Three candidates actually. (Bernie, Warren, and Yang.)

...

Loss aversion is a powerful emotion with destructive effects on our politics.

Once enough people have something to lose from a change, change becomes extremely hard, even if the overall net effect would be positive.

Not only does this preserve bad policies, it turns some into a one-way ratchet--where it's easy to make things worse and very hard to make them better.

Examples

- Medical middlemen (insurance, insurance brokers, billing companies...) are pure waste. But they employ so many people and generate so much revenue that they are very hard to attack. The US has slowly climbed to ~2x the per-person medical spending of our peers... so now, any effort to reduce that to 1.9x will be met with fierce resistance.

- Prison guard unions are powerful nationally and in many states, including California. They fight any and all attempts to reduce incarceration. That was true in 1980 with ~100 prisoners per 100k population... and it's true now with ~650, by far the highest in the world.

- Realtors and car dealers essentially tax the two biggest purchases most people in America make, house and car. They have powerful lobbies in all 50 states.

There is no particular amount that will placate these rent-seekers. They just never want their income stream reduced.

They could be strung up as combined they do not have enough marketing power as a strong populist political party. Unfortunately, as we've seen, the closest USA has for this is Trump, who is playing the Republican playbook.

Both parties are economically right wing. Third party is easily squished by tribalism and system being unbalanced.

I strongly support the Warren/Sanders universal healthcare plan, but in terms of optics, I don't actually see what the point is to making “duplicate coverage” private insurance illegal. It invites FUD and provides a convenient bogeyman while being entirely irrelevant in practical terms. If the government is providing comprehensive free healthcare to all, why would anyone need duplicate private health insurance? There's no reason to make it illegal, because there's no reason anyone would continue to pay for it. It will shrivel up and die on its own.

The reason is so that there aren't "boutique" private practices. Keeping the rich people in the same boat as the poor people is actually quite important for the long-term health and welfare of the system. Members of the Canadian parliament have the same healthcare system as anyone else. Thus they aren't terribly tempted to cut it.

If private insurance was allowed (in Canada), the elite would have expensive plans that had physicians only caring for a few people each, and so on. This worsens the care in the general system but more importantly, it splits the interests of the elite from the general public.

So how do you justify to your family that you are voting for someone who will reduce availability of very specialized treatment for them (those boutique doctors), so some random people you've never heard of can have better care "on average"?

Becuase that's where I get stuck.

From a selfish perspective, because you run into those random people. When your servers and your retail employees can go to the doctor instead of "waiting it out" because of medical expenses, that's less likely to make you and your family ill.

From a less selfish perspective, there but for the grace of God go you.

Hoy por ti, mañana por mi.

Specialized care is not synonymous with boutique care. We have a robust research and development economy in the US that will continue to exist without the perverse incentives of private insurance.

Is that why people from all over the world come to USA for cancer care, against all costs?

And people all over the world go to South Korea for plastic surgery. We don’t stop being the best because we now pay for the care for every American at the point of need.

Specialized illnesses don’t discriminate by class. Those without means don’t receive the care they need. We are fighting so that the system centers that care instead of revolving around a third party private payer that has every incentive to deny that care.

Having boutique practices is what reduces the availability of very specialized treatment, not the reverse. You're stuck because your understanding is completely backwards.

Just FYI, Warren is backpedaling heavily on Medicare for All. She released her “healthcare plan” the other day and it its full of obvious outs and hedges away from M4A. Sanders is the only candidate still really fighting this fight.

Disappointing but expected.

M4A just won't work when half the country is completely against it. A public option as a stepping stone is much more feasible. We also need to stop limiting the number of doctors and nurses artificially.

It won't die, as private extra healthcare helps reduce queues, so a small amount thereof makes public services more available.

But they would never be able to outcompete it.

Elizabeth Warren’s plans are very vague, and only a few weeks old at this point. We still know very little about what she actually proposes. Bernie Sanders’ plans are about 5 years old at this point, and have been modified, but are rather solid.