), Gil Cisneros (New Dem-CA), Debbie Wasserman Schultz (New Dem-FL), Stephen Lynch (New Dem-MA) and Elaine Luria (New Dem-VA).

Back to Politico: "The big picture: The pharmaceutical industry almost always gets its way in Washington. The industry's top two trade organizations, together, spent more than $35 million on lobbying in 2018, more than they've ever spent before. That doesn't include individual companies' contributions, nor does it include any of the industry's campaign contributions, which are substantial."

Cenk Uygur, the progressive reform candidate running for the open congressional seat in a district in the suburbs north of Los Angeles (CA-25) told us this morning that "Drug companies don't give politicians money for charity, they do it to buy them. And unfortunately it works. Everyone knows these are bribes. The only people who won't acknowledge it are corporate politicians on both sides and the corporate media. This is a sick system that lets people die for profit. Any politician that takes money from the drug companies is selling out their voters on behalf of their donors."

This is a list of current House members who have taken the most in bribes from the health sector (which includes Big PhRMA) since 1990. All of them have been in top leadership and committee positions to prevent any movement on meaningful reform. All of them belong in prison:

• Frank Pallone (D-NJ)- $6,610,354
• Steny Hoyer (D-MD)- $4,970,630
• Michael Burgess (R-TX)- $4,466,629
• Kevin McCarthy (R-CA)- $4,403,284
• Fred Upton (R-MI)- $4,276,714
• Kevin Brady (R-TX)- $3,611,054
• Greg Walden (R-OR)- $3,468,191
• Anna Eshoo (D-CA)- $3,207,836
• John Shimkus (R-IL)- $3,026,262
• Nancy Pelosi (D-CA)- $2,944,209
• Ron Kind (D-WI)- $2,869,860
• Richard Neal (D-MA)- $2,869,426

On Friday, Adam Cancryn and Sarah Karlin-Smith, writing for PoliticoPro, reported that House progressive leaders were testing support for an effort to block Pelosi’s bill, "amid rising frustration over the crafting of the Democrats’ signature legislation.

The Congressional Progressive Caucus circulated a questionnaire asking its members if they would be willing to oppose a procedural vote on the bill-- effectively stalling the top Democratic priority-- unless Pelosi agrees to make a series of changes moving it further left, or allow votes on progressive amendments." Pelosi, who has a bizarre relationship with Big PhRMA and with their lobbyists and "ex"-lobbyists, hit the ceiling.

Few progressives have publicly suggested opposing the drug pricing legislation up until now, even as they complained of being locked out of negotiations over its specifics. The Progressive Caucus has struggled in the past to marshal its diverse membership against major Democratic priorities, and Pelosi’s drug pricing bill is seen as key to keeping Democratic control of the House in 2020.

But progressives' anger with top Democrats reached a new pitch Friday, after Politico reported that leadership weakened a key provision authored by Rep. Pramila Jayapal (D-WA) and approved by the Education and Labor Committee in October.

“I don’t know why I’m having to fight so hard for an amendment that already passed through committee,” Jayapal said.

The bill originally directed the federal government to study how it could require drugmakers to refund money to employer-sponsored health plans when the companies raised prices above the inflation rate-- and then issue regulations based on those conclusions.

Yet in a private meeting with advocacy groups on Thursday, top aides led by Pelosi health adviser Wendell Primus said they were cutting the regulations mandate, effectively reducing it to a simple call for a study, people who were in the room said.

You may have noticed that Blue America is in the middle of a fundraiser for Pramila's campaign. It's because of this kind of thing that we're trying to help her. Who else is going to stand up to Primus who is exactly as anti-healthcare as any garden variety Republican. There is no presence more detrimental to healthcare policy in Congress than Wendell Primus. You can help-- and maybe win a Nirvana gold record award-- by clicking on the Blue America Nirvana thermometer above.

Cancryn and Karlin-Smith continued that "Progressives have unsuccessfully pressed leadership for months to make changes in the bill that would fully eliminate the ban on Medicare’s ability to directly negotiate drug prices, increase the number of drugs the government can target for direct negotiation and make negotiated prices available to the uninsured." Big PhRMA's man inside Pelosi's office warned that Pramila and other progressives are "gravely misreading the situation if they try to stand in the way of the overwhelming hunger" for Pelosi's bill that most people view as slightly better than nothing.

The last-minute changes have left liberals irate over what they characterized as a leadership attempt to steamroll the left wing on a top priority.

Leaders had vowed to allow rank-and-file members to help shape the bill for months, they said, only to speed the legislation to the floor in the final weeks of the year. Now, they said, they were quietly watering down language that progressives touted as the element that justified supporting a bill they otherwise saw as far too timid.

“For many of my residents at home, constantly there’s this lack of a sense of urgency they feel is coming out of this chamber,” said Rep. Rashida Tlaib (D-MI). “If we’re not going to take this head-on right away, it’s not going to make a difference.”

In an interview, Rep. Alexandria Ocasio-Cortez (D-NY) characterized the drug pricing bill as the latest in a string of issues where Democratic leaders ignored progressive lawmakers.

Meanwhile, Doggett, the congressman from Texas who actually wrote the good drug pricing legislation said "I've tried to be positive throughout this and talk about improving the bill, rather than opposing the bill, but it would be really difficult to vote for it if no improvements are made... We are setting the standard, we are setting the model for what a Democratic president would do on prescription drugs."

Trump And Your Healthcare

The battle over impeachment has become everyone's favorite entertainment fare-- even Trump's. "Like an aging rock star, the president is now reprising many of the greatest hits from his hellion days. He has bullied and projected-- at times leveling against others the very charges he faces-- while simultaneously depicting himself as a victim. And he has turned to ominous depictions of America, and in moments sounded an authoritarian tone... Staring down impeachment, Trump has seemed to play the role of the nation’s Shakespearean monarch. At a rally Thursday night in Minneapolis, Trump boasted about his own fortitude in surviving so many scandals. Raising his hand and twirling his fingers to point to his right temple, the president mused, 'Maybe I’m a little different up here. I don’t know.' ... In moments, Trump seems to understand the peril he faces-- and acknowledges the differing ways he has responded to the impeachment threat engulfing his presidency. 'What they did to this country is unthinkable,' he said Monday in the Roosevelt Room of the White House. 'And it’s lucky that I’m the president, because I guess-- I don’t know why-- a lot of people said very few people could handle it. I sort of thrive on it,' he concluded."

Yes he does-- and it's quite a distraction from what he doesn't thrive on: policy discussions. Take healthcare. His pollsters told him that healthcare was the most important to the most voters in 2016. So, without giving it any thought, he promised voters he would oversee the best healthcare system the world had ever seen. Healthcare in the U.S.-- especially for many of his blue collar voters-- has gotten far worse since he took over the White House.

All lies. In fact, healthcare concerns have grown since Trump took over and a new Kaiser Family Foundation tracking poll shows that voters aren't buying his bullshit about delivering a "phenomenal health plan." Most voters now realize-- if they didn't from the beginning-- that he's been lying about doing anything to improve the country's healthcare system-- and that includes 61% of independents, which is fatal, not just for Trump, but for Republicans in congressional district that aren't deep, dark red. Even old people finally realize Trump is their enemy when it comes to protecting Medicare.

McMurray is running for Congress in western New York

Last week, writing for Axios, Caitlin Owens reported that Trump may be telling voters everything that they want to hear when it comes to health care, but most of it is just flat-out lies. "Trump is claiming victories he hasn't achieved and making promises he's not prepared to live up to, all on an immensely personal subject that voters consistently rank as one of the most important issues of 2020. And foremost among his endlessly repeated lies is his claim that he has lowered drugs prices. He hasn't and, in fact, drug prices for all but the most commonly used medicines have sky-rocketed since Trump got into the White House.

Trump's most demonstrably false claim is that, as he put it in May "we will always protect patients with pre-existing conditions."

• The Trump administration is currently urging the courts to strike down the Affordable Care Act, including its protections for pre-existing conditions.
• Trump and congressional Republicans' efforts to repeal and replace the Affordable Care Act in 2017 didn't include the same level of protection as the ACA does, nor have they ever proposed a plan that would.

...On defense-- attacking Democrats over "Medicare for All"-- Trump is also making some dubious claims.

• "Almost every major Democrat in Washington has backed a massive government healthcare takeover that would totally obliterate Medicare.... They want to raid Medicare to fund a thing called socialism," he said last week.
• Sen. Bernie Sanders' "Medicare for All" bill would indeed replace traditional Medicare, but seniors' health care benefits would get more generous under that plan, as written-- not less. However, critics of the plan say it would likely reduce seniors' access to care.
• And though it's true that Sanders' bill would eliminate private health insurance, other plans would retain it as an option.

Eva Putzova, the progressive Democrat running for an Arizona seat held by Blue Dog Tom O'Halleran, a former Republican state legislator pretending to be a Democrat, is eager to debate her opponents on expanding Medicare into a single payer system that covers everyone and all medical procedures, since she backs it and they don't. She told us that she believes that "the only way to bring down drug prices, ensure universal healthcare coverage, improve access to quality healthcare and bring down costs is to enact a Medicare-for-All program. It is no surprise that Trump lied to the American people and his own supporters about how he would fix the healthcare system and bring down costs.  It is also no surprise that the Republican Party wants to gut the ACA and ensure that only the wealthy can access and afford healthcare. This has been their agenda for decades. What is more surprising is that too many Democrats in congress propose half-measure that would leave millions uninsured and allow prices, dictated by private interests, to continue their upward climb. My opponent, the incumbent congressman, refuses to support Medicare-For-All or any type of single payer healthcare system and supports the current system dominated by insurance companies and drug companies. Maybe that is because he receives campaign contributions from corporate PACs like Cigna, one of the major health insurance companies who are fighting everyday to defeat a publicly funded, single payer system as described in the Jayapal and Sanders Medicare-for-All bills, or that his staff attends retreats at luxury resorts funded by that same industry."

Marie Newman is also running for a seat held by an anti-healthcare Blue Dog, Dan Lipinski, in a blue Chicagoland district. "I frankly, do not understand why my opponent does not support Medicare For All," she said last night. "He calls it 'socialism', a Republican talking point, and he shares that frequently. I support it because I know it will work if rolled out over time and we CAN pay for it vis a vis wealth tax and a Wall St. tax." By the way, that thermometer on the right is a way to help candidates who are running on Medicare-for-All.

Betsy Sweet is the progressive Senate candidate taking on Susan Collins and the corporate candidate Chuck Schumer is pushing, none of whom support Medicare-for-All. "We need," said Betsy, "to fix the system in which 30 cents of every health care dollar goes to profits of executives instead of to patient care. When we remove profits from health care as we do in Medicare for All then it not only cuts costs but it also changes the incentive of care to focus on preventive care and focusing on health, not illness. There is no room for a profit based system when millions of people who can't afford health care. Medicare for all is the path. We cannot be the only country in the world who cannot figure this out. We need a structural change in our system. But unless we eliminate the huge money that the health care industry and pharmaceutical companies give to politicians we will never move forward. It is why Susan Collins will never vote for structural change. This is a national crisis. It is not time to nibble around the edges. We must stop asking 'if' we should have health care for everyone and get busy on the details of the 'how.'"

Trump and Biden (and that little shit, Buttigieg) are getting immense contributions from Big PhRMA to help them bash Medicare-for-All and twist the meaning, the goals and the implementation. Watch Pramila Jayapal explain what Medicare-for-All really is on this NPR show aired last year:

Trump Has A Healthcare Plan? Like His Gun Safety Plan?

Kevin Drum and I were being treated at City of Hope for similar cancers at the same time. I'm confident that he-- unlike many members of Congress-- understands healthcare policy and the importance of Medicare for All. About a week ago, Mother Jones ran an essay by Kevin, Trump Health Care Strategy: Pretend to Have a Plan. Referencing a report from the Washington Post, he wrote that "Apparently Donald Trump plans to take his usual sober and considered approach to health care policy during campaign season:

White House advisers, scrambling to create a health-care agenda for President Trump to promote on the campaign trail, are meeting at least daily with the aim of rolling out a measure every two to three weeks until the 2020 election.

...Some, however, are doubtful a flurry of executive orders and new regulations would have an immediate effect on consumers’ pocketbooks. What is clear is that the approach, which includes White House support for a bipartisan Senate bill to cap Medicare drug price increases to the rate of inflation, is putting congressional Republicans in a tough spot: Embrace Trump’s agenda and abandon conservative precepts about interference in the marketplace, or buck the president on one of his top priorities.

...One lobbyist, who spoke on the condition of anonymity, described being stunned at a recent White House meeting when Domestic Policy Council Director Joe Grogan said the administration would not let Democrats run to the president’s left on lowering the prices of prescription medicines. In another tense meeting, top pharmaceutical executives were told bluntly “it wasn’t in the industry’s best interests” to block the bipartisan Senate bill backed by Trump. If it failed, they were told, they’d see “the president of the United States negotiating with Nancy Pelosi [on allowing the government to negotiate drug prices in Medicare],” said a person familiar with the meeting.

Uh huh. That’s a tough one. Should Republicans blithely abandon their principles and do what Trump wants or-- or what?

Of course, this isn’t a matter of sitting back and letting Trump attack brown or black or yellow people. This is a matter of by god interference with corporate interests, which really does put Republicans in a tough spot. They’re perfectly happy to let Trump tear into America’s oldest racial wounds, but reducing the profits of pharmaceutical companies by a few points? That’s a genuine chin scratcher. What’s a Republican to do?

Yesterday, Wall Street Journal reporters Stephanie Armour and Andrew Restuccia wrote that the White House will roll something out as a healthcare plan next month. Remember when Trump promised to create a healthcare utopia? A plan with heart? "i'm going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of-- much better than they're taken care of now." Don't remember? Watch:



Trump has done nothing... other than try to abolish Obamacare and cut Medicare and Medicaid. Now he wants a cohesive stacks of lies he can use on the campaign trail to contrast to Medicare-For-All. "Elements of the plan," wrote Armour and Restuccia, "could include providing coverage for people with pre-existing conditions, the people said, and spurring the sale of insurance across state lines. Other provisions being discussed include giving states more flexibility, expanding health savings accounts, linking price transparency to quality metrics, and more insurance options for consumers, they said. The plan would include a number of new elements that haven't yet been released, one person familiar with the work said. White House officials stressed that the plans haven't been completed, and some close to the president have privately expressed skepticism. One former White House official raised the possibility that the plan may not materialize this fall if Mr. Trump second-guesses the effort. The administration is also still weighing how specific the plan should be, the people familiar with the plan said, and the ideas have yet to get Mr. Trump’s sign off."

Kellyanne Conway, a senior adviser to the president who is involved in the discussions, met recently with House Republicans to brief them on the progress of the administration’s efforts, two people present said. She stressed that the administration’s plan would protect pre-existing conditions and she reviewed possible legal outcomes in the lawsuit to strike down the ACA. She is planning to brief Senate Republicans after they return from their August recess.

The push to put out a plan, which has already involved months of behind-the-scenes work, underscores growing concern on Mr. Trump’s team that the president could be vulnerable on health care. A recent Fox News poll of registered voters found Democrats had a 14-point advantage over Republicans on which party would do a better job handling the issue.

The administration is backing a lawsuit from GOP-led states to strike down the ACA, a stance that leaves Mr. Trump open to attacks from Democratic presidential candidates who say he is a threat to coverage.

“We are the Democrats. We are not about trying to take away health care from anyone,” Sen. Elizabeth Warren of Massachusetts said in the second Democratic debate in Detroit this week. “That’s what the Republicans are trying to do.”

The case may not be fully resolved until next year, placing health care at the center of the 2020 presidential campaign. An estimated 20 million people have gained coverage because of the ACA, and more than 100 million people with existing medical conditions could see their coverage lost or become more expensive if the law is struck down.

The White House has already released initiatives or been working on regulations that would accomplish some of the goals that could be in the president’s plan. But his fall proposal, if released, could go further-- for example, calling for state or state and federal high-risk pools, which aim to provide coverage to people who can’t get insurance because of expensive pre-existing health conditions, according to one person familiar with the planning.

“They definitely want to show they’re protecting pre-existing conditions,” said one GOP Hill staffer familiar with the discussions.

Parts of the plan would probably require congressional action, which is unlikely because the House and Senate remain divided.

The plan could call for grants to states to establish high-risk pools or programs that pay a portion of high-cost claims to buffer insurers and help drive down premiums. High-risk pools were used by more than 30 states and covered more than 200,000 people before the ACA, but some people had trouble getting coverage as states capped enrollment amid funding pressures.

The return of high-risk pools has been a longtime Republican goal; House Republicans pushed for the creation of a $15 billion federal high-risk pool in their proposals to replace the ACA. Critics say they cost too much money and have a long history of problems.

Mr. Trump may also lay out new strategies to jump start the sale of insurance across state lines, an idea he included in his 2016 campaign platform. The Centers for Medicare and Medicaid Service in March sought public input on how to eliminate barriers to such sales, which are already permitted, but have had few takers. Mr. Trump has also said he wants to let people on Medicare contribute to health savings accounts.

The proposal could also call for more action to link price information in health care to quality. Actions to provide more alternative forms of insurance that don’t comply with ACA regulations and consumer protections are also being discussed, one person familiar with the planning said.

The tentative release of a more complete plan in September is part of a broader strategy ahead of the 2020 election. The White House is planning to ramp up Mr. Trump’s speeches and actions on health care this fall because polls show it is a top issue for voters. The administration has already unveiled new efforts on a range of health-related issues, from improving kidney health to making it easier to import prescription drugs from other countries.

But skepticism abounds because Mr. Trump has repeatedly promised a health plan without delivering one. During the GOP push to repeal the ACA in 2017, he said he was close to finishing a plan that aimed to provide “insurance for everybody.”

Fault lines have emerged within the White House over how to accomplish aspects of the plan and how specific to be largely because of concerns it could open Mr. Trump up to attacks from Democratic presidential candidates, according to two people familiar with the discussions.

Yet allies of Mr. Trump believe it would give a boost to the president even though Congress is unlikely to take action on any of the ideas that require legislation.

At the White House, regular meetings on broad health-care strategy are being led by Domestic Policy Council Director Joe Grogan, with participation from Centers for Medicare and Medicaid Services head Seema Verma, Health and Human Services Department officials, and senior aides from the National Economic Council, Council of Economic Advisers and other White House offices, according to people involved in the talks.

Progressives expand healthcare; conservatives constrict it and block it. That's how it's always been and how it still is. If healthcare is important to you, never vote for a Republican and never vote for a Blue Dog or a New Dem. They're the enemy. If you click on the thermometer on the right, you'll find a list of progressive Democrats running for House seats, all of whom are campaigning on Medicare-For-All.

Marqus Cole is the strongest progressive running for the open congressional seat in the suburbs north of Georgia (GA-07) and one of the issues he's campaigning on is Medicare-for-All. This morning he told me that this week "here in Georgia we found out the 'Emperor had no clothes' the whole time when Governor Kemp's 'plan' to not cover all Georgians got shot down by the Trump Administration. Don't believe me? The major paper in town, the Atlanta Journal Constitution, had this to say about Georgia healthcare: 'Kemp’s plan for Georgia is still unknown at this point... [27%] of Georgians ages 19 to 34 are uninsured, one of the worst rates in the nation.' Much like the current administration, here in Georgia the plan for Georgia is still unknown while people go without access to basic affordable healthcare. Enough is enough. I'm heading to DC to fight for my neighbors here in Georgia and all around the country. We. Need. Healthcare. For. Everyone! Republicans like Rob Woodall, and those in his party trying to replace him, are on record for wanting to go back to the crazy world of pre-existing conditions, young adults without health care, and birth control that doesn't come standard. With a Democratic Congress and President we will make our first task ensuring Healthcare-for-all."

Shear across the country, in Oregon, Mark Gamba is thinking much the same way. "Here we are, the richest nation on the planet and we spend more per-capita than any other country in the world on healthcare, and yet out of the 11 top industrialized nations we rank number 11 in health outcomes. Not because our doctors, nurses and hospitals aren't outstanding-- they are-- it's just that millions of Americans can't access that outstanding health care, either because they can't afford health insurance or their deductibles are so high they can't access the care without going bankrupt. Republicans and corporate Democrats say it's 'too hard' or 'too expensive' to provide Universal Healthcare to all Americans and I say: That's B.S.! You are telling me that America isn't smart enough to accomplish what every other civilized nation on earth has managed to pull off? I wholeheartedly disagree. I know we can do it, and I know we can do it better than anyone else has done it because we ARE Americans. We just have to decide that it's more important to provide quality healthcare to all of our people for less money than it is for insurance companies and pharmaceutical companies to reap massive profits by denying us care and addicting us to opioids."

  

Does Elizabeth Warren Support Medicare for All?

Elizabeth Warren's Issues page from her campaign website. Do you see anything about Medicare for All, or even about health care?

by Thomas Neuburger

Does presidential candidate Elizabeth Warren support Medicare for All? I mean this as an actual question. I don't know the answer — or I think I know and I'm not sure — and I'd appreciate it if someone pinned her down on this. In the meantime I've been seeing articles like this one from Jacobin, "Elizabeth Warren Has a Plan for Everything — Except Health Care," which suggest that she may not.

Let's start with the Issues page at Warren's campaign website. Unless I missed it, I found nothing about health care (see image at the top). The "Rebuild the Middle Class" topic includes strong proposals for antitrust enforcement, her Ultra-Millionaire Tax plan, universal childcare, and a plan for housing. Nothing though about addressing the health care crisis.

"Latest Announcements" lists 21 proposals ranging from "Economic Patriotism" and green manufacturing to the aforementioned "Ultra-Millionaire Tax." The only topic that seems to touch health care is this one:

Tackling the Opioid Crisis Head On: Every day, 130 Americans die from an opioid overdose. This is a public health crisis – and we need to start treating it like one. That's why Congressman Elijah Cummings and I are rolling out the CARE Act, a comprehensive plan that invests $100 billion over the next ten years in states and communities that are on the frontlines of the epidemic - to provide prevention, treatment, and recovery services for those who need it most.

An important proposal to be sure, but it's not a health care plan. The website appears to have no stated comprehensive health care proposal at all.

Her campaign appearances are not more clarifying. As Jacobin writer Tim Higginbotham observes:

Warren had several opportunities in the [March 18 CNN] town hall to address the health care crisis. Instead, she avoided the topic almost entirely. Even when discussing issues directly related to health care like repealing the Hyde Amendment and improving access to hearing aides, she neglected to propose a comprehensive policy solution. ...

[This] continues a disturbing trend with the Warren campaign ... you’ll hear the usual platitudes (“health care is a human right;” “everyone deserves access to care”), but you won’t hear her endorse a specific policy.

The March 18 CNN Town Hall is an excellent example of Higginbotham's observation. Below is Warren's complete response to a Medicare for All question. Note first that the questioner starts by worrying that the Medicare for All bill, which Warren cosponsors and presumably supports, would eliminate private insurance plans. Then noe that the question is succinct — "Can you explain how Medicare for All would be better for workers than simply improving the Affordable Care Act?"

I don't see an answer to that question in her answer (emphasis mine throughout):

QUESTION: Senator Warren, thank you so much for being here this evening and your tireless advocacy for universal health care. As a supporter of universal health care and an advocate for organized labor, I do worry about the current bills' elimination of private health insurance...

WARREN: Oh, yeah.

QUESTION: ... that would eliminate the private health employer-based plans that so many unions have advocated for. Can you explain how Medicare for All would be better for workers than simply improving the Affordable Care Act?

WARREN: OK, so it's a good question. Let's start with our statement that we should make every time we start to talk about changes in our health care, and that is health care is a basic human right and we fight for basic human rights.

(APPLAUSE)

And then let's put these in order, because I appreciate that your question starts with the Affordable Care Act. Let's all remember when we're talking about what's possible, let's start where we are and the difference between Democrats and Republicans.

Right now, Democrats are trying to figure out how to expand health care coverage at the lowest possible cost so everybody is covered.

To interrupt for a moment: This is not an accurate statement of what Medicare for All is about. Medicare for All is instead an implementation of what she said earlier in this exchange, that "health care is a basic human right." Finding the lowest-cost solution among a suite of solutions is a neoliberal approach, not an FDR-style social insurance approach. But to continue:

WARREN: Republicans right this minute are out there trying to repeal the Affordable Care Act. They've got a lawsuit pending down in Texas where they're trying to roll it back. What they couldn't do with a vote, they're trying to do with the courts. HHS every day is doing what they can to undermine the Affordable Care Act.

So when we're talking about health care in America right now, the first thing we need to be talking about is defend the Affordable Care Act, protection under the Affordable Care Act.

(APPLAUSE)

Then part two. Let's make the improvements that are what I think of as low-hanging fruit. For example, let's bring down the cost of prescription drugs all across this country.

(APPLAUSE)

We got lots of ways we can do that. We can import drugs from Canada where the safety standards are the same. That would cut costs dramatically. We can negotiate the prices under Medicare. That would cut costs dramatically.

And I've got a proposal to help bring down the cost on generic drugs, which could be about 90 percent of all prescriptions. So let's get those costs down.

And then you know what you're going to hear from a consumer advocate, and that is we need to hold insurance companies accountable. And that means no tricking and trapping people on those insurance contracts.

(APPLAUSE)

And then when we talk about Medicare for all, there are a lot of different pathways. What we're all looking for is the lowest cost way to make sure everybody gets covered. And some folks are talking about let's start lowering the age, maybe bring it down to 60, 55, 50. That helps cover people who are most at risk and can be helpful, for example, to the labor's plans.

Some people say, do it the other way. Let's bring it up from — everybody under 30 gets covered by Medicare. Others say let employees be able to buy into the Medicare plans. Others say let's let employees buy into the Medicare plans.

For me, what's key is we get everybody at the table on this, that labor is at the table, that people who have to buy on their own, everybody comes to the table together. And we figure out how to do Medicare for All in a way that makes sure that we're going to get 100 percent coverage in this country at the lowest possible cost for everyone. That's our job.

Does "everyone at the table" include the health insurance companies? Note, by the way, that of this list of options, none receives her endorsement; they are presented merely as possibilities. What would a President Warren actually do? We still don't know.

About this exchange, Higginbotham says: "Taking this answer at face value, it seems Warren sees herself pursuing an incremental approach that expands public coverage while preserving the private insurance industry should she be elected president. This would likely surprise many of her supporters, who might view her cosponsorship of Sanders’s Medicare for All bill as an endorsement of single-payer health care."

Apparently, Jake Tapper didn't see an answer in her answer either, so he follows up by re-asking the question:

TAPPER: If I could just follow up a little on Jay's question, so you are a co-sponsor of Senator Bernie Sanders' Medicare for All bill, and I understand there are a lot of different paths to universal coverage, but his bill that you've co-sponsored would essentially eliminate private insurance. Is that something you could support?

WARREN: He's got a runway for that. I think we get everybody together. And that's what it is, we'll decide. I've also co-sponsored other bills, including expanding Medicaid as another approach that we use. But what's really important to me about this is we never lose sight of what the center is, because the center is about making sure that every single person in this country gets the coverage they need and that it's at a price that they can afford. We start with our values, we'll get to the right place.

(APPLAUSE)

TAPPER: So, theoretically, though, there could be a role for private insurance companies under President Warren?

WARREN: There could. Or there could be a temporary role. Even Bernie's plan has a runway before it gets there, because it's — look, it's a big and complex system, and we've got to make sure that we land this in a way that doesn't do any harm. Everybody has got to stay covered. It's critical.

Quite simply, I don't hear in any of those words the support for Medicare for All that's widely assumed to be her position.

What is Elizabeth Warren's actual plan for addressing the health care crisis in America? Is it anything like the Sanders and Jayapal proposals, or is she shielding with words and options her actual preference, which sounds suspiciously like a free-market-with-regulation plan?

If the latter, she should say so, because currently it looks like she's obfuscating, a dangerous approach for someone with her otherwise progressive credibility. I think it's time Elizabeth Warren announced her actual position.
 

Carole Cadwalladr Kicks Facebook's Ass-- The Petri Dish For Trump

Remember how Trump lied his ass off during the 2016 campaign about the "great healthcare" he would provide if voters elected him? No? You can watch him telling his health care lies here. Look at those morons behind him. Did the campaign rent them from Central Casting? How did he win? How? Yes, Hillary's horrible, and should have never been the nominee-- but not that horrible, not compared to what was then the alternative. I mean, even with the Russians cheating on his behalf-- which the Mueller report has now proven beyond any reasonable doubt-- Trump still got tens of millions of votes. Are there that many people that incredibly stupid? And, by the way, the CBO reported on Thursday that over a million Americans have lost their healthcare insurance since Trump occupied the White House. I wish I could say they're all Trump voters and will be incapacitated and unable to ever vote again. But...

In a Ted Talk this month in the Silicon Valley, U.K. journalist Carole Cadwalladr got into the details of how the Russians managed make sure Britain passed Brexit. As someone who has never looked at a Facebook ad in my life and as someone who thinks Facebook is primarily for pre-teens, it's almost unimaginable that a barrage of misleading Facebook ads targeted at vulnerable Brexit swing voters could have swung an election-- be it for Brexit or in the Trump/Clinton debacle. Cadwalladr called out those who she referred to as the "gods of Silicon Valley"-- the ones at Facebook in particular and by name-- for being on the wrong side of history and asked, ominously, "Are free and fair elections a thing of the past?"

She thinks so. I guess we'll find out next year, won't we? Please don't miss watching the Ted Talk; she's really excellent and enlightening. I mean what do you have better to do? Watch Game of Thrones or something?

Does The Government Work For Billionaires-- Or For The Rest Of Us-- A Guest Post By Daniel Biss

Daniel Biss practically was just a kid when DWT started covering his ideas about what could be accomplished in politics. When I first met him, in 2007, he told me that folks in Illinois "believe government is capable of benefiting people. The Republican Party functions as if government has to be kept out of the way." He's an intellectually rigorous mathematician, trained at MIT, now a state Rep with a great record of accomplishment, and a candidate for governor. His two opponents are hereditary billionaires with powerful names-- if not minds-- who can spend whatever they want without blinking an eye in an attempt to buy the race. Daniel's a middle class guy like you and I and he can't write himself a check to finance a political campaign. All he's got is what's in his mind... and heart. I asked him to re-introduce himself to DWT readers. If you like what he has to say, please consider chipping in what you can at the Blue America gubernatorial page, accessed my hitting the thermometer below.

No Time For Half Measures
-by Daniel Biss

The Democratic Party is at a crossroads. Amidst the fear and chaos of the Trump administration, and having lost control of many state governments, it’s time to reassess our priorities and ask where we went wrong. It’s time to ask whether we represent the middle class or the billionaire class, and whether we’re going to fight for progressive reform or just defend the status quo from attack.

I’m a progressive serving my seventh year in the Illinois legislature and I’m running for governor to fight for middle class families like mine. My opponents? A billionaire and a multi-millionaire, neither one of whom has ever held public office. The winner of the primary will take on Republican Governor Bruce Rauner, a private equity billionaire whose foray into politics has been an utter disaster for our state.

In this primary, and in primaries across the country, we are taking on this great challenge of defining our party’s values-- especially as we consider the future of healthcare.

I believe that healthcare is a human right. It’s something everyone deserves-- regardless of pre-existing conditions, citizenship status, or ability to pay. For me, believing that healthcare is a human right means fighting for a single-payer system in the Illinois. It’s right there on my website, and it’s been part of my platform since I launched my first campaign in 2007.

My opponents take a different view. While we agree that the federal government should move toward single-payer, we disagree about the role state government should have in these efforts. In other words, they want someone else to fight this fight for them.

The truth of the matter is that the best way to move the federal government towards single payer is to enact it at the state level first to build a movement of people across the country united around a shared vision of universal healthcare and armed with examples of success. We can’t just sit around and wait.

This is no time for half measures. It’s no time for concessions, and it’s no time to accept the status quo. This is a time to stand up for our values, to demand that our state government reflects our needs, and to rebuild our party from the ground up.

It’s larger than healthcare, and it’s larger than Illinois. It’s about deciding who the Democratic Party works for, and who our government works for. Does it work for billionaires, or for the rest of us? Does it respond to corporate greed, or people’s needs? And does it cling to the status quo with a tired machine playbook, or innovate and improve when we demand it?

And so we have a choice in March-- about who will be the Democratic candidate for governor in Illinois, but also about who our Party and government represent. But we also have a lot of choices before then. Every day, we have an opportunity not just to resist Trump’s disastrous attempts to repeal the Affordable Care Act but also to demand universal healthcare in Illinois, and to build a movement powerful enough to take our state back from the billionaires who have failed to represent us.

It's Not Happenstance That Americans Pay So Much For Prescription Drugs

A few weeks ago Digby and I went to dinner with Ted Lieu and Ro Khanna, two of Congress' most dedicated legislators-- guys actually looking for ways to make people's lives better. We asked David Dayen to come as well so he could explain the intense research he has been engrossed in involving pharmacy benefit managers. His piece, "The Hidden Monopolies That Raise Drug Prices," is running in the new issue of the American Prospect and it's worth reading in its entirety. But first a 101 definition for those who may not have heard of a pharmacy benefit manager (PBM), simply "a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. 266 million Americans are dependent on them doing a good job, which the American Pharmacists Association says includes "contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims.. striving to maintain or reduce the pharmacy expenditures of the plan while concurrently trying to improve health care outcomes." Sounds powerful, right? And that kind of power inevitably leads to abuse including lawsuits involving fraud, deception and antitrust claims.

Dayen pointed out that most people blame insurance companies and/or pharmaceutical companies for raising costs in the health-care system. He wants you to know how the PBMs have "morphed from processors to predators... Over the past 30 years, PBMs have evolved from paper-pushers to significant controllers of the drug pricing system, a black box understood by almost no one. Lack of transparency, unjustifiable fees, and massive market consolidations have made PBMs among the most profitable corporations you’ve never heard about."

Americans pay the highest health-care prices in the world, including the highest for drugs, medical devices, and other health-care services and products. Our fragmented system produces many opportunities for excessive charges. But one lesser-known reason for those high prices is the stranglehold that a few giant intermediaries have secured over distribution. The antitrust laws are supposed to provide protection against just this kind of concentrated economic power. But in one area after another in today’s economy, federal antitrust authorities and the courts have failed to intervene. In this case, PBMs are sucking money out of the health-care system-- and our wallets-- with hardly any public awareness of what they are doing.

Even some Republicans criticize PBMs for pursuing profit at the public’s expense. “They show no interest in playing fair, no interest in the end user,” says Representative Doug Collins of Georgia, one of the industry’s loudest critics. “They act as monopolistic terrorists on this market.” Collins and a bipartisan group in Congress want to rein in the PBM industry, setting up a titanic battle between competing corporate interests. The question is whether President Donald Trump will join that effort to fulfill his frequent promises to bring down drug prices.

Dr. David Gill is a policy-driven progressive candidate running for Congress against a backbench garden variety Republican incumbent, Rodney Davis, in a central Illinois swing district, IL-13. (Blue America has endorsed him and you can contribute to his campaign here.) This morning, after reading Dayen's article, he told us that as an emergency department physician he doesn't have direct dealings with pharmacy benefit managers. "However," he added, "it comes as no surprise to me that such abuses take place. Given that the benefit managers are subcontractors of insurance companies whose primary mission is to maximize their profit, it should be no surprise to anyone that these benefit managers are also largely focused on maximizing their own profit, and that the well-being of patients is of secondary importance. Until we finally adopt a single-payer healthcare system administered by the federal government ('Medicare for all'), such abuses will continue within many different layers of healthcare here in America. Uncle Sam does not run Medicare in order to make money; if only the rest of our healthcare system was run with such noble intentions."

Jason Westin is a first time candidate, a cancer researcher specialist and physician in Houston, who's running against reactionary GOP incumbent John Culberson, a long-time-corporate puppet. We turned to Jason immediately when Dayen made us aware of the PBM problem. He told us that as a cancer doctor he has "seen first hand the hard choices that patients are often forced to make when it comes to medications. Many of the newest and most promising new anti-cancer medications are also the most expensive due to unregulated pricing by Pharma and by the hidden charges of the pharmacy benefit managers (PBM). This predatory pricing puts desperate and vulnerable patients between a rock and a hard place. If they purchase the drug and it works, they will need to decide if they can continue to pay for it longterm and face financial ruin, or quit after a while and take their chances. If they do not purchase the drug, their families may long wonder 'what if?' As PBMs no longer provide any real benefit to patients, loosening their stranglehold on prescription medications should be a bipartisan issue. Many uninformed GOP members of Congress, like John Culberson of TX-07, think drug pricing would be solved if we could 'open up purchasing across state lines' (actual quote from 3/25/17 Town Hall). Their ignorance on the insidious effects of PBMs on drug pricing means they are completely incapable of regulating them: how can you fix what you do not understand?"

Like David Gill and Jason Westin, progressive candidates Tom Guild in Oklahoma and Kim Weaver in Iowa are running against extreme right wing incumbents, respectively Steve Russell and Steve King. Both had the same reaction to the GOP attack on Americans' privacy yesterday. "It's disappointing and disgusting that Big Corporate donations of nearly $100 million doled out  to members of Congress," said Tom, "including my opponent incumbent Clyde 'Steve' Russell, carried the day. Russell joined the list of U.S. House Members who were all but bribed to vote to take away Americans internet privacy, to the extent that even our browsing history can be peddled to the highest bidder, like a cyber-Snickers bar. As they say about Clyde and other career politicians who voted for this outrageous legislation, they can’t be bought but they can be rented for long periods of time. I’m looking forward to defeating Wall Street lackey Russell in November of 2018, and taking back our rights and freedoms, including the right to privacy, that Clyde blithely sells to the highest Wall Street and Big Corporate Bidder. Has he no shame? Apparently, not!"

"Once again Steve King showed that his loyalty rests with his corporate sponsors rather than with the people of Iowa," Kim told us. "I'm appalled that he thinks it's okay for cable and internet companies should have the right to sell our private information. The people of this district will be outraged when they see this vote-- American's privacy should not be for sale!"

Back to Dayen's piece, which doesn't end quite as bleakly as it starts. He's looking for a way to solve this mess:

Amid frustration on all sides of the market, some private-sector actors are attempting to break the PBM stranglehold. A group of 20 large employers representing four million patients, including Coca-Cola, Marriott, and Verizon, have formed the Health Transformation Alliance, seeking to break away from the “patchwork of complicated, expensive, and wasteful systems” in modern health care, including the pharmaceutical supply chain.

The alliance has expressed interest in a “transparent PBM” model, which takes a flat administrative fee on each prescription, with all rebates and discounts fully disclosed and no hidden spreads. Transparent PBMs only have a sliver of the market, but they can get results: A hospital nonprofit network named Meridian Health Systems claimed to Fortune magazine that a transparent PBM saved it $2 million in the first year, about one-sixth of its total drug costs.

But many employers don’t know enough about the system to go outside the Big Three, says Susan Hayes. “They’re trying to manage something they don’t understand. If you put blinders on, and hire one of the Big Three, you won’t get in trouble with the boss.”

Another model would empower pharmacies. A 2016 report from the Institute for Local Self-Reliance highlights a quirk of law in North Dakota, which only allows drugstores to operate if owned by pharmacists (similar laws exist in Europe). The law prohibits chain pharmacies from entering the state. Not surprisingly, North Dakota’s independents deliver among the lowest prescription drug prices in the country, along with better health outcomes and more drugstores per capita than any other state. This flies in the face of industry claims that big chains and giant conglomerates save consumers money or improve services.

Why can’t this successful model be replicated elsewhere? “The answer is PBMs,” says Stacy Mitchell, the report’s author. “Because in North Dakota, independents are the only game in town, PBMs have to negotiate with them. In other states, they have no leverage.” Unsurprisingly, PBMs and chains want the North Dakota law overturned rather than adopted in other states.

For a more immediate impact, we must turn to Washington. And there, solutions often emerge when one large industry starts pointing the finger at another. Under fire for their many drug-pricing scandals, from Martin Shkreli to Valeant, the pharmaceutical industry has tried to deflect blame by citing PBMs. GlaxoSmithKline CEO Andrew Witty said in a February conference call that so much of the list price on the company’s drugs went to “non-innovators in a system which thinks it’s paying high prices for innovation,” a veiled reference to PBMs. An industry-funded report in January asserted that manufacturers took only 63 percent of gross drug revenues, attributing the decline to discounts and rebates paid to PBMs. (Of course, this hasn’t stopped pharmaceutical companies from earning higher profit margins than any other industry.)

For their part, PBMs insist that drug prices would be even higher without them, arguing that they deliver broad access to medications and 90 percent customer satisfaction rates. But in an industry-on-industry arms race, the millions of dollars that leading PBMs and their trade groups spend each year on lobbying would be no match for the pharmaceutical industry. That creates opportunities for longtime PBM opponents in Washington, which include several Republicans representing rural districts, where independent pharmacies are getting crushed.

Doug Collins, a third-term House member, experienced the PBM issue personally, when his mother couldn’t get her regular medications and her plan had no substitute on the formulary. “I am a free-market person, as conservative as they come,” Collins says. “When dealing with this, it’s not a free market.” Buddy Carter, his colleague, has worked in independent pharmacies since 1980, and sees himself as their voice in Congress. I asked him if he had difficulty explaining the PBM market and its problems to his colleagues. “Heck, it’s difficult for me to understand and I’ve worked in the industry over 35 years!” Carter says.

Watch some hearing soundbites from these two and you’d think you’re seeing the second coming of William Jennings Bryan. “Who will my folks in my district of Georgia call, when they need someone at night and their local pharmacist is the one they trust?” Collins asked two PBM representatives in 2015. “They’re going to try and find their local pharmacist, who has been closed because of the anti-competitive nature of this field.” Carter grilled top PBM lobbyist Mark Merritt in 2016: “I notice that the profits of the PBMs have increased enormously over the past few years. In fact, almost doubled. And I find that very disturbing.” These are conservative Republicans!

What can Congress do to reform PBMs? More than 20 states have passed laws to require more frequent MAC list updates, so PBMs can’t drag their feet and generate large pricing spreads. But PBMs started to circumvent the laws, in one case by eliminating the term “maximum allowable cost” from contracts. Collins’s bill, the MAC Transparency Act, would take care of this at a federal level, to stop the game-playing.

Other bills in the House and Senate would prohibit retroactive DIR fees on Medicare Part D plans, stopping the after-the-fact clawbacks on pharmacy reimbursements. A separate bill would allow any willing pharmacy to participate in a PBM’s preferred pharmacy networks if they agree to the terms, increasing access in communities without chains. All of these bills would add transparency to the system, and reduce the incentives to constantly jack up prices. And they all have bipartisan cosponsors.

...The wild card in all this is Donald Trump. At his one and only pre-inauguration press conference, Trump singled out drug companies for “getting away with murder,” vowing to create “new bidding procedures” for Medicare and earning praise from the likes of Bernie Sanders. But when Trump met with pharmaceutical executives two weeks into his presidency, he focused more on speeding up new drug approvals from the FDA and cutting regulations than on reducing industry profits. This lines up with the perspective of a key aide, Silicon Valley billionaire Peter Thiel, who wants to overhaul the FDA process. (In fact, the Republican Congress just overhauled the FDA process in one of the last bills signed by Barack Obama.) Trump doesn’t appear to understand the cost excesses in the supply chain.

Trump did say in his address to a joint session of Congress that he would “bring down the artificially high price of drugs.” And in his confirmation hearing, Health and Human Services Secretary Tom Price, discussing Trump’s idea for competitive bidding in Medicare, said that “right now the PBMs are doing that negotiation… I think it is important to have a conversation and look at whether there is a better way to do that.”

But where Trump’s team will ultimately land is unknown. “We need to get to a point of clarity about whether the administration is serious,” says the NCPA’s John Norton. Furthermore, any attempt to move forward legislatively on any part of health-care policy will run headlong into the deeply polarized debate over the Affordable Care Act. While a bipartisan alliance appears possible on the PBM issue in isolation, it will be difficult to separate anything health-related from the Obamacare vortex.

The PBM industry’s leading trade group isn’t sleeping on the possibility of an attack. Days after Trump met with pharma execs, the Pharmaceutical Care Management Association issued an internal memo leaked by Buzzfeed, stressing the need for “building a political firewall” in Congress to stop any legislative action.

Frightened about drug manufacturers highlighting a “bloated supply chain,” PCMA CEO Merritt laid out a six-point strategy that included meetings with White House staff and key members of Congress, a digital ad campaign targeting congressional leaders, partnerships with right-wing think tanks like the American Action Forum, and working groups to shape regulatory changes that make PBMs the savior instead of a villain. “We will continue to show how competition—not government intervention-- is the way to manage high drug costs,” Merritt wrote, apparently without irony. Merritt even scheduled a meeting with the main health insurance lobby, AHIP, “to make sure the payer community is aligned and coordinated.”

With drug companies on one side and PBMs and insurers on the other, both camps will have plenty of resources. In that environment, is bipartisan action possible to break up a powerful monopoly? “My answer would be absolutely,” says Representative Carter. “Everyone is impacted by prescription drug prices.”

Does Jeff Merkley Have The Magic Key To Break The Partisan Deadlock Over Healthcare Reform?

Blue America first met Jeff Merkley almost a decade ago when he was Speaker of Oregon's state House. There seemed so much promise in his candidacy for the U.S. Senate and we endorsed him-- and have never regretted it for a moment. At the time, we introduced him as someone who had been an outstanding and accomplished statewide leader who not only had good ideas, but translated this ideas into legislation. Merkley comes from humble rural Oregon origins and was the first in his family to go to college. He led Habitat for Humanity in Oregin and worked to help families work their way into the middle class by purchasing a home, starting a business, or saving for college. One of the reasons Blue America was so enthusiastic about him-- despite his being the choice of Chuck Schumer and the DSCC-- was that he loudly and unambiguously vowed to take on the special interests, like the big insurance companies and big drug companies who underwrite Schumer's power. And that's the kind of Senator he's been since winning that first election in 2008. He was reelected in 2014 and his seat isn't up again until 2020 but he's working as hard as most senators do when they're up for reelection-- but working on the people's business, not his career.

Over the weekend, Daniel Marans, writing for Huff Po about Bernie's push for Medicare for All. Progressives-- like Merkley and Bernie-- have always talked about the need to correct some of the Affordable Care Act flaws. In the final stages of passage, there was a big debate among progressive activists whether to back passage or not, the compromises with corporate greed and that flaws that brought being so transparent. The thought was always that the ACA would be a step towards single payer-- in effect, Medicare for All.

On Friday Bernie was on Chris Hayes show and explained to the viewers that "We have got to have the guts to take on the insurance companies and the drug companies and move forward toward a ‘Medicare for all,’ single-payer program."

“The problem is the insurance companies, Big Pharma-- they’re gonna come back and use the chaos to their advantage,” predicted Social Security Works executive director Alex Lawson. “If Democrats go with a half-a-loaf policy, Republicans are going to blame them for the failures of Big Pharma. They have to immediately pivot to expanding Medicare.”

Notwithstanding the support of the influential groups for the proposal and-- according to a May 2016 Gallup poll-- even a majority of the American people, Medicare-for-all legislation is a non-starter in the current Congress. Single-payer health insurance still lacks support from many, if not most, Democrats, let alone from the Republican lawmakers who control both chambers.

But the proactive strategy speaks to increasing confidence among progressives that if they stick to their ideals and build a grassroots movement around them, they will ultimately move the political spectrum in their direction.

...In the meantime, a potential benefit of this ambitious approach is what’s known as shifting the “Overton Window,” a political science term for the narrow range of acceptable political views at a given moment in time.

By adopting a position that is considered extreme by contemporary standards, politicians and activists can make more attainable policy goals start to seem reasonable by comparison.

That phenomenon already seems to be working in progressives’ favor.

Sen. Jeff Merkley (D-Ore.), the only one of Sanders’ Senate colleagues to endorse his presidential bid, discussed the possibility of lowering the Medicare eligibility age or empowering Medicare to negotiate drug prices in his statement on the Republican bill’s collapse.

“There are plenty of ideas already on the table that would make health care more affordable for working families, from a public option, to prescription drug negotiations, to offering older Americans the chance to buy into Medicare,” Merkley said on Friday. “I’m happy to work with anyone, from either side of the aisle, to explore these or any other ideas that would improve health care for working Americans.”

Lowering the Medicare eligibility age from its current level of 65 is a “very interesting” idea, because of the positive financial effect it would have on the Obamacare insurance exchanges, said Austin Frakt, a health economist for the Department of Veterans Affairs.

By allowing the oldest exchange participants to enroll in Medicare, lowering the Medicare age would relieve the health insurance marketplaces of some of their costliest customers, said Frakt, who also has academic posts at Boston University and Harvard.

“It would reduce the premiums in those markets,” he predicted. (Frakt noted, however, that absent measures to offset the cost of the additional beneficiaries, the change would increase Medicare’s financial burden.)

Social Security Works’ Lawson praised the idea as an incremental step toward Medicare for all.

“Start by lowering the age to 62 and get it down to zero,” he said.

With Bernie about to offer a full-on Medicare for All bill, which he announced he would do Sunday on State of the Union, Merkley's idea might get traction among mainstream Republicans who aren't ready to go all the way but who are serious about correcting some of the Obamacare defects. Although Bernie invited Señor Trumpanzee to hop on board, it's not likely the Regime would get anywhere near a full-on Medicare for All plan. Can you imagine the reaction from HHS Secretary Price? Sure, Bernie said "President Trump, come on board. Let's work together. Let's end the absurdity of Americans paying by far the highest prices in the world for prescription drugs." But, this isn't something Trump would/could embrace. But Merkley's plan... I'm betting that is. I mean who wouldn't want to see premiums come down across all age levels? What Merkley's bill is, in effect, just an extension of a system that already works and is universally popular across the country and with all Democrats, all independents and even most Republicans. If people started joining Medicare at 50 instead of 65, it wouldn't just be the biggest imaginable boon for them, it would, by taking a less healthy cohort out of the general population insurance pools, lower premiums for everyone under the age of 50 as well. It sounds like something Trump could understand and get behind.



UPDATE: Bannon's Evil As Well

Please watch Ted Lieu on MSNBC with Lawrence O'Donnell (last night). And remember-- the most effective voices in Congress for the resistance can all use some help with their reelection efforts.