Democrats should stop treating votes to allow debate as votes supporting the legislation

I think it’s time for Democrats to stop treating a vote to have a debate about the health care bill the same as a vote in support of the bill. I don’t think that having a conversation about what the Republicans are proposing and what Democrats would propose as an alternative is a bad idea. Proceeding with the debate will allow Democrats to make proposals about how they would improve the Affordable Care Act and gives them the opportunity to be clear that they would want to improve it rather than just stand on what they have already done. A big part of the problem with this debate now is that you don’t ever really hear Democrats recognize that there really are problems with the way the Affordable Care Act actually works that need to be dealt with and that Democrats want to deal with those problems. A debate about the Republican proposal will give Democrats an opportunity to say they understand that some things needs to be fixed and propose a fixes that they would support. Thus I think John McCain cast the correct vote in both instances.

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Single Payer should not be the first proposal

Democrats need to stay with their principles but also look for ways to develop policies that are likely to be OK with most Americans so that the choices can be viable on a long-term basis. That means that in terms of healthcare you cannot just say single-payer is the solution since it’s clear that lots of people won’t accept that as a solution unless they see it working somewhere and decide that it can work well for them. This is not a situation which exists today since we do not have any state that actually uses single payer so that people can see it working. People need to be able to see things in action before having it offered to them as their only choice. It would make more sense for progressives to focus first on a public option as the alterative that you make available first. After people see the public option in action, then you can go from there and try to sell  sell single payer.

Saying Resist is not enough

The progressive message should not be resist, it should instead be providing a worthwhile alternative. With respect to health care that means explaining what you would actually do to fix Obamacare rather than just complain about what Republicans are trying to do. This is the work that Democrats have failed to do.

There are real ways to fix the problems. The most obvious starting point is the notion of offering a public option along with the private insurance plans that are now available. This would both provide an option a lot of the public really wants. If it really is a better it should probably provide a lower cost than the private insurance companies charge for their coverage. Having this offered as an option, rather than as requirement everybody must use might make it politically acceptable to Republicans as well as Democrats. That’s important if we are trying to create a system that will stand the test of time. If you insist instead on offering only a single-payer approach, rather than approach that allows people to choose the public option and also offers options for people who do not want to use  a public provider until they have seen it work and see that it will save them and the country as a whole a cost savings with respect to heath care costs.

Progressive need with  to do the same thing and offer their own alternatives with respect to tax reform, the budget and infrastructure. This conversation should begin with taxes so that when the spending side is offered it is clear where the money will be coming from and it is clear that it won’t be based on raising the debt which lots of people for good reasons are unwilling to accept as a basis for supporting additional spending.

Medical malpractice

We need to create a new way to deal with medical malpractice. Having people file a bunch of lawsuits against doctors in order to get compensated for the results of medical mistakes means that only people who have access to good lawyers get what they are entitled to as recompense for problems caused by medical mistakes and errors by their doctors. That is true even though most lawyers who deal with these kinds of cases take them on a contingent fee basis, meaning you don’t pay until the case is over, and only get paid if you win. That doesn’t help with the fact that one still needs to know how to find a good attorney to represent one.  There are many fly-by-night personal-injury lawyers and many advertise for their clients. Lots of poor people end up using these lawyers because they do not know their options.

The difference in lawyer competence will mean that poor people will end up getting much worse representation than people with lots of resources and personal contacts. Another problem with the lawsuit approach is that people typical only file these lawsuits when they have suffered a grievous loss and most medical mistakes don’t result in this kind of loss.  This means that people who suffer minor loss as a result of medical error or mistake typically get no compensation whatsoever. Another problem is that it takes many years to complete the process of receiving compensation through a lawsuit, which means that people who do suffer a serious problem don’t get any compensation until long after the problem occurs.

In some Scandinavian countries and in New Zealand there is a process by which people can seek compensation through a system operated by the state, which doesn’t require anyone to file a lawsuit to get compensation. These system are not based on fault. Instead, these systems are designed to see everybody compensated who has a bad experience. Unlike the American system where people who suffer minor problems never end up getting any help, these alternative systems provide help regardless of whether your problem is a big one or a small one.

The countries that that currently provide this sort of system are countries where the government is paying for healthcare without the use of private insurance companies. Although I don’t think it is necessarily a requirement for setting up a system that compensates individuals for medical issues without the use of lawsuits. It seems to me that if this kind of a system exists people will decide to stop using medical professionals who do not participate in this system regardless of what the payment system is and whether private insurance companies are involved.

In these systems your claim is reviewed by both medical and legal professionals, but not ones that you paid to represent you, instead they are professionals who are not attached to any party to the proceeding.  But, if you think you’ve gotten a bad decision from these people, you can appeal to a review board. You can hire yourself your own attorney to participate in this process with you so you can get assistance if you want to.

Complaints about public accommodations

I am starting to file complaints against restaurants and entertainment venues in Massachusetts and will post the results here for people that have an interest in such things. I began with a complaint against the WaterClub in Marina Bay where all the seating was bar height. They have already fixed the issue by adding three new normal height tables. There are a few other restaurants where I have had the same problem and I intend to make similar complaints about them in the coming weeks.

Other people with disabilities that require them to be in a wheelchair should file complaints as well if you encounter similar problems in restaurants that you would like to be able to use. Whatever complaints I hear about that are resolved with the restaurant or venue changing its seating arrangements as a result I will also post here. I would like to maintain some of this blog as a place to keep track of all such issues and resolutions.

I am going to put this on twitter with hash tags that will allow disabled folks in Massachusetts to know that this is available if people find it useful. I look forward to hearing from anybody who would like to participate in this or who would find this information useful to them.

My name is Ross Dolloff as you can see and my e-mail address is Dolloff.ross@gmail.com and you can contact me there if you are interested in participating.

Democrats should work with Trump on healthcare

I think that Trump might well be willing to focus on fixing the Affordable Care Act rather than repealing it if Democrats offered to work with him on a fix.  And the Affordable Care Act really does need some fixing. The alternative is what seems to be happening now, Trump deciding to work with the Freedom Caucus. What they want is to repeal the Affordable Care Act without any real alternative offered.

I am not sure that there is more than one other area where working with Trump in this way makes sense, but in terms of healthcare I think the other available choice is too horrible to let happen. As I write this I am listening to Maxine Waters say that Democrats should never work with Trump on anything. I think if that’s the approach that party leaders take the Democratic party is in big trouble nationally. I think that infrastructure spending also deserves this approach since it is something Democrats have been seeking for a long time but have been unable themselves to bring Republicans to support.