"[T]his whole debacle must not be allowed to fade into the rearview mirror. It must be held up as the deeply costly blunder that it was... ." Sure. Just like our introspection about our kidnapping operation in Venezuela, our regret for the Caribbean boat murders, and our apology and compensation offered for killing thousands of Iranian citizens. The US has no rearview mirror.
Correction: This administration has no rearview mirror. The president has no empathy whatsoever and all he cares about his lining his pockets. It's HIS blunder.
Sorry, Ellen, but no. This is a US problem. Trump was placed in his position by racist, low-information voters, billionaire financial supporters and power-hungry authoritarians. Republicans have been laying the groundwork for Trump for many decades. For over 200 years, many Americans have been quite happy to fall in line and support US military action without question because to do otherwise meant being labeled as "leftist", "communist", "traitor", or ironically, a coward. And each time, regardless of the physical and psychological damage we've caused (abroad and at home), we quietly buried our dead, waved away the absurd financial costs and prepared for the next boogeyman to be targeted. History can teach us many lessons, but it's hard for some people to see them when the brim of their MAGA hat obscures their view.
Rearview mirror? The fecklessness of the American people and academic commentators is astonishing. The war is unconstitutional, its conduct has involved war crimes, and it has impacted and will continue to impact for years the cost of living in every country on the planet. But no public outrage at home, no millions protesting in the street, just Jared’s wistful hope that it won’t be forgotten … at some future date. If not now, when? It seems that there is no line to be crossed that will motivate Americans to meaningfully challenge this administration.
OK, a clear loss, but trump has backup Plans B + C teed up, so, could be "so much winning!" ahead, as Cuba (Plan B) and Greenland (Plan C) seem to be advancing with alacrity...never a dull moment with the "peace president!"
Takeaway lesson: Only attack those who don't possess air-defense or other retaliatory systems...works almost every time.
Since Iran proved that the Trump Gang doesn't plan and is unable to imagine unconventional air defenses, here are likely response to Plans B and C. Power-starved Cuba responds to Plan B by lobbing thousands of conventional artillery shells filled with spoiled fish and human waste into Gitmo rendering the base uninhabitable. Greenland responds to Plan C by using rocket-assisted trebuchets to drop ice boulders on our billion-dollar radar installations inside Pituffik Space Base and destroy them. Then they cut power to the base and post the following message on Trump's Truth DM: "Now you know how Cuba feels, you motherf*cker." So much winning.
So far, it's "negotiations" via trump's SM posts, and we all know how those have gone: he alternately posts some encouraging then threatening nonsense, the Iranians mock him, and ultimately NO change. More of the same here until we hear something both conclusive and confirmatory from the Iranian side ONLY, and not before.
You’re always very thoughtful and I appreciate your analyses.
I do, however, have to object to the phrasing “getting dragged into this war,” which implies the US was a hesitant, even unwilling participant. I reject that characterization and I think it’s irresponsible to frame it as such.
So if we had forced Iran back to the status quo at the end of Obama’s presidency we don’t hold it up as the deeply costly blunder that it was? We wronged Iran. It should be held up as a crime.
WRT Iran, Trump messed around and found out. He believes in his own “towering genius” narcissism, that norms are not for him. These are also the only qualifications of his cabinet officials.
Therefore. The only strategic outcome the White House is interested in is Emperor Tang furthering that illusion. Now that is abundantly clear this was an epic folly, he’s off to conquer Cuba to have something to beat his chest over IAO The July 4th party and the midterms.
While it may have had no purpose for the US, its greater purpose was to hammer home to Europe just how dangerous American imperialism is. Let's be clear, US will stop at nothing to colonise the world, because the alternative is that China will eclipse the US. Most of us think that's inevitable, but the US will try every dirty trick it can against whoever it can, including potentially mass climate distruction, and potentially WW3 to make that not happen. Trump is the most vulgar impetuous imperialist, but the Democrats are just smarter at their imperialist plans. This has been a great wake up call to Europe, who might have been caught napping by Democrat "boil the frog" policies.
It’s not a peace deal at all, it’s a structural pause for 60 days. Both sides get out of a jam for a bit. Market uncertainty reigns over the rest of the year while Iran gets market waivers and can sell 150 million barrels of oil on the water for $100 per barrel. This will be a major boost to the regime. The expiry will be right before July 4th. More TACOs for the bash.
The war, being jumped into by a president apparently ignoring advisors in the various agencies with expertise, based on a ridiculous belief that his intuition must yield the best action (characteristic of "malignant narcissists"--I don't know?), is an example of a thinking pattern and its consequences that others have observed in other areas.
In my own case (on the health insurance system), the non-extension of the ACA expanded subsidies resulted because of Trump having this idea "lets get the insurers out, and give the money directly to the people". It was quite unworkable, especially in the time frame available before the expanded subsidies lapsed. And the Republicans went along. Going with the half-baked impulse of the great leader.
Now, there was CBO research.
It was:
"Without an extension through 2026, CBO estimates, the number of people without insurance will rise by 2.2 million in that year. Without a permanent extension, CBO estimates, the number of uninsured people will rise by 2.2 million in 2026, by 3.7 million in 2027, and by 3.8 million, on average, in each year over the 2026-2034 period. 3 (The initial increase is significantly smaller because CBO expects that some people will remain temporarily enrolled after the expanded credits expire at the end of 2025. CBO assumes enrollees would need time to fully respond to the expiration, for example, because of automatic renewal policies.)"
Instead of the heeding the CBO, the president and Republicans made use of alternative "research" by a "Paragon Health Institute", which recommended a lapsing of the expanded subsidies. And, so that lapsing did happen Jan 1, 2026.
1)Paragon I and others have found very questionable.
1a) First, questions around prior research finding lots of fraud in the ACA
Details on this: Paragon Health Institute has attacked the ACA based on findings of fraud, which findings were based substantially on ACA “zero-claim enrollees”, being people with an ACA plan, who never file a claim.
I looked into this, and Paragon’s general policy advice, a bit myself within these two posts from months ago:
and, not only did many of the analyses look fishy to me, but, as on that second post, I found out that several organizations with large technical staffs also took issue with the analyses.
"It is therefore imperative that policymakers understand that Paragon developed these allegations using inaccurate data, dubious assumptions, and an apparent lack of understanding of how health insurance actually works."
(Incidentally, about 6 months ago Paul Krugman addressed the "how insurance actually works" issue, with an example of you can have fire insurance, and not filing a claim does not mean you shouldn’t have had insurance. He did not attack Paragon, or its head, Dr. Brian Blase, by name, but he must have been thinking of those fraud allegations. That Krugman post is: https://paulkrugman.substack.com/p/the-republican-brain-doesnt-want )
1b) Secondly, the Paragon Health Institute produced a graph which was used by both Senate Majority Leader John Thune (in this video, from the day the Senate voted against extending the expanded subsidies: https://www.youtube.com/watch?v=FWmkb_rdUrI&t=287s)
and House Majority Leader Mike Johnson (in this tweet:
Now, the thing is, I’m pretty sure that graph is completely erroneous, due mainly an omission of the cost-sharing-reductions direct to insurer payments that existed only from 2014 to 2017 as a cost, and a shifting by a year of the employer-plan cost because the 2026 data on employer costs was not yet available.
When I tried to adjust for the errors, I got that the ACA plan cost tracked in the graph rose either slightly more, or slightly less, than employer-based plan.
2) Now, as more information about the lapsing of the expanded subsidies keeps rolling in, the CBO numbers look about correct, with it looking like 3 million to 5 million of about 24 million getting ACA on-exchange coverage in 2025 will wind up losing coverage.
(To save space, and avoid redundancy, I have a comment on a prior JB post with the info showing 3 to 5 million will wind up losing coverage, and, as well, that a cover-up with false propaganda may be coming from the administration. https://econjared.substack.com/p/why-are-people-so-damn-mad/comment/261550456 )
--
Oh, by the way, if you like, or are interested in Walter Lippmann and John Dewey, I just did a post on some of what Lippmann wrote, integrating in a bunch of the avoiding of experts stuff from above in this comments.
In it, I have mention of 3 Lippmann and Dewey books that are available for free online, and I think many of JB's readers will find them excellent summer-season beach reading.
This looks to me like deja vu all over again. It's not at all clear just what Iran has agreed to and I certainly wouldn't put any weight on statements from Trump. Remember the "deal" they negotiated in Pakistan? How'd that work out?
The most plausible explanation for the war is that Trump was duped into it by Netanyahu. An all out war with Iran has been Netanyahu's dream for years but he needed America as an ally in war. Trump can be played as has been demonstrated many times before. Netanyahu saw that Trump is losing his grip on reality and decided that the time was right. As far as the prospect of a deal now I wouldn't bet on it. This cycle has repeated itself several times since the war started. Trump announces that a peace deal is at hand. The media falls for it and so does the oil futures market. Oil futures go down. But before they do, insiders have already shorted the market. It's corruption on steroids.
PK had previously been going with that the ACA, with an undoing of the damage done last year on it by the lapsed expanded subsidies, and the coming OBBB changes mainly to the ACA's expanded Medicaid component, and other smallish changes to it, would be the best that is politically possible at the moment.
He, today, has changed sis stance toward more substantial changes, not going immediately directly to single payer, but more in a gradual, non-mandatory way, that will tend to eventually get insurance companies out because of their lower efficiency. And the changes may morph gradually into something close to single payer.
Quoting from today:
"Single-payer isn’t a perfect system, but it is a system that has been run effectively not only abroad but in the United States. While I am by no means dogmatic about this, my view is that the next phase in U.S. health reform should involve an effort to transition away from private insurance to single-payer.
Longtime readers may recall that this was not my position in 2009-10, when Obamacare was being put in place. Nor did I support Bernie Sanders’s call for single-payer in 2016. However, like many and probably most supporters of Obamacare, I backed patchwork rather than comprehensive reform not because I believed that it was the best policy but because I believed that it was the only politically realistic way forward in 2010 and in 2016.
But it’s now 2026, and the political landscape has changed in ways that arguably put fundamental reform in reach."
...
"This suggests that an attempt to push people into Medicare-for-all would run afoul of concerns about change.
But it would be much less controversial, I believe, to offer a public option — allowing Americans, including employers providing insurance to their employees, to buy into a Medicare-type system. Many people surely would avail themselves of that option. And if they like what they get, which they probably would, we could transition over time to a single-payer system without forcing Americans into it.
Of course, insurance companies would hate this, and campaign furiously against it. But given their current reputation, this might even help the cause of reform.
Now, I am not offering policy specifics, partly because this post is already long but mostly because this is the point at which we need details from real experts. And I am not at all dogmatic about the path forward.
The main point is, instead, that we are approaching a point at which ambitious healthcare reform, well beyond simply repairing the damage to Obamacare, will be possible. And Democrats should be prepared to rise to the occasion."
--
(OK, JB. You may have to coordinate some Democrat real experts. Get cookin! I don't know what you had planned for Memorial Day, but....? (😊))
Seriously, now, I need to add: There is a question of any new plan, does it cover long-term-care and nursing homes?
The Sanders proposal for single-payer did. Otherwise, nothing we have as standard health insurance covers it. That is, not Medicare, not ACA coverage, not employer coverage. What we do have is that Medicaid covers it, but only after a family has spent down to the traditional-Medicaid requirements of being basically dirt poor in both income and assets. (With some exceptions.) (There is also private nursing-home insurance, which is pre-existing-condition screened, too expensive for many people, often falls short of full-enough coverage, and only about 10% of people over 65 have.)
I actually attempted to research this in other developed countries. Not all of them do cover long term care without requiring spending down virtually all of assets. Notably, the U.K. is like the U.S. on long term care.
However, other countries, like Canada and Germany (I think) seem to have a much better system.
Anyway, note that for most people, who do have secure regular health insurance for non-long-term-care (say having aged into Medicare, or having sound retiree coverage, or government-worker coverage which becomes permanent often after 10 years), nursing home and other long-term-care coverage is a big issue.
A big issue, that most people don't know about, but that takes individuals, and often, it can take down the member of a couple that stays out of the nursing home, as the impoverishment requirement for Medicaid applies to the couple, not just the individual.
(Lawyers, with enough pre-planning, can sometimes get people out of it. But not always. And sometimes, the way of getting people out of it is a "Medicaid Divorce".)
So, potentially solving a problem that can affect a broader population makes it a reason to try to include long-term-care in a new Democratic proposal, that you might possibly start working on tomorrow or Tuesday.
--
P.S. PK has been tending to unpaywall his most significant paywalled posts within a month after the paywalled post. So people without a paid subscription should be able to get the whole thing soon.
I am not sure if the unpaywalling is part of JB's "Affordability Agenda"--I don't recall seeing it there, but I might have missed it.
Also, it could be a mayor Mamdani thing.
Also, it could be that either in front of Professor K's New York apartment building, or in front of the various hotels where he is staying now while in Europe. there are protestors with signs "From Each According to His Ability. To Each According to His Needs."
(😊)
Whatever the cause, I expect the full text will be available free in a few weeks.
"[T]his whole debacle must not be allowed to fade into the rearview mirror. It must be held up as the deeply costly blunder that it was... ." Sure. Just like our introspection about our kidnapping operation in Venezuela, our regret for the Caribbean boat murders, and our apology and compensation offered for killing thousands of Iranian citizens. The US has no rearview mirror.
Correction: This administration has no rearview mirror. The president has no empathy whatsoever and all he cares about his lining his pockets. It's HIS blunder.
Sorry, Ellen, but no. This is a US problem. Trump was placed in his position by racist, low-information voters, billionaire financial supporters and power-hungry authoritarians. Republicans have been laying the groundwork for Trump for many decades. For over 200 years, many Americans have been quite happy to fall in line and support US military action without question because to do otherwise meant being labeled as "leftist", "communist", "traitor", or ironically, a coward. And each time, regardless of the physical and psychological damage we've caused (abroad and at home), we quietly buried our dead, waved away the absurd financial costs and prepared for the next boogeyman to be targeted. History can teach us many lessons, but it's hard for some people to see them when the brim of their MAGA hat obscures their view.
Well I sure as hell didn’t vote for him!
Rearview mirror? The fecklessness of the American people and academic commentators is astonishing. The war is unconstitutional, its conduct has involved war crimes, and it has impacted and will continue to impact for years the cost of living in every country on the planet. But no public outrage at home, no millions protesting in the street, just Jared’s wistful hope that it won’t be forgotten … at some future date. If not now, when? It seems that there is no line to be crossed that will motivate Americans to meaningfully challenge this administration.
OK, a clear loss, but trump has backup Plans B + C teed up, so, could be "so much winning!" ahead, as Cuba (Plan B) and Greenland (Plan C) seem to be advancing with alacrity...never a dull moment with the "peace president!"
Takeaway lesson: Only attack those who don't possess air-defense or other retaliatory systems...works almost every time.
Since Iran proved that the Trump Gang doesn't plan and is unable to imagine unconventional air defenses, here are likely response to Plans B and C. Power-starved Cuba responds to Plan B by lobbing thousands of conventional artillery shells filled with spoiled fish and human waste into Gitmo rendering the base uninhabitable. Greenland responds to Plan C by using rocket-assisted trebuchets to drop ice boulders on our billion-dollar radar installations inside Pituffik Space Base and destroy them. Then they cut power to the base and post the following message on Trump's Truth DM: "Now you know how Cuba feels, you motherf*cker." So much winning.
So far, it's "negotiations" via trump's SM posts, and we all know how those have gone: he alternately posts some encouraging then threatening nonsense, the Iranians mock him, and ultimately NO change. More of the same here until we hear something both conclusive and confirmatory from the Iranian side ONLY, and not before.
You’re always very thoughtful and I appreciate your analyses.
I do, however, have to object to the phrasing “getting dragged into this war,” which implies the US was a hesitant, even unwilling participant. I reject that characterization and I think it’s irresponsible to frame it as such.
It was Trump who dragged the American people into this war, although most people did not want it!
So if we had forced Iran back to the status quo at the end of Obama’s presidency we don’t hold it up as the deeply costly blunder that it was? We wronged Iran. It should be held up as a crime.
Actually, attacked twice in less than 12 mos., both due to Israeli prompting, with moron trump following along.
WRT Iran, Trump messed around and found out. He believes in his own “towering genius” narcissism, that norms are not for him. These are also the only qualifications of his cabinet officials.
Therefore. The only strategic outcome the White House is interested in is Emperor Tang furthering that illusion. Now that is abundantly clear this was an epic folly, he’s off to conquer Cuba to have something to beat his chest over IAO The July 4th party and the midterms.
Absolutely nuthin
The Epstein files - the Donald-Melania-Jeffrey fest: your questions answered!
While it may have had no purpose for the US, its greater purpose was to hammer home to Europe just how dangerous American imperialism is. Let's be clear, US will stop at nothing to colonise the world, because the alternative is that China will eclipse the US. Most of us think that's inevitable, but the US will try every dirty trick it can against whoever it can, including potentially mass climate distruction, and potentially WW3 to make that not happen. Trump is the most vulgar impetuous imperialist, but the Democrats are just smarter at their imperialist plans. This has been a great wake up call to Europe, who might have been caught napping by Democrat "boil the frog" policies.
What was it for? You seem to have misunderstood. The US has been DEFEATED in a war of choice. We don't yet know the scale of the costs.
It’s not a peace deal at all, it’s a structural pause for 60 days. Both sides get out of a jam for a bit. Market uncertainty reigns over the rest of the year while Iran gets market waivers and can sell 150 million barrels of oil on the water for $100 per barrel. This will be a major boost to the regime. The expiry will be right before July 4th. More TACOs for the bash.
Heckuva job, Donnie.
The war, being jumped into by a president apparently ignoring advisors in the various agencies with expertise, based on a ridiculous belief that his intuition must yield the best action (characteristic of "malignant narcissists"--I don't know?), is an example of a thinking pattern and its consequences that others have observed in other areas.
In my own case (on the health insurance system), the non-extension of the ACA expanded subsidies resulted because of Trump having this idea "lets get the insurers out, and give the money directly to the people". It was quite unworkable, especially in the time frame available before the expanded subsidies lapsed. And the Republicans went along. Going with the half-baked impulse of the great leader.
Now, there was CBO research.
It was:
"Without an extension through 2026, CBO estimates, the number of people without insurance will rise by 2.2 million in that year. Without a permanent extension, CBO estimates, the number of uninsured people will rise by 2.2 million in 2026, by 3.7 million in 2027, and by 3.8 million, on average, in each year over the 2026-2034 period. 3 (The initial increase is significantly smaller because CBO expects that some people will remain temporarily enrolled after the expanded credits expire at the end of 2025. CBO assumes enrollees would need time to fully respond to the expiration, for example, because of automatic renewal policies.)"
Instead of the heeding the CBO, the president and Republicans made use of alternative "research" by a "Paragon Health Institute", which recommended a lapsing of the expanded subsidies. And, so that lapsing did happen Jan 1, 2026.
1)Paragon I and others have found very questionable.
1a) First, questions around prior research finding lots of fraud in the ACA
Details on this: Paragon Health Institute has attacked the ACA based on findings of fraud, which findings were based substantially on ACA “zero-claim enrollees”, being people with an ACA plan, who never file a claim.
I looked into this, and Paragon’s general policy advice, a bit myself within these two posts from months ago:
https://normspier828307.substack.com/p/who-are-the-economic-advisors-who
and
https://normspier828307.substack.com/p/who-are-the-economic-advisors-who-5ef
and, not only did many of the analyses look fishy to me, but, as on that second post, I found out that several organizations with large technical staffs also took issue with the analyses.
For example, from the American Hospital Association (https://www.aha.org/news/blog/2025-08-28-setting-record-straight-separating-fact-fiction-health-insurance-marketplace-fraud):
"It is therefore imperative that policymakers understand that Paragon developed these allegations using inaccurate data, dubious assumptions, and an apparent lack of understanding of how health insurance actually works."
(Incidentally, about 6 months ago Paul Krugman addressed the "how insurance actually works" issue, with an example of you can have fire insurance, and not filing a claim does not mean you shouldn’t have had insurance. He did not attack Paragon, or its head, Dr. Brian Blase, by name, but he must have been thinking of those fraud allegations. That Krugman post is: https://paulkrugman.substack.com/p/the-republican-brain-doesnt-want )
1b) Secondly, the Paragon Health Institute produced a graph which was used by both Senate Majority Leader John Thune (in this video, from the day the Senate voted against extending the expanded subsidies: https://www.youtube.com/watch?v=FWmkb_rdUrI&t=287s)
and House Majority Leader Mike Johnson (in this tweet:
https://x.com/SpeakerJohnson/status/2000690200008139250?s=20 ) to justify not exending the ACA expanded subsidies
The graph is labelled, and purports to show, “Obamacare Plan Premiums Have Increased Nearly 2x Faster than Employer-Based Premiums Since 2014”, and is to be found here: https://paragoninstitute.org/paragon-pic/obamacare-plan-premiums-have-increased-nearly-2x-faster-than-employer-based-premiums-since-2014/
Now, the thing is, I’m pretty sure that graph is completely erroneous, due mainly an omission of the cost-sharing-reductions direct to insurer payments that existed only from 2014 to 2017 as a cost, and a shifting by a year of the employer-plan cost because the 2026 data on employer costs was not yet available.
When I tried to adjust for the errors, I got that the ACA plan cost tracked in the graph rose either slightly more, or slightly less, than employer-based plan.
(I’ll spare the details here. But I have them, and my alternative correction attempt here: https://normspier828307.substack.com/p/senate-republican-leader-john-thune , if interested.)
2) Now, as more information about the lapsing of the expanded subsidies keeps rolling in, the CBO numbers look about correct, with it looking like 3 million to 5 million of about 24 million getting ACA on-exchange coverage in 2025 will wind up losing coverage.
(To save space, and avoid redundancy, I have a comment on a prior JB post with the info showing 3 to 5 million will wind up losing coverage, and, as well, that a cover-up with false propaganda may be coming from the administration. https://econjared.substack.com/p/why-are-people-so-damn-mad/comment/261550456 )
--
Oh, by the way, if you like, or are interested in Walter Lippmann and John Dewey, I just did a post on some of what Lippmann wrote, integrating in a bunch of the avoiding of experts stuff from above in this comments.
In it, I have mention of 3 Lippmann and Dewey books that are available for free online, and I think many of JB's readers will find them excellent summer-season beach reading.
Here: https://normspier828307.substack.com/p/walter-lippmanns-public-opinion-and ,
if interested.
This all sounds suspiciously like how the Vietnam war ended.
This looks to me like deja vu all over again. It's not at all clear just what Iran has agreed to and I certainly wouldn't put any weight on statements from Trump. Remember the "deal" they negotiated in Pakistan? How'd that work out?
The most plausible explanation for the war is that Trump was duped into it by Netanyahu. An all out war with Iran has been Netanyahu's dream for years but he needed America as an ally in war. Trump can be played as has been demonstrated many times before. Netanyahu saw that Trump is losing his grip on reality and decided that the time was right. As far as the prospect of a deal now I wouldn't bet on it. This cycle has repeated itself several times since the war started. Trump announces that a peace deal is at hand. The media falls for it and so does the oil futures market. Oil futures go down. But before they do, insiders have already shorted the market. It's corruption on steroids.
What was the war for? Penance for re-electing Trump after all that we knew about him.
Off topic, but I feel important news on a recommendation change on the health insurance system by Paul Krugman in today's paywalled post ( https://paulkrugman.substack.com/p/curing-us-healthcare-part-iii-the ).
PK had previously been going with that the ACA, with an undoing of the damage done last year on it by the lapsed expanded subsidies, and the coming OBBB changes mainly to the ACA's expanded Medicaid component, and other smallish changes to it, would be the best that is politically possible at the moment.
He, today, has changed sis stance toward more substantial changes, not going immediately directly to single payer, but more in a gradual, non-mandatory way, that will tend to eventually get insurance companies out because of their lower efficiency. And the changes may morph gradually into something close to single payer.
Quoting from today:
"Single-payer isn’t a perfect system, but it is a system that has been run effectively not only abroad but in the United States. While I am by no means dogmatic about this, my view is that the next phase in U.S. health reform should involve an effort to transition away from private insurance to single-payer.
Longtime readers may recall that this was not my position in 2009-10, when Obamacare was being put in place. Nor did I support Bernie Sanders’s call for single-payer in 2016. However, like many and probably most supporters of Obamacare, I backed patchwork rather than comprehensive reform not because I believed that it was the best policy but because I believed that it was the only politically realistic way forward in 2010 and in 2016.
But it’s now 2026, and the political landscape has changed in ways that arguably put fundamental reform in reach."
...
"This suggests that an attempt to push people into Medicare-for-all would run afoul of concerns about change.
But it would be much less controversial, I believe, to offer a public option — allowing Americans, including employers providing insurance to their employees, to buy into a Medicare-type system. Many people surely would avail themselves of that option. And if they like what they get, which they probably would, we could transition over time to a single-payer system without forcing Americans into it.
Of course, insurance companies would hate this, and campaign furiously against it. But given their current reputation, this might even help the cause of reform.
Now, I am not offering policy specifics, partly because this post is already long but mostly because this is the point at which we need details from real experts. And I am not at all dogmatic about the path forward.
The main point is, instead, that we are approaching a point at which ambitious healthcare reform, well beyond simply repairing the damage to Obamacare, will be possible. And Democrats should be prepared to rise to the occasion."
--
(OK, JB. You may have to coordinate some Democrat real experts. Get cookin! I don't know what you had planned for Memorial Day, but....? (😊))
Seriously, now, I need to add: There is a question of any new plan, does it cover long-term-care and nursing homes?
The Sanders proposal for single-payer did. Otherwise, nothing we have as standard health insurance covers it. That is, not Medicare, not ACA coverage, not employer coverage. What we do have is that Medicaid covers it, but only after a family has spent down to the traditional-Medicaid requirements of being basically dirt poor in both income and assets. (With some exceptions.) (There is also private nursing-home insurance, which is pre-existing-condition screened, too expensive for many people, often falls short of full-enough coverage, and only about 10% of people over 65 have.)
I actually attempted to research this in other developed countries. Not all of them do cover long term care without requiring spending down virtually all of assets. Notably, the U.K. is like the U.S. on long term care.
However, other countries, like Canada and Germany (I think) seem to have a much better system.
(My little bit of research: https://normspier828307.substack.com/p/paying-for-nursing-homes-and-long .)
Anyway, note that for most people, who do have secure regular health insurance for non-long-term-care (say having aged into Medicare, or having sound retiree coverage, or government-worker coverage which becomes permanent often after 10 years), nursing home and other long-term-care coverage is a big issue.
A big issue, that most people don't know about, but that takes individuals, and often, it can take down the member of a couple that stays out of the nursing home, as the impoverishment requirement for Medicaid applies to the couple, not just the individual.
(Lawyers, with enough pre-planning, can sometimes get people out of it. But not always. And sometimes, the way of getting people out of it is a "Medicaid Divorce".)
So, potentially solving a problem that can affect a broader population makes it a reason to try to include long-term-care in a new Democratic proposal, that you might possibly start working on tomorrow or Tuesday.
--
P.S. PK has been tending to unpaywall his most significant paywalled posts within a month after the paywalled post. So people without a paid subscription should be able to get the whole thing soon.
I am not sure if the unpaywalling is part of JB's "Affordability Agenda"--I don't recall seeing it there, but I might have missed it.
Also, it could be a mayor Mamdani thing.
Also, it could be that either in front of Professor K's New York apartment building, or in front of the various hotels where he is staying now while in Europe. there are protestors with signs "From Each According to His Ability. To Each According to His Needs."
(😊)
Whatever the cause, I expect the full text will be available free in a few weeks.