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I fully understand the details of M4A, and Bernie called it that for a reason, it was not a mistake, there is a reason for it. The reason he didn't want to talk about how it was paid for and Warren actually came up with a better means to pay for it is that it would still result in a number of issues that have not been resolved, however both of their options still greatly underestimated the funding that would be necessary to maintain quality of care while simultaneously increasing services.
I think you are overlooking the loopholes in the ACA that the poor are currently using to obtain actual treatment while not paying their monthly premiums or their deductibles. In states where they expanded the ACA Medicaid, they can go straight through medicaid to receive their care. In other states, like Texas however, they are still able to have insurance, receive treatment and not pay much out of pocket. Here is how:
1)They apply for Blue cross Blue shield on the healthcare exchange, due to their low income, they qualify for the subsidies.
2) They differ their monthly payments to their taxes. This means they do not pay anything, it is supposed to be taken out of their tax return at the end of the year but due to their low income, they do not take it out at all.
3) Visits to their Primary care doctor for regular care, usually only paying a $25 copay.
4)Paying low co pays for medication at the pharmacy usually between $5-$25 for most medications that would be hundreds of dollars otherwise.
Yes, they are currently billed for large hospital copays and deductibles, but that is why we need to expand the ACA to resolve that as well. It is however providing millions of people who have no other options right now access when they could not afford to get help at all without it. If the GOP states that rejected the medicaid expansion finally accept it, they could go through that rather than be forced to use the loophole. If they get the medicaid expansion, they would not be billed at all.
The reality we have right now is that we do not have enough votes in congress for M4A. How would it be better to make it worse rather than take the smaller improvements in the meantime because we can actually get those passed? Democrats having a supermajority =\= progressives having a supermajority. We simply do not have enough progressives in congress to make that happen. Our only way I see to ever get enough progressives to have a supermajority is for progressives to physically move to conservative districts and outnumber them to change who wins. They are not willing to do that, so in the meantime we have to work with what we have. That means trying to keep as many people alive in the process until we finally get to where we want to be.
Punishing the only party that has progressives in it at all does not suddenly result in having enough progressives to have a supermajority, it just makes sure the progressives we do have will not be able to help at all. The only people you help by not voting for the only party who has progressives at all in it is the far right, it doesn't help the few progressives we have in congress, it just makes sure they will never be able to get anything done at all and the right will just make everything worse in the process. Being willing to take the axe ( republicans ) to hurt yourself is one thing, but what it does in reality is it is putting all of the poor on the guillotine with you when you do it. I have worked with people every day who literally will not survive even a few months under GOP's current policy plans, some of them will not even survive a day without their medication. They will quite literally die if the GOP current plan goes through and they have no other options than the ACA right now. When my vote = their deaths, I no longer view it as " it's my call, or your call..." At that point is now: " IF I allow these polices to take affect, I am directly responsible for their deaths because I did not do everything within my capability to stop it from happening" and so is everyone else who allowed this to happen. So yes, I do feel that you, or I or anyone else who allows the GOP to retain power right now by either not voting, voting 3rd party or vote for GOP is directly causing their deaths.
Show me the plan to keep these people alive when the GOP win and then we can consider another plan here. That plan doesn't exist so until that happens, we do not have that luxury. Are you going to personally pay out of pocket to keep the millions of people alive while we wait out the boycott? If not, then I have to consider that they want to live, not die, and I am going to do everything within my power to ensure they do as well as do everything within my power to make sure everyone else I speak to does as well. I do not accept" I'ts your call" when it comes to others lives, and yea, we should accept being directly responsible for their deaths if we know this is what will happen and choose to allow it to happen regardless.