Thread by @ASlavitt

As #Iowa caucuses tonight, I have the following advice on health care if this issue is important to you. Vote for the candidate who within 4 years has the greatest chance to pass legislation that does the most good for the most people and sets us up for more progress ahead.

1/

There is no “one and done” bill, there’s only progress. The future is unknowable, the system too complex, and our needs are changing significantly every few years anyway. Plus there will be pieces that just don’t work on any bill. 2/

Insurance companies do not need to be part of the future. No one likes them. But hospitals and doctors do and someone needs to pay them. And someone needs to coordinate care.
3/

As a political reality, the current balance of power on any bill is in the Senate. Which means rural considerations will dominate from both parties.

The Murk-McCain-Collins block becomes the Jones-Manchin-Tester block if Dems manage 2 win the Senate. 4/

Without them, even with no R votes, nothing passes in the first term.

I predict every Dem candidate will for that reason make health care largely a second term issue. I believe that no matter who the Dem is. 5/

That doesn’t mean nothing passes.

-Underwood House Bill gets done (it’s great)
-Drug costs get done finally
-Surprise medical bills get done
-Money for mental health gets done
-Women’s health gets restored

The table gets set for more, including potential big 2nd term bite. 6/

This is not what a lot of us who want it all now want to hear. But as you vote, consider the persuasive power of the candidate more than the fine details of their plans.

And who can shove Trump’s record in his face as he lies abou5 it all. Not simple. /end