Hope, Change, and Nutmeg - A US political timeline
- Thread starter Seleucus
- Start date
I hope so. Also hoping for the following legislation later on ITTL:
First, a bill adjusting the number of representatives in the US House to the Cube Root of the US Population, expanding it to 675 seats.
Second, after a while, a bill establishing proportional representation and multi-member congressional districts, akin to what FairVote is proposing:http://www.fairvote.org/reforms/fair-representation-voting/
I've been meaning to getting around to reading this timeline for awhile. Finally blitzed through it this week and...wow. It's one of the best timelines I've read on this site, and I like the randomizing done to achieve results in an objective manner.
Also, I may be biased, because having Senator Holt and (I'll assume he was the Democratic candidate) Governor Corey Booker is like my dream for New Jersey. Certainly makes this state much better in my view.
Also, I may be biased, because having Senator Holt and (I'll assume he was the Democratic candidate) Governor Corey Booker is like my dream for New Jersey. Certainly makes this state much better in my view.
And for Obama's first term. Maybe Seleucus could do a post based on this article: http://www.vox.com/2015/6/26/8849925/obama-obamacare-history-presidents
I think, of course, it would be nice for this to come back, however, it's reached a good point to end.
The POD and resulting results is a good vehicle for a more progressive Obama administration. I'm sure someone could branch out and make it even lefter or a bit of a wank scenario. Either way, it's in a good place for inactivity.
The POD and resulting results is a good vehicle for a more progressive Obama administration. I'm sure someone could branch out and make it even lefter or a bit of a wank scenario. Either way, it's in a good place for inactivity.
So, this TL isn't dead, but as you've probably noticed, attempting to continue it has proven a bit hard for me. The main reasons for that are:
- Being busy in real life (of course; I have an actual job now, after all. Which none of us can do anything about.)
- The very nature of this TL (attempting to realistically explore the impact of a PoD upon the modern political world) means that it gets exponentially more complex as time goes on. From 2006-2008, the differences for the world were manageable and tiny. Past then, we enter the regime of changes begetting more changes and so on.
To some extent, the job of the TL-author is always impossible, in that it requires a level of omniscient knowledge about every subject to a degree that no one actually possesses. There are certainly areas that I'm more familiar with than others [which to some degree is why this TL hasn't really covered events in, e.g. Latin America], and no matter what happens, it will never be a true reflection of reality. Which is why most TLs tend to go with a more narrative/prescriptive route. I do still think that I have a story to tell there, but figuring out how to do so plausibly [and again through the lens of a news article-style format when much is going on behind the scenes] is more difficult.
- I'm rather less fond of the earlier parts of this TL [as you've probably noticed, I've moved heavily away from the minimalist headline-style format, especially since I've seen it done poorly elsewhere on this site.] There's very much a desire on my part [which I've voiced before] to revise and redo many of the earlier parts... which is, of course, a time commitment of a scale that's slightly intimidating.
- Since this is by its nature a (semi)-current events TL, it's subject to our knowledge of the present day - which is of course incomplete and only comes out in hindsight. More than once, I've found myself revising my plans for the TL after a piece of news comes out that affects how I think events would have progressed in this ATL. The point is that as we get closer to the current day, it will by nature become less and less accurate, and the corollary is that the instinct is to delay writing until we have a better sense of the time we're writing about... which is also an excuse for procrastination.
That said, I do very much have quite a bit planned out for the say 2008-2012 era; the difficulty is more on figuring out how to express the story I want to tell [while still having an actual life, of course
]
- Being busy in real life (of course; I have an actual job now, after all. Which none of us can do anything about.)
- The very nature of this TL (attempting to realistically explore the impact of a PoD upon the modern political world) means that it gets exponentially more complex as time goes on. From 2006-2008, the differences for the world were manageable and tiny. Past then, we enter the regime of changes begetting more changes and so on.
To some extent, the job of the TL-author is always impossible, in that it requires a level of omniscient knowledge about every subject to a degree that no one actually possesses. There are certainly areas that I'm more familiar with than others [which to some degree is why this TL hasn't really covered events in, e.g. Latin America], and no matter what happens, it will never be a true reflection of reality. Which is why most TLs tend to go with a more narrative/prescriptive route. I do still think that I have a story to tell there, but figuring out how to do so plausibly [and again through the lens of a news article-style format when much is going on behind the scenes] is more difficult.
- I'm rather less fond of the earlier parts of this TL [as you've probably noticed, I've moved heavily away from the minimalist headline-style format, especially since I've seen it done poorly elsewhere on this site.] There's very much a desire on my part [which I've voiced before] to revise and redo many of the earlier parts... which is, of course, a time commitment of a scale that's slightly intimidating.
- Since this is by its nature a (semi)-current events TL, it's subject to our knowledge of the present day - which is of course incomplete and only comes out in hindsight. More than once, I've found myself revising my plans for the TL after a piece of news comes out that affects how I think events would have progressed in this ATL. The point is that as we get closer to the current day, it will by nature become less and less accurate, and the corollary is that the instinct is to delay writing until we have a better sense of the time we're writing about... which is also an excuse for procrastination.
That said, I do very much have quite a bit planned out for the say 2008-2012 era; the difficulty is more on figuring out how to express the story I want to tell [while still having an actual life, of course
]I hadn't had the pleasure of reading this TL before. Congratulations for it (and on your new job)!
I have to say, even though I'm not the biggest fan of election nights, seeing so many Republican big names fall was a bit of a guilty pleasure. And Mississippi going full Democratic? Why, that was just the cherry on top. Even though, as an European, I can't help but grit my teeth at seeing Alex Weber at the head of the ECB.
It's actually pretty funny that you've been able to express so much complex nuances, especially for the 2006 to early 2008 period where the butterflies had not yet fully taken wing, in that most sensationalistic and news-distorting medium, headlines!
The reforms led by Obama and the 111th Congress are mostly ones that I can get behind. And voting reform is something the US sorely need. I mean, really? Having party officials elected to supervise elections? What could possibly go wrong?
Have you decided what Krugman position in the administration is? From his blog, I got the impression that he would dread being put in charge of a bureaucracy, but would do very well as an advisor. In the same way that former President Bill Clinton was dubbed Secretary of Explaining Stuff after his 2012 convention speech, I would love having Krugman having a sort of remit of explaining on YouTube or social media what the President is doing this week and talking about the confidence fairy, zombie ideas and sado-monetarians. It probably would drive some Republicans crazy. One thing that is quite likely, though, is that with the troika of Stiglitz-Reich-Krugman in the administration or close to it, the Bowles-Simpson commission and the general obsession over the deficit would not be as favorably welcomed by President Obama.
I could go on and on about the interesting new developments in foreign countries (the Pakistanis avoiding becoming a failed state and willingly turning over Bin Laden, new, more female-dominated Ukrainian politics, and so on) but that would be somewhat long. So, once again, kudos!
Appreciate the praise [though it's perhaps premature to conclude anything about a lot of the changes you note.] On Krugman's potential role, I do wish to note that he commented on the idea of an administration job IOTL.
Similar in spirit but not quite the same. For instance, Tanner's bill has the redistricting committee appointed by state legislators (and an equal number appointed by each party, without independents.) It's the same bill he offered up several times IOTL (and was offered up in his name after he left Congress) - see e.g. here for the 2007 bill text.
Highly unlikely to happen - it's too drastic a change from OTL.
Thanks for the kind words. I should say however that Cory Booker is not the Governor of New Jersey ITTL.
Obama will certainly be one of the most consequential presidents ever ITTL.
With that said, the next aspect of this TL will not all be sunshine and butterflies. Success brings division just as failure, and with a Democratic supermajority in Congress, many may find issue with President Obama's vision, especially if it is not quite as transformative as they had hoped...
I guess a 1 trillion dollar stimulus wasn't enough.
- It's a 1.7 trillion dollar stimulus.
- IOTL, Christine Roemer calculated that a $1.8 trillion stimulus was needed to fill the output gap. Said output gap is larger ITTL.
- Despite what Carville said, "The economy isn't everything, stupid."
So, after going back and reading through the thing, I do think that many parts of it really do need a revision [not to mention the unfinished parts of the 2008 election.]
This is how it'll go: I'll start revising/rewriting the timeline in the test forum. In the meantime, I'll post a teaser update or two here to keep your updates whetted. But in the end, everything will go into a new thread.
4.16 - December Surprise
Teaser update [sometime in January 2010], as events move more and more away from the domestic U.S.:
"December Surprise" hits the Ukraine - Scandal before the election!
As Ukrainians finish celebrating the New Year and look forward to voting come January 17, a scandal has the potential to severely shake up the first round of the election. On December 23, a cache of documents was published by the site Wikileaks.org, an online clearinghouse for leaked documents.
This cache purports to be the financial records of Raisa Bogatyrova and appears to show large-scale corruption and embezzlement on the scale of millions of Ukrainian hryvnia. Bogatyrova is the Chairman of the Verkhovna Rada and a key ally of Prime Minister Yulia Tymoshenko - the frontrunner in the elections this month. [1]
The complexity of the documents, and the timing of their publication at the Christmas holidays meant that they received little attention for the first week, but the Ukrainian media is now beginning to cover the case in detail. Prime Minister Tymoshenko has denounced the accusations as "baseless" and "politically motivated", and questioned why these revelations came out just before the election.
According to an anonymous official at the U.S. State department, the timing of the revelations and their targeted nature points fingers at the Party of Regions and Russia, both of whom have grievances against Bogatyrova. He notes that as a former member of the Party of Regions, it would certainly have significant 'dirt' on Bogatyrova, and believes that the accusations probably have some basis in reality. If not, he says, it's unlikely that Wikileaks - no Kremlin stooge - would act as a third party. Besides, the two groups would certainly have targeted Tymoshenko as well prior to the election, if she had viable weaknesses to use.
[1] Bogatyrova is certainly a very interesting character in Ukrainian politics. IOTL, she ended up staying with the Party of Regions, was accused of embezzling 6 million hryvnia of public funds shortly after the election of President Poroshenko, fled before her arrest, and is probably a fugitive somewhere. Interpol has published an international red notice on her.
"December Surprise" hits the Ukraine - Scandal before the election!
As Ukrainians finish celebrating the New Year and look forward to voting come January 17, a scandal has the potential to severely shake up the first round of the election. On December 23, a cache of documents was published by the site Wikileaks.org, an online clearinghouse for leaked documents.
This cache purports to be the financial records of Raisa Bogatyrova and appears to show large-scale corruption and embezzlement on the scale of millions of Ukrainian hryvnia. Bogatyrova is the Chairman of the Verkhovna Rada and a key ally of Prime Minister Yulia Tymoshenko - the frontrunner in the elections this month. [1]
The complexity of the documents, and the timing of their publication at the Christmas holidays meant that they received little attention for the first week, but the Ukrainian media is now beginning to cover the case in detail. Prime Minister Tymoshenko has denounced the accusations as "baseless" and "politically motivated", and questioned why these revelations came out just before the election.
According to an anonymous official at the U.S. State department, the timing of the revelations and their targeted nature points fingers at the Party of Regions and Russia, both of whom have grievances against Bogatyrova. He notes that as a former member of the Party of Regions, it would certainly have significant 'dirt' on Bogatyrova, and believes that the accusations probably have some basis in reality. If not, he says, it's unlikely that Wikileaks - no Kremlin stooge - would act as a third party. Besides, the two groups would certainly have targeted Tymoshenko as well prior to the election, if she had viable weaknesses to use.
[1] Bogatyrova is certainly a very interesting character in Ukrainian politics. IOTL, she ended up staying with the Party of Regions, was accused of embezzling 6 million hryvnia of public funds shortly after the election of President Poroshenko, fled before her arrest, and is probably a fugitive somewhere. Interpol has published an international red notice on her.
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Woah, new content slipped under the radar! I am mortified that it took almost three weeks to see it!
One would expect these altered circumstances to more negatively affect Tymoshenko, but of course she lost the election anyway. Doubtful this would be enough to swing the thing to Yanukovych in the first round. And the third place party was also pro-Russia, so they're not benefiting much from a Tymoshenko stumble.
But maybe a weaker Fatherland Party just means a more legitimate pro-Russian swing, moribund opposition, and less perceived need by Yanukovych to sing out in the more fascist octaves. I hate to phrase it this way, but if Tymoshenko doesn't feel like she's in a position to speak out so vocally against Tymoshenko, he wouldn't feel the need to imprison her. God, awful logic, but...there you are.
One would expect these altered circumstances to more negatively affect Tymoshenko, but of course she lost the election anyway. Doubtful this would be enough to swing the thing to Yanukovych in the first round. And the third place party was also pro-Russia, so they're not benefiting much from a Tymoshenko stumble.
But maybe a weaker Fatherland Party just means a more legitimate pro-Russian swing, moribund opposition, and less perceived need by Yanukovych to sing out in the more fascist octaves. I hate to phrase it this way, but if Tymoshenko doesn't feel like she's in a position to speak out so vocally against Tymoshenko, he wouldn't feel the need to imprison her. God, awful logic, but...there you are.
That makes two of us!
I want to help with the revision. Please let me help with the revision.
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4.17 - Final teasers
Some further preview-updates around the health care debate and the carbon tax:
Natural gas stockholders rush to sell, after EPA crackdown on methane leaks
The jump in natural gas stock prices after the passage of the carbon tax last year turned out to be short-lived. Last Friday, EPA officials announced that their satellite measurements on natural gas production leak rates vastly exceeded previous industry estimates - with many fracked wells emitting as much as 10% of their production, compared to previous estimates of 0.2% [1]. Natural gas [methane] is a potent greenhouse gas with a global warming potential 25 times as strong as CO2 in a 100-year timeframe (and 72 times as strong in a 20-year timeframe); as such, the measurement means that many natural gas companies will be far more heavily penalized by the carbon tax than previously expected. Stock prices have already crashed dramatically in the natural gas sector, with fracking leader Chesapeake Energy [CHK] falling from $45.76/share last week to $9.45/share as of this morning - a drop of almost 80% in the blink of an eye.
An industry insider who spoke on the condition of anonymity stated: "This is a catastrophe for the natural gas industry, and perhaps the death knell for the nascent fracking boom. Profit margins for unconventional gas and oil were never high, and this ruling has left many companies underwater. Many of us will think about moving abroad instead. No other country regulates fossil fuel production and transport emissions the way the U.S. does[2]; it's regulatory madness that will result in hundreds of thousands of job losses in the middle of a recession. How do you expect to use a natural gas bridge to a low-carbon future, if you tax the very industry out of existence?" [3]
[1] Many scientific studies in recent years have found that the methane leak rate was vastly underestimated. E.g. here, here, and here. The implementation of a comprehensive carbon tax that includes resource production emissions [unlike every other carbon tax] would certainly have incentivized these studies, wiping away the theoretical rationale of a natural gas carbon bridge.
I'm also positing a more aggressively regulatory EPA on the carbon question. IOTL, the EPA has been notoriously conservative [e.g. continuing to use low-ball figures as much as 20 years out of date on the global warming potential of methane.] My assumption is that with a clearer motive and rationale for measuring emission equivalent, the EPA would move with TTL's political times.
[2] As far as I'm aware, no carbon taxes or cap and trading schemes have targeted resource production emissions, such as emissions from natural gas flaring and leakage. My guess is that this is the case for reasons of practicality - it's frankly very hard to measure gas leakage along long pipelines for instance, and doing so would require considerable regulatory powers. At the same time, this fact also means considerable inefficiencies and the partial breakdown of the Pigovian taxation rationale for carbon taxation. Standard carbon taxes make natural gas look very attractive compared to oil and coal as an electricity/heating source because only the costs from burning the fuel are included - but in reality, natural gas is no better than oil [and only somewhat better than coal] once you include the much higher carbon costs of producing it.
[3] This quote is entirely fictional and written by yours truly.
The leftwing case against single-payer:
Why Congress settled for a public option
The following anonymous op-ed appeared in the New York Times:
Many activists and advocates on the left have bemoaned the failure of Congress to reach for a comprehensive single-payer solution, of "snatching defeat from the jaws of victory." Yet at the same time, it's important for us to remember not only the benefits of a mixed public-private health care system, but also the disadvantages of implementing single-payer in the midst of the largest recession since the 1930s.
It's certainly true that the U.S. health care system is very bloated and overgrown, spending around 40% more per capita than comparable countries. And yet, the advantage of single-payer - the opportunity to dramatically slash health care costs by 40% - also double as disadvantages. For one thing, the cost savings of single payer health care come from the ability to refuse payment and veto procedures over the objections of patients and doctors. For another, although high health care expenditures are usually negative, it's a different question when we're in the midst of a giant recession.
The direct cause of recessions is well-known by the field of macroeconomics - insufficient aggregate demand. As John Maynard Keynes argued in a cheeky analogy for gold mining [4]:
The Great Depression ended when World War II accomplished what FDR could not - convince the nation conduct massive deficit spending for the purpose of producing tanks and planes, sending our boys overseas to defeat Hitler and Tojo. No equivalent is in sight for this recession, though Paul Krugman has joked about the utility of a fake alien invasion to fix the economy. [5] And although this Congress has proven much more willing to enact stimulus, it's still not enough - a $1.7 trillion stimulus sounds suitably impressive, until you realize that Christina Romer estimated a $2.4 trillion stimulus would be necessary to fill the ~$3 trillion output gap. [6] The point is: Single-payer health care is expensive, requiring trillions of dollars worth of new taxes - certainly not ideal in the midst of a recession. And although in normal times spending 17% of our GDP on health care is a colossal waste, the equations change in the midst of a recession. Money spent on the inefficient health care system is no worse than money spent to fight a fake alien threat, or bury banknotes in the ground. Implementing a mixed public-private system has the advantage of a far more gradual transition and decline in health care spending, of spreading out the transition costs over time.
There's a comparison to be made [at the risk of unpopularity among both the left and the right] between single-payer health care and the historic free trade debate in the United States. Both represent the opportunity to make large net efficiency gains, but at the cost of imposing massive losses on existing stakeholders [the health care industry for single-payer, manufacturing for free trade]; the opportunity for efficiency gains seems less appealing when it's less "free money for everyone" and more "take $50 from Person 1 and give $10 to Persons 2-10". Without detailed policies to compensate those disadvantaged by the scheme, the result would invariably be unemployment and discontent among many, despite the net gains overall. Advocates of single-payer point out the opportunity to dramatically cut costs by 40% in one fell swoop, but rarely consider the realistic short-term human consequences of cutting health care expenditures by 40%.
The U.S. health care sector employed some 15 million workers last year.[7] [in comparison, U.S. manufacturing at its height employed 17-19 million workers.] Cutting the bloated U.S. health care sector will also invariably mean cutting jobs in said sector. If we cut health care spending by 40%, Okun's law[8] as a rule of thumb translates that into 20% less employment in health care, meaning 3 million lost jobs. Of course, this reduction would happen over time rather than all at once, but barring targeted large-scale government intervention, we'd soon see masses of unemployed doctors, nurses, medical technicians, hospice workers, etc. looking for new jobs, akin to the decline in factory workers.
In short, the same reasons that make single-payer in the U.S. especially attractive - the bloated U.S. health care spending compared to other developed nations - also make it especially difficult to implement. Slashing said health care spending would invariably hurt existing stakeholders - ranging from insurance companies to doctors/nurses/etc. Single-payer hasn't led to dramatic health care unemployment in other nations because none of them had health care sectors as bloated as the United States. The reason why Congress decided against single payer was simple: They decided that cutting 3 million jobs in the midst of a giant recession was not the best of ideas.
One must also find passing curious the existence of left-wing politicians who rail against the negative consequences of globalization while simultaneously denouncing the failure of Congress to slash health care payments by passing single-payer health care. Perhaps it's simply due to the fact that the unemployment consequences of the former are well-known, whereas the unemployment consequences of the latter are theoretical and essentially unknown. At the same time, it's important to remember the main difference between the two fields: Health care workers are 80% female, while manufacturing workers are 80% male. [9]
[4] Quote from General Theory, Chapter 10
[5] Krugman's snarky comment about an alien invasion as solution to recession also occurred in OTL
[6] In OTL, Christina Romer advised a $1.8 trillion stimulus to fill a $2 trillion output gap. As mentioned before, TTL's recession is considerably worse than OTL's.
[7] For reference, health care employment in OTL's 2014 was 18.06 million workers.
[8] Okun's Law is a rule of thumb-style empirical observation that a 2% increase in output corresponds to a 1% decrease in cyclical unemployment [and vice versa]
[9] This op-ed is entirely fictional and written by yours truly.
Natural gas stockholders rush to sell, after EPA crackdown on methane leaks
The jump in natural gas stock prices after the passage of the carbon tax last year turned out to be short-lived. Last Friday, EPA officials announced that their satellite measurements on natural gas production leak rates vastly exceeded previous industry estimates - with many fracked wells emitting as much as 10% of their production, compared to previous estimates of 0.2% [1]. Natural gas [methane] is a potent greenhouse gas with a global warming potential 25 times as strong as CO2 in a 100-year timeframe (and 72 times as strong in a 20-year timeframe); as such, the measurement means that many natural gas companies will be far more heavily penalized by the carbon tax than previously expected. Stock prices have already crashed dramatically in the natural gas sector, with fracking leader Chesapeake Energy [CHK] falling from $45.76/share last week to $9.45/share as of this morning - a drop of almost 80% in the blink of an eye.
An industry insider who spoke on the condition of anonymity stated: "This is a catastrophe for the natural gas industry, and perhaps the death knell for the nascent fracking boom. Profit margins for unconventional gas and oil were never high, and this ruling has left many companies underwater. Many of us will think about moving abroad instead. No other country regulates fossil fuel production and transport emissions the way the U.S. does[2]; it's regulatory madness that will result in hundreds of thousands of job losses in the middle of a recession. How do you expect to use a natural gas bridge to a low-carbon future, if you tax the very industry out of existence?" [3]
[1] Many scientific studies in recent years have found that the methane leak rate was vastly underestimated. E.g. here, here, and here. The implementation of a comprehensive carbon tax that includes resource production emissions [unlike every other carbon tax] would certainly have incentivized these studies, wiping away the theoretical rationale of a natural gas carbon bridge.
I'm also positing a more aggressively regulatory EPA on the carbon question. IOTL, the EPA has been notoriously conservative [e.g. continuing to use low-ball figures as much as 20 years out of date on the global warming potential of methane.] My assumption is that with a clearer motive and rationale for measuring emission equivalent, the EPA would move with TTL's political times.
[2] As far as I'm aware, no carbon taxes or cap and trading schemes have targeted resource production emissions, such as emissions from natural gas flaring and leakage. My guess is that this is the case for reasons of practicality - it's frankly very hard to measure gas leakage along long pipelines for instance, and doing so would require considerable regulatory powers. At the same time, this fact also means considerable inefficiencies and the partial breakdown of the Pigovian taxation rationale for carbon taxation. Standard carbon taxes make natural gas look very attractive compared to oil and coal as an electricity/heating source because only the costs from burning the fuel are included - but in reality, natural gas is no better than oil [and only somewhat better than coal] once you include the much higher carbon costs of producing it.
[3] This quote is entirely fictional and written by yours truly.
The leftwing case against single-payer:
Why Congress settled for a public option
Many activists and advocates on the left have bemoaned the failure of Congress to reach for a comprehensive single-payer solution, of "snatching defeat from the jaws of victory." Yet at the same time, it's important for us to remember not only the benefits of a mixed public-private health care system, but also the disadvantages of implementing single-payer in the midst of the largest recession since the 1930s.
It's certainly true that the U.S. health care system is very bloated and overgrown, spending around 40% more per capita than comparable countries. And yet, the advantage of single-payer - the opportunity to dramatically slash health care costs by 40% - also double as disadvantages. For one thing, the cost savings of single payer health care come from the ability to refuse payment and veto procedures over the objections of patients and doctors. For another, although high health care expenditures are usually negative, it's a different question when we're in the midst of a giant recession.
The direct cause of recessions is well-known by the field of macroeconomics - insufficient aggregate demand. As John Maynard Keynes argued in a cheeky analogy for gold mining [4]:
The Great Depression ended when World War II accomplished what FDR could not - convince the nation conduct massive deficit spending for the purpose of producing tanks and planes, sending our boys overseas to defeat Hitler and Tojo. No equivalent is in sight for this recession, though Paul Krugman has joked about the utility of a fake alien invasion to fix the economy. [5] And although this Congress has proven much more willing to enact stimulus, it's still not enough - a $1.7 trillion stimulus sounds suitably impressive, until you realize that Christina Romer estimated a $2.4 trillion stimulus would be necessary to fill the ~$3 trillion output gap. [6] The point is: Single-payer health care is expensive, requiring trillions of dollars worth of new taxes - certainly not ideal in the midst of a recession. And although in normal times spending 17% of our GDP on health care is a colossal waste, the equations change in the midst of a recession. Money spent on the inefficient health care system is no worse than money spent to fight a fake alien threat, or bury banknotes in the ground. Implementing a mixed public-private system has the advantage of a far more gradual transition and decline in health care spending, of spreading out the transition costs over time.
There's a comparison to be made [at the risk of unpopularity among both the left and the right] between single-payer health care and the historic free trade debate in the United States. Both represent the opportunity to make large net efficiency gains, but at the cost of imposing massive losses on existing stakeholders [the health care industry for single-payer, manufacturing for free trade]; the opportunity for efficiency gains seems less appealing when it's less "free money for everyone" and more "take $50 from Person 1 and give $10 to Persons 2-10". Without detailed policies to compensate those disadvantaged by the scheme, the result would invariably be unemployment and discontent among many, despite the net gains overall. Advocates of single-payer point out the opportunity to dramatically cut costs by 40% in one fell swoop, but rarely consider the realistic short-term human consequences of cutting health care expenditures by 40%.
The U.S. health care sector employed some 15 million workers last year.[7] [in comparison, U.S. manufacturing at its height employed 17-19 million workers.] Cutting the bloated U.S. health care sector will also invariably mean cutting jobs in said sector. If we cut health care spending by 40%, Okun's law[8] as a rule of thumb translates that into 20% less employment in health care, meaning 3 million lost jobs. Of course, this reduction would happen over time rather than all at once, but barring targeted large-scale government intervention, we'd soon see masses of unemployed doctors, nurses, medical technicians, hospice workers, etc. looking for new jobs, akin to the decline in factory workers.
In short, the same reasons that make single-payer in the U.S. especially attractive - the bloated U.S. health care spending compared to other developed nations - also make it especially difficult to implement. Slashing said health care spending would invariably hurt existing stakeholders - ranging from insurance companies to doctors/nurses/etc. Single-payer hasn't led to dramatic health care unemployment in other nations because none of them had health care sectors as bloated as the United States. The reason why Congress decided against single payer was simple: They decided that cutting 3 million jobs in the midst of a giant recession was not the best of ideas.
One must also find passing curious the existence of left-wing politicians who rail against the negative consequences of globalization while simultaneously denouncing the failure of Congress to slash health care payments by passing single-payer health care. Perhaps it's simply due to the fact that the unemployment consequences of the former are well-known, whereas the unemployment consequences of the latter are theoretical and essentially unknown. At the same time, it's important to remember the main difference between the two fields: Health care workers are 80% female, while manufacturing workers are 80% male. [9]
[4] Quote from General Theory, Chapter 10
[5] Krugman's snarky comment about an alien invasion as solution to recession also occurred in OTL
[6] In OTL, Christina Romer advised a $1.8 trillion stimulus to fill a $2 trillion output gap. As mentioned before, TTL's recession is considerably worse than OTL's.
[7] For reference, health care employment in OTL's 2014 was 18.06 million workers.
[8] Okun's Law is a rule of thumb-style empirical observation that a 2% increase in output corresponds to a 1% decrease in cyclical unemployment [and vice versa]
[9] This op-ed is entirely fictional and written by yours truly.