Sexual Hypocrisy

Politico reports

Sen. Martha McSally, a 26-year military veteran, said Wednesday that she was raped in the Air Force by a superior officer.

The Arizona Republican spoke at a Senate hearing on the armed services’ prevention of and response to sexual assault, an issue she called “deeply personal.”

McSally did not name the officer who she says raped her, and said she did not report the incident because she was ashamed and confused, and felt powerless.

“I stayed silent for many years, but later in my career, as the military grappled with the scandals, and their wholly inadequate responses, I felt the need to let some people know I too was a survivor,” she said at the hearing. “I was horrified at how my attempt to share generally my experiences was handled. I almost separated from the Air Force at 18 years of service over my despair. Like many victims, I felt like the system was raping me all over again.”

In her two-and-a-half statement about military commanders who tolerate such behavior, the Senator never once referred, directly or indirectly, to the Commander-in-Chief (of the Armed Forces when called into service).

In its "Tracking Congress In The Age Of Trump," Five Thirty Eight reveals that (as of late February) McSally has voted  "in line with President Trump's position" 95.2% of the time. She ranks fourth in the US Senate in the "difference between a member's actual and predicted Trump-support scores." (This considers Trump's vote margin in the presidential election.)

This is the Donald J. Trump Senator McSally so loyally supports:

I moved on her like a bitch. But I couldn’t get there. And she was married. Then all of a sudden I see her, she’s now got the big phony tits and everything. She’s totally changed her look...

Yeah, that’s her. With the gold. I better use some Tic Tacs just in case I start kissing her. You know, I’m automatically attracted to beautiful — I just start kissing them. It’s like a magnet. Just kiss. I don’t even wait. And when you’re a star, they let you do it. You can do anything.

Though an endorsement of sexual assault, this was not an endorsement of rape, unless Trump defined "anything" as "including rape."

Nonetheless, it's legitimate here to use an expansive definition of rape, given that McSally herself has when she remarks "I felt like the system was raping me all over again." And the list of women who have accused Donald Trump if sexual misconduct and/or assault is legendarily, almost incomparably, long.

Politico adds

The senator’s disclosure comes at a time when more voices — including Sen. Joni Ernst (R-Iowa), a veteran who said in an interview this year that she was sexually assaulted in college — seem to be calling for new ways to address reports of sexual assaults in the armed services.

The  allegations, presumably truthful and accurate, by Ernst and McSally have come in the wake of the "MeToo" movement. But they came also after the election of Donald J. Trump, whose presidency has been faithfully supported by both.

Even after the election, McSally and Ernst have been careful not to link Trump to sexism and misogny. At a news conference in September, the President claimed "I was accused by four or five women who got paid a lot of money to make up stories about me."

Senator McSally, who now maintains she was raped twice, is still staying silent. If she wants to have a real impact on devaluation of women in the culture, Donald Trump should not be far from her lips when she comments about sexual assault. Better yet, she can try voting against the President's position once in a while. When she does, she can talk.

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Procrastination

Sometimes Nike's ad slogan, "Just Do It," works.  Reprising her earlier role as an anti-Semite,  Ilhan Omar appeared last Wednesday on a panel with Representative Rashida Tlaib. At the end of a mostly innocuous statement, Omar commented "So for me, I want to talk about the political influence in this country that says it is okay for people to push for allegiance to a foreign country."

Six-plus days have passed, Omar has been condemned by members of the Jewish community and supporters of Israel, defended by supporters, and only now, as Politico reports

A vote on a resolution condemning anti-Semitism in response to controversial comments by Rep. Ilhan Omar is set to slip past Wednesday amid intensifying pressure from the left both inside and outside the House Democratic Caucus.

An array of progressive groups declared their support for Omar, while both the Congressional Black Caucus and Congressional Progressive Caucus — two of the most important factions among House Democrats — wanted more time to review the situation, lawmakers and aides said.

Speaker Nancy Pelosi (D-Calif.) and House Majority Leader Steny Hoyer (D-Md.) said in a closed-door meeting Tuesday that the vote would likely happen Thursday. They also said a draft resolution would be updated to include additional language rejecting anti-Muslim bias, although some Democratic sources believe that an entirely new document might be crafted.

What is clear, however, is that the furor over Omar's remarks — the second time in two months the Minnesota Democrat has made comments that were condemned by her own colleagues as anti-Semitic — is threatening to overshadow everything else happening in the House. House Democrats are set to pass a major anti-corruption package that deals with ethics and campaign finance reform initiatives and voting rights, but much of the attention is on Omar and how party leaders respond to her comments.

A more important issue is in danger of being overshadowed by the furor over anti-Semitism, as reflected by

"We're still discussing it," Hoyer said on Tuesday. "The sentiment is that it ought to be broad-based. What we're against is hate, prejudice, bigotry, white supremacy, Islamophobia, and anti-Semitism."

"Yes, we're strongly against anti-Semitism, but we're strongly against prejudice directed at any group," Hoyer added.

An old joke, updated for the current situation: Stop the presses- and social media! Democrats oppose prejudice!

Hoyer- himself Jewish and presumably taking his cues from Speaker Pelosi- has it wrong.

The caucus had a chance to do the right thing. On Monday, Speaker Pelosi received a letter written by House Foreign Affairs chairperson Elliot Engel, with eleven Jewish and/or Zionist organizations as signatories, arguing

We need to ensure that anti-Semitism has no place within the venerable House Foreign Affairs Committee. We therefore respectfully request that Congresswoman Omar be removed, immediately, from the sensitive work of the House Foreign Affairs Committee.

(Engel has now reversed himself; evidently, he got the message- video, below.)

Four days after Republican Steve King's remark supporting white nationalism was published, Minority Leader McCarthy stripped the Iowan of his two committee assignments, on Judiciary and Agriculture.

Yet 6-7 days after Democrat Omar made her comment decrying alleged dual allegiance, House leadership has been unable or unwilling either to remove Omar from the Foreign Relations Committee or to denounce anti-Semitism.

In the coming days, Pelosi and her caucus will do something. The optimum decision would be to remove her from a committee which has jurisdiction over foreign affairs, including in the Middle East, which includes the Jewish state and American ally, Israel.

Many people- perhaps your neighbor and undoubtedly some US representatives- have one or another bias, whether against Jews, Muslims, atheists, blacks, or another group. But Omar expressed hers publicly, and they bear on her work on the committee.

It is not absolutely necessary to do that, however. The House can simply pass a resolution condemning anti-Semitism and move on.

As Hoyer's remark indicates, however, leadership- cowed by misguided interest groups in the Democratic caucus- probably won't take even that minimal action.  It won't do it even though while anti-Semitism and anti-Islamic sentiments are bad, so is prejudice against Hindus (where are you, Tulsi Gabbard?) and all other religious groups, as well the non-religious.

Additionally, Omar is not accused of making anti-Muslim remarks. She stands accused, justifiably, of making one or more anti-Jewish statement. Were a US Represntative- particularly a member of the Foreign Affairs Committee- to make an anti-Muslim remark, the burden of proof would be on the individual's  supporters to demonstrate why he/she should not be penalized.

Perhaps Pelosi sees strategic value in making Republicans vote against anti-Islamic bias, given that much of the GOP base and President Trump are not partial to Muslims. However, that is not her primary motive in hesitating (and probably avoiding) to do the right thing.

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Bernie's Gift To Democrats

When I first saw and heard on You Tube Bernie Sanders' response (beginning at 18:42 of the Tube video below), I thought it was a good response. Reviewing it, I think it's a very good response. Vice explains

On Monday morning, Sanders appeared on The Breakfast Club, a hip-hop morning show in New York that has become a regular stop for Democratic candidates. (Sanders was also on the show in 2016.) He touched on issues ranging from decreasing mass incarceration to Medicare for all, largely focusing on how his economically populist initiatives can help African Americans. But things got touchy, to say the least, when the hosts pressed him on some race-specific issues that are bound to keep coming up as 2020 approaches....

In recent weeks 2020 hopefuls Elizabeth Warren and Kamala Harris have voiced support for reparations for black Americans, though they haven't explained what that exactly means. And though they were vague about the specifics, the moral stance was still a big moment for Democrats, considering Sanders, Barack Obama, and Hillary Clinton hadn't taken that stand. Sanders, faced with questions about giving money to descendants of slaves Friday on The View, voiced his opposition, saying, “I think that right now, our job is to address the crises facing the American people and our communities, and I think there are better ways to do that than just writing out a check.”

In all fairness, Warren and Harris were, to their credit, vague about their support for this hideous idea, which does not let them completely off the hook. Vice continues

On The Breakfast Club, Sanders was taken to task for his stance. When host Charlamagne tha God asked why it seems like he's been "dodging the reparations question," Sanders responded, “Well, the question is what do we mean by reparations?” When defined as economic empowerment for black Americans, he said that ending discrimination in the banking system and paying attention to distressed communities is how he intends to make that happen.

Years ago I was asked by an avidly pro-life friend whether I was "pro-life." I foolishly stated "yes' without asking what she meant by "pro-life,"  thus probably leaving her with the mistaken impression that I condone abortions at any stage of pregnancy for any reason at taxpayer expense. In this instance, Sanders' initial response "the question is what do we mean by reparations" did not prove to be sufficient, but was (and is) necessary. Nonetheless

once the question was point-blank about cash payouts Sanders quickly gave a hard no. “I think the way we go forward is to build America together,” he said, pointing out white and Latinx communities are also struggling. “We’re going to pay attention to the needs of working families and low-income families in this country in a way you’ve never seen.” That wasn't exactly the response Charlamagne was looking for, who pointed out, "the government has systemically oppressed [African Americans] in a way that they haven't for other people," pointing to slavery and mass incarceration. "There should be something done specifically for African Americans," he said. Sanders stuck to his view that tackling mass incarceration and other inequities is a way to help mend that history.

In an earlier post, I argued in part that wealth inequality, addressed by Sanders and Warren, contributes to the racial wealth gap. Reforming the tax system, as well as policies pertaining to a whole range of matters- including but not limited to criminal justice, housing, day care,  health care, transportation- can dramatically mitigate racial injustice. Concentrating resources on distressed communities- as Sanders noted- is critical.

Obviously, Sanders understands that. He did not mention (though it shouldn't have been necessary) that making cash payments to people on the basis of race is politically toxic to a general election electorate. He realizes, though, the slippery slope this would create. "You mean a check to every African-American?" he asked. "Well, then, a check to every Native American."

Bernie Sanders may have done a favor to the other Democratic presidential aspirants and especially to the eventual nominee.  This may have deflated the issue. Before the opposition expressed by Sanders, reparations were becoming a major issue in the primary process with candidates virtually compelled to be favorable, which would not have gone unnoticed in a general election campaign.  Donald J. Trump would have been ecstatic.

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And A Bad Imitation, At That

He lied about California governor Gavin Newsom, lied about President Obama, ridiculed generals, mocked a reporter for lacking a private jet, lied (again) about the size of his inauguration crowd, and lied some more. Earlier, he had threatened the United Kingdom in a "shameless, corrupt, and repugnant" tweet.

So why do I care about President Trump ridiculing former Attorney General Jeff Sessions?

At CPAC on Saturday, Trump stated

Robert Mueller never received a vote and never did the person who appointed him and as you know, the Atrorney General said "Ahm going to recuse myself. Ridiculous.





Of course, neither did the secretaries of state, treasury, defense, interior, agriculture, commerce, labor, health and human services,housing and urban development, transportation, energy,education, veterans affair, and homeland security. Neither did the Director of the CIA, the Director of National Intelligence, Director of the Office of Management and Budget, the US Trade Representative,nor  the Administrator of the Environmental Protection Agency or of the Small Business Administration. There was no election either of the Chief Justice of the US Supreme Court or of the eight Associate Justices.

Nonetheless, we all knew that Donald Trump believes he is the USA and the USA is Donald Trump and that he is entitled to be king as his greatest of all inaugural crowds proved.

We know, too, that the Confederate States of America was formed by seven states (including Jeff Sessions' Georgia), all of whom voted for Donald Trump in 2016. Four states, three of whom voted for Trump, joined afterward and two states, both of whom voted for the Republican informally joined still later. Without the support of these 12 states, Trump could not have sniffed the presidency

Yet- or, rather- therefore- Donald Trump sported a southern accent to ridicule his former Attorney General.

We've seen this play before. We've seen it in the strong majority of veterans, and probably an overwhelming majority of non-Hispanic white veterans, voting for Trump. They did so after Trump  reinforced a stereotype about veterans with PTSD. It was after he ridiculed Lieutenant Commander John S. McCain for being captured (but before he mocked the late Senator McCain), and many years after he felt like "a great and very brave soldier" by avoding sexually transmitted diseases while he eluded the draft with five deferments.

Evangelicals voted for Trump in droves, even after he ridiculed communion, denied he ever had asked God for forgiveness, and tried to put money into the communion tray. They continue to adore him, even while he lies, swears, sells out Israel to Russians, and is dedicated to amassing as President ever greater personal profit.

Ridiculing southerners with his bad imitation is merely the latest example of Donald Trump's disloyalty, his practice of thumbing his nose at supporters. The swindler has found his marks.



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Bad Followed By Bad

This guy is a presidential contender?

It's silly to say that if one can't stand up to MirandaHobbes that he won't be able to stand up to Kim Jong-Un. But really, Joe?

You’re right, Cynthia. I was making a point in a foreign policy context, that under normal circumstances a Vice President wouldn’t be given a silent reaction on the world stage.

But there is nothing decent about being anti-LGBTQ rights, and that includes the Vice President.

— Joe Biden (@JoeBiden) February 28, 2019

This exchange transpired because

Biden's comments about Pence came as he discussed foreign policy and how the international community had reacted to Pence during the vice president's speech at the Munich Security Conference earlier in February.

"The fact of the matter is it was followed on by a guy who's a decent guy, our vice president, who stood before this group of allies and leaders and said, 'I'm here on behalf of President Trump,' and there was dead silence. Dead silence," Biden recounted Thursday at the Chuck Hagel Forum in Global Leadership at the University of Nebraska at Omaha.

The former vice-president was not emphasizing the decency of the current vice-president, though he did imply that his successor would not call an opponent "crazy" and another a "nut job," brag about the size of his penis, or sell out the nation to aformer power. His message was that Donald Trump is held in such disrepute that simply stating the obvious- "I'm here on behalf of President Trump"- would be met with "dead silence. Dead silence."

Because the context of Biden's remark was clear, there would have been no need for him to apologize which- given that he did not say that he regretted labeling Pence "decent"- he avoided. However, there also was no need for Biden to retreat from his statement, given that Mike Pence does not compare in character to, say, Donald Trump or David Duke.

Pence's faults, especially on related issues such as reproductive choice and the right to discriminate against individuals on the basis of claimed religious belief, are numerous.  Moreover, the Vice President has remained loyal to Donald Trump, for whom endangering national security is simply the price of conducting business in the White House.

However, Biden never claimed Pence is an angel and did not suggest that the Democratic Party can play ball with "the monsters from inside The Bubble," as Charlie Pierce has described GOP legislators. (Give Joe time; he hasn't announced yet.) He was merely taking a shot at President Trump, which shouldn't be controversial to any Democrat or, for that matter, the politically unaffiliated.

Nonetheless, many independent-minded voters (as well as Republicans which, Biden may not realize, will not vote for any Democratic nominee) and a few Democrats will not be comforted by a candidate unable to tell a relative nobody like Cynthia Nixon to buzz off.  A voter doesn't have to admire Trump's fascistic celebration of strength to recognize a Democrat who folds upon application of the most minimal of pressure.   Cynthia Nixon was wrong. But when Joseph R. Biden folds like a cheap suit, it is reasonable to wonder if he is an empty one, too.

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Someone In Prague?

On Thursday, Andrew Prokop of Vox wrote

Furthermore, unless Cohen is blatantly lying in his new testimony, his account appears to put the nail in the coffin of some long-simmering claims from the Steele dossier (the reports compiled by former British spy Christopher Steele alleging a Trump-Russia conspiracy).

The dossier claimed that Cohen had a major role in conspiring with Russia. Steele wrote that during the campaign, Cohen traveled to Prague at Trump’s request to secretly meet Russian officials. There, Steele claimed, they discussed how to cover up Trump’s relationship with Russia, and Cohen even discussed how to make “deniable cash payments” to hackers directed by the Kremlin.

But very quickly, Cohen vociferously disputed this claim that he had been to Prague — and he continued to do so after his plea deal, and in his testimony Wednesday.

Trump TV's Tucker Carlson, whose career unhappily did not end when he was pantsed by Jon Stewart. snidely commented "Oh damn, he did it again, straying from the script. Instead of confirming the Russia conspiracy that dominated and controlled American politics for more than two years, Michael Cohen just refuted it."

In Carlson's vernacular: oh damn, he did nothing of the sort. Even laying aside Cohen's testimony about Trump Tower Moscow and the Trump/Roger Stone/Wikileaks connection, the ex-fixer and lawyer did not "refute" the theory of a conspiracy between Russian actors and the Trump campaign to thwart a democratic election.

In his appearance Wednesday before the House Oversight Committee, Cohen stated "I have never been to Prague" and in response to the follow-up question, "I've never been to (the) Czech Republic."

It probably was a wise claim, given that it lines up with what he told the Special Counsel. However, at first glance it appears to conflict with McClatchy's report last December that 

A mobile phone traced to President Donald Trump’s former lawyer and “fixer” Michael Cohen briefly sent signals ricocheting off cell towers in the Prague area in late summer 2016, at the height of the presidential campaign, leaving an electronic record to support claims that Cohen met secretly there with Russian officials, four people with knowledge of the matter say.

During the same period of late August or early September, electronic eavesdropping by an Eastern European intelligence agency picked up a conversation among Russians, one of whom remarked that Cohen was in Prague, two people familiar with the incident said.

The phone and surveillance data, which have not previously been disclosed, lend new credence to a key part of a former British spy’s dossier of Kremlin intelligence describing purported coordination between Trump’s campaign and Russia’s election meddling operation.

The dossier, which Trump has dismissed as “a pile of garbage,” said Cohen and one or more Kremlin officials huddled in or around the Czech capital to plot ways to limit discovery of the close “liaison” between the Trump campaign and Russia.

When Buzzfeed in January maintained that the President had directed Cohen to lie to Congress about the Trump Tower project, the Special Counsel's office denied the report, albeit in a slightly cryptic manner. (That may be because, according to Cohen on Wednesday, Trump had merely made it clear to him what he should say without directing or ordering him to do so.)

Yet, McClatchy in its Prague story added "Peter Carr, a spokesman for Mueller's office, declined to comment about the electronic evidence."  Additionally

Cohen’s spokesman, Lanny Davis, reiterated his client’s denials about Prague in a phone interview this week.

Cohen “has said one million times he was never in Prague,” Davis said. “One million and one times. He’s never been to Prague. … He’s never been to the Czech Republic.”

Davis, a longtime Democratic political operative, declined to comment about the new foreign intelligence.

Christopher Steele's dossier was merely a compilation of raw intelligence rather than a doctoral dissertation or prosecutorial indictment. Having earlier sworn that he had not made the trip, Cohen's denial on Wednesday was predictable.

The burden of proof in this matter lies with skeptics of the claim that Cohen never has been in Prague. Even the normally objective Prokop believes that the denial puts "the nail in the coffin" of the claim of a surreptitious meeting. However, phone data picked up signals from Cohen's phone and neither the Special Counsel's office nor Cohen's attorney has denied the McClatchy report.

Michael Cohen may be telling the truth. Or McClatchy's report may be accurate. Or both.

It is unlikely Cohen was in Prague. However, it also is probable that his phone was there, indicating someone else had been using it. Were that the case, Cohen is not lying and McClatchy is not mistaken, and another, extraordinarily intriguing, line of inquiry has opened.  No one should assume the meeting occurred- but no one should assume it did not. Because when we assume....

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Making Single Payer Sustainable

Perhaps the only question guaranteed, in whatever form it is posed, to be asked at every Democratic presidential debate is: do you support a single payer health care system?

If it were not certain, it is now that Representative Pramila Jayapal, a Democrat from Washington State, has introduced a bill which would

- create a single-payer, government-funded health-care program within two years, eliminating the age 65 threshold for Medicare eligibility.

- not charge beneficiaries copays, premiums or deductibles.

- cover prescription drugs, vision, dental, mental health, substance abuse and maternal care. It would - also provide universal coverage for long-term care for people with disabilities.

- not include methods to pay for the health-care overhaul. Jayapal mentioned higher taxes on the wealthy or contributions from employers as potential ways to fund it.

As to the latter, "Ay, there's the rub," remarked Shakespeare's Hamlet, concisely and eloquently, albeit with a misplaced apostrophe.

Phillip Longman of the Open Markets Institute in late 2017 examined some of the benefits and pitfalls of Medicare for All, first promulgated by Senator Bernie Sanders, at least with such strategically savvy branding.

Fundamental to his analysis is that Medicare "doesn't produce health care. Rather, it pays bills submitted by private health care providers" and thus MFA "would remain almost entirely in the hands of private enterprise. Meanwhile, its financing would become exclusively a burden borne by government."

Longman explains "starting in the 1980s and continuing through the '90s" most health care providers

found themselves at the mercy of increasingly monopolistic health insurance companies. Doctors and hospitals were put on the defensive as insurers merged with one another and forced providers to make price concessions if they wanted to keep their insured patients. Insurers used their increasing "monopsony" power to put the screws on drug companies and everyone else in the medical supply chain. This explains why, for a brief moment in the 1990s, the nation’s overall health care bill actually declined.

But then came a counterrevolution that has proven far more consequential. Not only did sixty drug companies combine into ten, but hospitals, outpatient facilities, physician practices, labs, and other health care providers began merging vertically and horizontally into giant, integrated, corporate health care platforms that increasingly dominated the supply side of medicine in most of the country. Like Amazon or Google, these platforms extend their power by controlling the very marketplace in which customers and suppliers have to do business. Even nominally independent surgeons, for example, can’t stay in business if the only hospital in town won’t grant them admitting privileges, or if it grants “affiliated” surgical teams better terms. Many of these platforms became part of large chains operating in multiple regions; others achieved dominance in a single city, which still gave them extraordinary market power.

Therefore, "in a local market that’s been cornered, even the largest purchasers of health care, including insurance companies and large national employers, become price takers, not price makers."  A recently published study, Longman notes, "found that hospital ownership in 90 percent of metro areas is so concentrated that it exceeds what antitrust regulators have historically regarded as the threshold for when action is needed to avoid inefficiency and collusion." Prices have soared because

As hospitals combine into local and regional monopolies, they can leverage their power by buying out local physician practices. Consider the anticompetitive effects of these deals. Doctors play a large role in steering patients to different hospitals, and anti-kickback laws prevent hospitals from paying doctors for these referrals. Yet those laws become inoperative when a hospital simply buys a doctor’s practice and puts him or her on its payroll. Such a deal not only allows a hospital to effectively buy referrals, it also forecloses future competition. To win the business of these referred patients, a rival hospital would generally first need to convince them to change doctors.

It is likely, therefore, that although under Medicare for All some cost savings would accrue from the federal government's monopolistic power as a purchaser, it would be negotiating with a single provider. Longman wants us to

think about how well our “single-payer” Pentagon procurement system does when it comes to bargaining with sole-source defense contractors. Not a pretty picture. In theory, the government could just set the price it’s willing to pay for the next generation of fighter jets or aircraft carriers and refuse to budge. But in practice, a highly consolidated military-industrial complex has enough economic and political muscle to ensure not only that it is paid well, but also that Congress appropriates money for weapons systems the Pentagon doesn’t even want.

The dynamic would be much the same if a single-payer system started negotiating with the monopolies that control America’s health care delivery systems. Think about how members of Congress representing, say, western Pennsylvania would be likely to respond if Medicare-for-all dared to reject the terms demanded by the University of Pittsburgh Medical Center, the region’s dominant health care provider. Notwithstanding its academic name and origins, UPMC is a Goliath that controls nearly 60 percent of the inpatient medical-surgical market in the greater Pittsburgh area.

This problem would have been mitigated if the Affordable Care Act had produced the revolutionary health care reform, insuring tens of millions of additional Americans with reduced costs and bureaucracy, that President Obama and his supporters intimated it would. Alas, those hopes were dashed even before the Trump Administration and its allies started to decimate "Obamacare." Longman reminds us

Big Pharma made sure that the Affordable Care Act contained language forbidding the federal government from engaging in cost-benefit analysis of drugs, and has dissuaded Congress from allowing Medicare to bargain over drug prices. Similarly, hospital supply cartels have fought off government regulation despite the demonstrably high prices they were extracting from the system. It is frankly naive to expect that health care regulators won’t become even more captured than they already are if the industry they are supposed to regulate gains even more concentrated economic, and therefore political, power.

Jayapal has laid down a marker by proposing a health care framework more ambitious than "Medicare for All" and less complicated and easier to navigate than Obamacare. Writing before introduction of the congresswoman's bill, Longman acknowledged

socialized medicine might work to contain prices and make the U.S. health care system sustainable. But short of flat-out nationalizing America’s health care delivery system, the only other option is to make sure that the market power of hospitals and other providers is sufficiently dispersed that it remains politically possible to regulate them.

Single-payer is therefore doomed to fail unless supporters fuse it with another reform: the aggressive use of antitrust and other competition policies not just to lower drug prices but, even more crucially, to bust up the monopolies that dominate the American health care delivery system.

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