文章来源:机锋网|www.kv009.comwww.kv009.com发布时间:2019-12-06 10:47:47  【字号:      】


  Last week, Bernie Sanders released the latest version of his “Medicare for all” plan, which would establish a federally run single-payer system to finance care for everyone in the United States. The plan has changed little from its previous iterations, but there is one crucial difference: This version is backed by several of Mr. Sanders’s rivals for the Democratic presidential nomination.

  Republicans are, by most appearances, thrilled — or at least relieved — to be running against Mr. Sanders and his plan, which would wipe out most private health insurance coverage, with prominent Republican politicians from President Trump on down taking repeated swipes at the idea.

  But rather than simply mocking him, Republicans should take a minute to learn from what he has accomplished, and how. You don’t have to support single payer — I certainly don’t — to see that Mr. Sanders has been remarkably successful as a policy entrepreneur.

  Working as an outsider over the course of a long political career, he has moved a sweeping and radical idea into the mainstream of Democratic policymaking. In doing so, he has modeled a certain kind of tenacious political salesmanship, using the Senate and his presidential campaigns as platforms to advance a major policy idea without initial backing from party leadership.

  Few if any legislators on the right are attempting anything comparable. And yet they could. The strategies Mr. Sanders employed would be available to any Republican or independent right-of-center politician inclined to use them.

  First, and most important, he had a clear vision, and he has tirelessly made the case for that vision and the benefits he believes it will provide: coverage for everyone, no premiums or co-payments, no maze of insurance paperwork to navigate. When Mr. Sanders talks about Medicare for All, he doesn’t treat it as a bureaucratic system, a complex piece of legislation to be explained. Instead, he is relentlessly focused on why he believes his ideas would improve the lives of ordinary voters.

  That persistence is another of Mr. Sanders’s strengths. The latest version of his Medicare for All legislation is the fifth iteration, a sign of his long-term commitment not only to the broad strokes of the idea but also to legislation that gives it shape and form. Building on the democratic socialist politics of his youth, he has been pushing for government-run universal coverage for years, even in the face of considerable resistance from the Democrats he has caucused with.

  That, too, accounts for some of his success: Mr. Sanders, probably the nation’s most successful independent politician, has not been afraid to oppose Democratic Party leadership or work outside of traditional partisan power structures. Instead, over the years, he has built his own base of political power, including the Congressional Progressive Caucus, a group for liberal legislators that he helped found and led in the 1990s. In the process, he has helped promote others who share his ideas and can echo and amplify his message — lawmakers like the co-chairwoman of the Progressive Caucus, Representative Pramila Jayapal, who recently introduced a single-payer plan that is, if anything, more far-reaching than Mr. Sanders’s.

  The radicalism of single payer has long been seen as a drawback, but Mr. Sanders has arguably used it to his advantage. Instead of pushing for incremental tweaks, he has forced a broad discussion about upending the nation’s entire health care system in one fell swoop. In fact, he has recently rejected some of the more incrementalist tweaks to Obamacare favored by party leadership.

  Mr. Sanders has paired his radicalism with transparency and a willingness, at least up to a point, to talk about some of the trade-offs his plan would require. He has been blunt about the fact that his plan would largely eliminate private insurance and has argued that this is both necessary and good.

  At the same time, he has left some of the most difficult policy questions open for discussion — in particular the problem of how to finance the significant increase in government spending that Medicare for all would entail. Here, his strategy seems to be to open the floor for discussion, allowing third parties to present various ideas, and then see which ones, if any, take hold.

  In the end, it may still not be enough. A full-fledged Sanders-style single payer system is almost certainly too disruptive, too fiscally burdensome, too big a political lift, at least for the foreseeable future. And Mr. Sanders’s brand of cantankerous democratic socialism would pose real risks if he was installed in the presidency, where he would be expected to manage and govern rather than simply campaign.

  Yet even in defeat, he is likely to come out ahead. Over the past several years, he has pushed Democrats in Congress and the progressive policy apparatus — think tanks, activist organizations, academic influencers — to think seriously about ways to move closer to his goal, laying the groundwork for a big health care push at the next opportunity. Democrats may not follow his exact plans, but the party is now chasing his vision.

  Mr. Sanders doesn’t deserve all the credit for Democrats’ leftward turn, but he was ready and waiting when it happened. And he has thus provided Republicans and others on the right with a model — not of policy design, but of legislative advocacy, of using the power of the Senate and a presidential campaign to build support for a major substantive idea.

  Republicans have, on occasion, pressed similarly to bring issues to the fore — think of Rand Paul’s opposition to federal surveillance policy. But there’s no Republican who has played a similar role on health care, and none who appears poised to do so. And any Republican lawmaker who wanted to do so would need to have a big idea, like, say, the conservative health analyst Avik Roy’s plan to restructure Medicare, or the Cato Institute health policy scholar Michael Cannon’s idea for large, tax-free health savings accounts.

  Instead, Republicans tend to work within the system, defer to leadership and duck difficult questions about trade-offs. Needless to say, there’s hardly a policy vision to guide them.

  But if Republicans want to become, as President Trump says, the “party of health care,” Mr. Sanders has demonstrated the sort of long-term, dogged effort it is likely to take. His single-payer plan may thus prove to be a gift to Republicans in more ways than one.

  Peter Suderman is the features editor at Reason.

  The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.

  Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.



  www.kv009.com“【老】【婆】【大】【人】!【手】【下】【留】【情】!【青】【了】!【青】【了】!”【夏】【白】【嗷】【嗷】【的】【叫】【着】。 “【给】【老】【娘】【记】【住】!【老】【娘】【永】【远】【是】【正】【宫】~” “【是】【是】【是】~”【夏】【白】【点】【头】【哈】【腰】【的】【伺】【候】【着】【总】【算】【是】【妥】【过】【了】【一】【劫】:“【对】【了】!”【夏】【白】【忽】【然】【想】【起】【什】【么】【东】【西】:“【吉】【尔】【呢】!” “【额】……”【苏】【茜】【脸】【色】【一】【僵】【哭】【丧】【着】【脸】:“【吉】【尔】【姐】【说】……” “【吉】【尔】【姐】~!?【你】【俩】【在】【房】【间】【里】【干】【了】【啥】

  “【那】【万】【一】,【他】【要】【是】【就】【这】【样】【一】【去】【不】【会】,【怎】【样】【办】?” 【嗯】~~~! 【简】【直】【就】【在】【韩】【关】【等】【人】【处】【理】【蒙】【吉】【利】【王】【国】【血】【祸】【的】【同】【一】【时】【间】。 【灭】【苍】【生】【心】【中】【泛】【起】【波】【涛】,【不】【过】【也】【仅】【仅】【就】【是】【波】【涛】。 【小】【情】【人】? 【韩】【关】【轻】【轻】【點】【瞭】【點】【頭】,【可】【以】【佈】【置】【齣】【這】【種】【险】【地】【的】【人】,【確】【實】【很】【聰】【明】,【而】【且】【對】【阵】【法】【的】【瞭】【解】【非】【常】【深】【入】,【法】【寶】【壓】【阵】,【阵】【閤】【自】【然】,【這】【種】【人】【肯】

  【眼】【见】【得】【夏】【紫】【曦】【又】【沉】【浸】【在】【书】【本】【里】,【轻】【纱】【只】【得】【福】【了】【福】【身】【往】【外】【走】,【等】【走】【到】【门】【口】【了】【整】【个】【人】【又】【是】【一】【愣】! 【咦】——【不】【对】【呀】!【五】【姑】【娘】【不】【是】【失】【忆】【了】【吗】?【她】【竟】【然】【在】【看】【书】? 【呃】?【话】【说】,【失】【忆】【的】【人】【会】【不】【会】【忘】【记】【自】【己】【曾】【经】【学】【过】【的】【东】【西】? 【轻】【纱】【突】【然】【发】【现】【自】【己】【的】【脑】【子】【似】【乎】【有】【些】【不】【大】【够】【用】【了】! …………………… 【瑞】【王】【气】【冲】【冲】【地】【出】【了】【海】【棠】

  【永】【宁】, 【临】【别】【数】【月】,【刚】【刚】【已】【收】【到】【你】【的】【信】。【不】【用】【猜】【测】,【我】【对】【你】【的】【心】,【虽】【然】【比】【不】【上】【你】【对】【于】【我】【的】【万】【分】【之】【一】,【但】【是】,【我】【是】【喜】【欢】【你】【的】! 【你】【说】【你】【愿】【意】【等】【我】,【可】【我】【不】【能】【让】【一】【个】【喜】【欢】【我】【的】【人】,【等】【的】【太】【久】【了】。【所】【以】【我】【决】【定】,【用】【我】【最】【快】【的】【速】【度】【回】【去】【看】【你】。 【我】【不】【管】【别】【人】【怎】【么】【说】,【请】【你】【记】【住】,【这】【个】【李】【昕】【阳】,【喜】【欢】【的】【人】,【她】【叫】【做】【夏】【永】【宁】!

  【纪】【凡】【回】【到】【京】【都】【后】【比】【从】【前】【更】【加】【忙】【碌】,【只】【他】【回】【来】【对】【希】【希】【也】【不】【是】【全】【然】【没】【有】【好】【处】。 【至】【少】【他】【跟】【何】【保】【国】【的】【接】【触】【越】【来】【越】【密】【切】,【他】【们】【两】【家】【人】【相】【互】【间】【的】【来】【往】【也】【更】【密】【切】【了】【几】【分】。 【纪】【凡】【再】【如】【何】【不】【情】【愿】【也】【要】【带】【希】【希】【和】【叶】【回】【到】【何】【保】【国】【家】【做】【客】,【反】【之】【亦】【然】。 【两】【家】【的】【孩】【子】【可】【以】【在】【一】【起】【玩】【得】【好】,【除】【了】【纪】【凡】【其】【他】【人】【都】【是】【乐】【见】【其】【成】,【他】【反】【对】【似】【乎】【也】【没】www.kv009.com【一】【概】【被】【耍】【一】【概】【晓】【得】【后】,【周】【大】【妈】【倒】【还】【沉】【得】【住】,【气】【有】【变】【脸】【没】。 【可】【胡】【来】【娥】【却】【没】【那】【么】【好】,【袖】【子】【一】【撸】【就】【吼】【上】【了】。 “【没】【大】【没】【小】【的】【东】【西】,【也】【就】【那】【么】【点】【出】【息】,【咱】【们】【多】【大】【岁】【数】【了】,【还】【当】【猴】【来】【耍】,【别】【高】【兴】【早】【了】,【到】【时】【候】【你】【妈】【咱】【们】【一】【遇】【上】【一】【论】【理】,【治】【你】【还】【不】【一】【二】【三】,【简】【单】【又】【简】【单】!” 【这】【分】【明】【就】【是】【找】【嘴】【吵】!【可】【邢】【跃】【进】【心】【里】【透】【得】【很】,【一】【切】

  “【伯】【母】【好】【啊】。”【平】【冢】【美】【惠】【子】【就】【坐】【在】【面】【前】,【穗】【乃】【宇】【连】【忙】【打】【了】【个】【招】【呼】。 “【哦】,【你】【好】【你】【好】。”【平】【冢】【美】【惠】【子】【点】【了】【点】【头】,【然】【后】【继】【续】【打】【量】【着】【穗】【乃】【宇】。 【看】【年】【纪】,【挺】【小】【的】,【而】【且】【给】【人】【一】【种】【人】【畜】【无】【害】【的】【感】【觉】,【很】【明】【显】【就】【是】【那】【种】【未】【进】【社】【会】【的】【学】【生】【样】【啊】。 【不】【会】【是】【自】【己】【女】【儿】【的】【学】【生】【吧】? “【呐】,【静】,【这】【位】【小】【帅】【哥】【和】【你】【什】【么】【关】【系】?”

  “【砰】!”【震】【耳】【欲】【聋】【的】【一】【声】【巨】【响】,【宛】【若】【大】【地】【都】【颤】【抖】【了】【几】【分】。 【光】【明】【川】【几】【人】【脸】【色】【变】【得】【惨】【白】,【耳】【膜】【仿】【佛】【要】【被】【炸】【裂】【开】【了】。 【左】【以】【娜】【惊】【恐】【地】【想】【要】【叫】【出】【声】【来】,【但】【像】【是】【被】【人】【遏】【住】【了】【喉】【咙】【一】【样】,【咕】【隆】【了】【几】【下】,【双】【脚】【发】【软】,【跪】【坐】【在】【了】【地】【上】,【双】【手】【捂】【住】【了】【耳】【朵】。 【好】【难】【受】,【好】【痛】【苦】……【一】【呼】【一】【息】【难】【受】【得】【很】,【空】【气】【都】【仿】【佛】【变】【得】【炽】【热】【了】【起】【来】,

  【可】【行】【李】【刚】【收】【拾】【好】,【正】【准】【备】【跑】【路】,【他】【妈】【把】【儿】【子】【送】【回】【来】【了】,【可】【能】【是】【哭】【久】【了】,【小】【身】【板】【一】【抽】【一】【抽】【的】,【看】【着】【特】【别】【可】【怜】。 “【这】【孩】【子】【昨】【晚】【半】【夜】【醒】【来】【就】【开】【始】【找】【妈】【妈】,【一】【直】【哭】,【一】【直】【哭】,【谁】【哄】【都】【没】【用】,【没】【办】【法】,【只】【好】【给】【你】【们】【送】【来】【了】,”【冷】【清】【雅】【一】【边】【将】【孩】【子】【放】【下】,【一】【边】【解】【释】【说】。 【霍】【小】【闹】【脚】【刚】【踩】【地】【上】【就】【迈】【着】【小】【短】【腿】【朝】【着】【亲】【妈】【奔】【去】【了】,【看】【到】

  【柳】【清】【秋】【也】【不】【好】【直】【接】【拒】【绝】【这】【些】【秀】【女】【的】【拜】【见】,【只】【能】【笑】【着】【和】【这】【些】【姑】【娘】【们】【绕】【着】【弯】【子】,【毕】【竟】【她】【们】【中】【有】【不】【少】【人】【家】【世】【都】【很】【不】【错】,【就】【是】【自】【己】【不】【怕】【她】【们】,【真】【的】【得】【罪】【狠】【了】,【万】【一】【报】【复】【到】【宫】【外】【的】【柳】【家】【人】【身】【上】【就】【不】【好】【了】。 【待】【到】【这】【群】【秀】【女】【离】【开】,【柳】【清】【秋】【觉】【得】【已】【经】【过】【去】【了】【好】【长】【时】【间】,【就】【连】【脸】【都】【笑】【得】【有】【些】【僵】【硬】。 “【娘】【娘】,【要】【不】【要】【奴】【婢】【帮】【您】【揉】【揉】?”




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