Sanders: Single-payer isn't a litmus test for Dems
Source: The Hill
BY JACQUELINE THOMSEN - 08/28/17 11:21 AM EDT
Sen. Bernie Sanders (I-Vt.) said that supporting a single-payer healthcare system shouldn't be a litmus test for Democrats, but that he believed more members of the party will grow to back the policy in the future.
Sanders told The Washington Post that hes building support for his Medicare for All bill, which would institute a single-payer health insurance system.
The former presidential candidate's backing for the policy has raised questions about whether he and his supporters might launch primary challenges against Democrats who do not back a single-payer plan.
But Sanders told The Post that healthcare, and support for a single-payer system, is just one issue for voters to consider. Is this a litmus test? No, you have to look at where candidates are on many issues, Sanders said.
Read more: http://thehill.com/homenews/senate/348258-sanders-single-payer-isnt-a-litmus-test-for-dems
dalton99a
(81,450 posts)BigmanPigman
(51,584 posts)The momentum is there now so take advantage of it! Even 45 voters want single payer or universal or Medicare for All. This is a way to get some borderline Repub votes and finally health care that works. Nixon, Jesse Jackson, etc have been pushing for this and its time has finally come.
Squinch
(50,949 posts)But dollars to doughnuts she won't listen.
George II
(67,782 posts)Blue_Tires
(55,445 posts)If Bernie really believes this, then he should want to reel in his people who have turned the crazy up to 11
LiberalLovinLug
(14,173 posts)Is "the crazy turned up to 11"?
Bernie has always been pragmatic about this. He's been working at politics for a long time. At the same time it must get mentioned or it will never be discussed and accomplished. Definitely better than "Its not going to happen". But of course there will always be those even more enthused and radical about pushing it now. And its perfectly understandable in that it would seem to be a good time to push it, just after the colossal failure of the GOP to come up with anything else.
But he knows that the Democratic party is a slow mule and stubborn to take a step. Many top Democrats are invested in working with the private insurance and pharmaceutical industry. Not to mention it would no doubt be a complicated, initially costly venture to set up, and displace thousands of workers. Sad that the US did not adopt SP earlier when everyone else on the planet was doing so, it would have been easier than now when the private insurance industry is so huge and entrenched.
Blue_Tires
(55,445 posts)is not only crazy, it's a losing proposition...
Demsrule86
(68,544 posts)payer types...universal is what we need to go for...and if if means some hybrid system...that is OK. There will never be a big single payer bill that passes congress...there should be a public option...and a lowering of Medicare for 55 and older.
Turn CO Blue
(4,221 posts)but insurance companies make most their profits off of the age group 45- 65 year olds.
They're going to hold on to their profits and not lose the people who pay the most - the average 50 year old pays $1000 in premiums per month right now, and goes up 5-10% per year.
So it is possible the best strategy would be to to allow all age groups to buy into Medicare.
Demsrule86
(68,544 posts)back a majority in Congress (please the Senate even if it is a lift) we won't have the numbers for something like that...maybe 55 and older or maybe a public option. I worked for insurance companies years ago.They prefer young healthy people...older people get sick more.
LiberalLovinLug
(14,173 posts)Is that basic medical coverage is a right and not a privilege. That there is a basic coverage for every citizen that is not based on employment, their age, or where they live, or most importantly that any private profit based industry whose job it is to raise their bottom line by finding any way they can to deny you a life-saving but expensive operation, is in control. That it doesn't matter if you go in for a nagging cough or have to get cancer treatment, because you are a citizen, and even if you are not in most countries, you are entitled to it as a right. That there is a law in these countries stating that right.
Yes different countries that have universal healthcare have different systems which combine the private and public. And the rich, as usual, can find ways to jump the queue or fly to special clinics. And its usually the conservative parties in these countries that push for more options for them and their rich friends. What I'm talking about is that their is still a basic coverage that is paid for by a single payer....the tax payer...in most every other country. That there is no concept of "pre-existing conditions" or even the word "insurance", even though it works the same in that everyone is pooling their money as an insurance against injury or illness. (And is thus cheaper because everyone is in the same big boat...by law). It is simply a basic human right in the countries that have adopted it. Like you pay your taxes in order that you have the right to and can rely on police and fire fighting services when you need them.
"Universal healthcare" cannot exist without some form of single payer setup.
Demsrule86
(68,544 posts)This why so many were protesting and the GOP still has not repealed the ACA. We need baby steps on this. as the poster below noted.
tonyt53
(5,737 posts)Hell, even some in the GOP would be willing to begin allowing those over 50 to buy into Medicare. It is a baby step, but it is a start. At the same time maybe, start actually negotiating with the drug manufacturers to lower prescription prices for those on Medicare.
LiberalLovinLug
(14,173 posts)Now that your private insurance industry has grown so entrenched. That wasn't my argument.
Sorry, but in no way has Obama or anyone else managed to accomplish establishing a law around a guaranteed minimum universal healthcare right for any and all procedures no matter your condition or wealth or age or employment status. Where its not even called 'insurance' anymore. Where it is simply a right to have a home doctor. You don't apply to any insurance company because there are none anymore other than the one big pool of citizens, with standards set and administered by the federal or state governments. Sorry but that is not the ACA.
Demsrule86
(68,544 posts)fixing it in Congress not playing around with Medicare for all which can't pass right now.
BainsBane
(53,031 posts)If fact most countries do not have single-payer systems. Single-payer doesn't not mean heatlhcare is a right. It means the government is the single payer for heatlhcare. It says nothing about how that care is delivered, while universal healthcare doesn't specify its funding mechanism. How are you supposed to generate a conversation when you use language and arguments that are factually false?
And the fact is in the US, the Constitution determines what constitutes a right, not the Democratic Party or legislation. Social Security isn't a right under the Constitution, but it is a third rail.
The fact is knowledge and facts actually matter to making good policy.
LiberalLovinLug
(14,173 posts)By "right" I mean that it is backed by law in Canada. That everyone is entitled to their own doctor, and will be covered for medical expenses no matter the cost. That it is backed by law seems to me to be the same as a right. Maybe its semantics. That health care is a right and not a privilege. Even in the US and your Social Security example. Maybe its not an official "right" written into the Constitution in the US, but for all intents and purposes it is. I'd like to see a court deny someone the right to receive SS payments if they have been paying into all their lives. In fact the courts in the US interpret the law very heavily in the clients favor:
https://en.wikipedia.org/wiki/Social_Security_(United_States)
The United States Court of Appeals for the Seventh Circuit has indicated that the Social Security Act has a moral purpose and should be liberally interpreted in favor of claimants when deciding what counted as covered wages for purposes of meeting the quarters of coverage requirement to make a worker eligible for benefits
Yes there are as many forms of universal health coverage as there are countries that have it. Some are a mix of private and government funded. So I will give you that point. But the common thread is that the governments in these countries will always garantee basic health care and then, if it is a mixed system, will compensate payments to any private insurers for any procedures that these companies do not cover. In effect, it is a guarantee of health care, if you don't want to use the word "right " in that you don't have to go bankrupt and lose your house. So in any case all universally covered countries run a 'single payer' backed system of guaranteed health care, no matter what other peripheral structural tangents exist . That is what I'm getting at.
Turn CO Blue
(4,221 posts)There are now 100 sponsors (that is more than 51% of House Democrats) which includes moderate, progressive and liberal Dems of HR 676
It is way past time to protect the most vulnerable in our society from catastrophic medical bills.
It ain't Bernie's bill anymore -- IT IS OUR BILL.
Blue_Tires
(55,445 posts)I said I was against it being used as a litmus test for who is or isn't a real Dem...
Turn CO Blue
(4,221 posts)There are 99 other Congr Dems who think it is important, and also some Senators.
The DNC just did a series of focus groups in Jul and Aug on adopting MFA or M for More as our campaign strategy - still ongoing. It could become a party platform sooner than we think.
Blue_Tires
(55,445 posts)and many of them (Konst, Halper, Goodman, Turner, etc.) are as crazy as the day is long...
BainsBane
(53,031 posts)Because as much as you if others might think the battle is with random Democratic voters online, that's not how laws are passed. Most objections to single payer are not with the idea of it but whether it can pass. The way to win that argument is to pass it.
lapucelle
(18,249 posts)He first introduced it more than 16 years ago. It is the bill that has 116 co-sponsors.
No Senate version of a single payer bill has been introduced in this session of Congress
lapucelle
(18,249 posts)It never was.
This bill was introduced in the House last January for the 14th time by John Conyers.
There has never been a Senate version of this bill.
https://www.congress.gov/bill/115th-congress/house-bill/676
http://www.pnhp.org/news/2011/february/summary-hr-676-the-expanded-improved-medicare-for-all-act
http://www.md.pnhp.org/docs/Comparison-HR676-and-S703.pdf
YOHABLO
(7,358 posts)I don't think it's too much of a stretch to say our healthcare system is totally fucked up.
Freddie
(9,259 posts)There are many ways besides single payer. But supporting universal healthcare should be a litmus test IMO.
Demsrule86
(68,544 posts)People understand it...run on making it better.
Freddie
(9,259 posts)If tweaked when needed and allowed to work as intended (with the Medicaid expansion) the ACA could provide universal coverage. Based on the the Swiss (or German) system which does and works well for them.
lapucelle
(18,249 posts)of the Democratic party since the Hillarycare days in 1993.
http://www.ontheissues.org/2016/Hillary_Clinton_Health_Care.htm
George II
(67,782 posts)...in today's political climate. Better to spend time drumming up support for what we now have with possible improvements.
comradebillyboy
(10,143 posts)being able to tilt at windmills and be uncompromising purists. Just look at the Freedom Caucus to see how that works.
murielm99
(30,733 posts)Let's fix the ACA.
Is he out on tour again? Why? Isn't there work to be done in his state?
Turn CO Blue
(4,221 posts)murielm99
(30,733 posts)and its intent. It has been around for a long time. This is Conyers' resolution, not Sanders!
Why push this now? Why all these people jumping on the bandwagon?
This is a pipe dream, pie in the sky bs. Let's do something practical, like improving the ACA. And if we are going to do that, we have to put first things first, like GOTV in 2018.
Turn CO Blue
(4,221 posts)Dem leadership have a fantastic bullet point list to improve the ACA that solves the gap, helps rural hospitals, helps smaller insurance providers, etc.
and she also sponsors Medicare for All.
Every year it gets more sponsors and support.
Just like with support for other new ideas, keep talking about benefits, keep adding sponsors, eventually, public support will make it obvious (just like we did on social issues and civil rights) -- it will get out of committee for debate, for markup, for vote.
Walk and chew gum at the same time.
murielm99
(30,733 posts)This is divisive. It is being used as a purity test and I am suspicious of it. I get the feeling that some people are sponsoring it just to stay out of trouble. There are various groups, some on the left and some of even more suspicious origins, who are using this as a litmus test and vowing to primary anyone who does not jump on board.
Turn CO Blue
(4,221 posts)It looks like they're very close to making a decision to adopt Medicare for All or Medicare for More as a party platform and what our candidates will run on in 2018 and 2020.
I'm not even commenting about the litmus test side issue in this thread. That seems to me to be a side issue completely and utterly secondary since the Democratic Party itself - not Bernie -- could adopt this issue as our main message in the elections.
George II
(67,782 posts)clu
(494 posts)is what made him popular among non-democrats in the first place
Turn CO Blue
(4,221 posts)Their names are on the bill including almost all of the Congressional Black Caucus.
lapucelle
(18,249 posts)The bill has consistently drawn wide support and robust co-sponsorship from Democrats in the House.
2003 38 co-sponsors
2005 78 co-sponsors
2007 93 co-sponsors
2009 87 co-sponsors
2011 77 co-sponsors
2013 63 co-sponsors
2015 62 co-sponsors
2017 117 co-sponsors
yodermon
(6,143 posts)ever since Reagan and the 3rd way dems.
Campaign on the ideal (single payer), compromise on what's possible (public option).
Instead we get your hand wringing, and Dems who listen to you don't TALK about single payer, and so the general public DOESN'T EVEN UNDERSTAND it, and the Right gets to demonize it as communism and we just concede the fucking point.
That's how we BARELY got the ACA, and it came within a whisker of being repealed (and it still might).
We need to keep talking about single payer in positive terms so it gets into the public consciousness, and in a GOOD way.
IF that leads to improvements in the ACA then good.
Doremus
(7,261 posts)Excellent points all.
Thank you.
HughBeaumont
(24,461 posts)Place is becoming something I don't even know or WANT to know anymore.
Neoliberalism (YES, IT IS A THING) doesn't win elections.
geek tragedy
(68,868 posts)1) ACA exchanges and individual mandate;
2) Medicaid?
George II
(67,782 posts)geek tragedy
(68,868 posts)http://www.timesfreepress.com/news/politics/state/story/2017/jul/05/poll-60-percent-tennesseans-oppose-congressio/436702/
Sponsored by the American Medical Association, the June 15-19 poll of 500 registered Tennessee voters was among surveys conducted in seven states by the Republican polling firm Public Opinion Strategies. The poll had a margin of error of plus or minus 4.4 percent.
Republicans don't even favor cutting Medicaid.
joshcryer
(62,269 posts)Politicians are liars. Sanders himself said they didn't have the votes for Single Payer when Obamacare was being panned / voted upon.
Vermont couldn't even pass state-wide singlepayer. Much less other more viable states.
It's a goddamn hard fucking pill to swallow because with everything there are upsides and downsides.
George II
(67,782 posts)...and voted for REGRESSIVE legislation because "it would have passed anyway".
He's voted with the gun lobby several times over the years because that was the "will" of his constituency - a constituency of several hundred thousand Vermonters vs. the good of 300+ MILLION Americans.
JNelson6563
(28,151 posts)Show up every year at the beginning of Congress. Propose a bill that contains stuff you know many won't vote for. Walk off in self-righteous huff when it doesn't pass. Purer than pure status in tact! Winning! lol
More_Cowbell
(2,191 posts)I haven't seen him discussing litmus tests for Republicans. Or independents.
phleshdef
(11,936 posts)And he is as member of our caucus, whether you like it or not
FairWinds
(1,717 posts)relentlessly attacked on DU - I mean, it is constant.
LiberalLovinLug
(14,173 posts)Personally I don't know why or how you'd even be a Democrat if you weren't a progressive. They should be pushing for new goals to make America greater (for its citizens) I mean what else is there? Try to stay afloat by just maintaining the status quo and keeping your head down? Why even enter politics?
JHan
(10,173 posts)People who disagree with LiberalLovinLug are now "proliferate anti progressives" , did you lose track of what the OP is about?
LiberalLovinLug
(14,173 posts)Where did I ever personalize it to just myself?
And I was replying to another poster on a tangent issue related to the OP. What's your problem?
JHan
(10,173 posts)LiberalLovinLug
(14,173 posts)lapucelle
(18,249 posts)in the context of the phrase "proliferate anti progressives".
proliferate (verb)
1. to grow or produce by multiplication of parts, as in budding or cell division, or by procreation.
2. to increase in number or spread rapidly and often excessively.
betsuni
(25,462 posts)Maybe there's an anti progressive orgy going on here I'm not aware of
OOooooOooooo Orrr maybe there's a secret orgy forum we don't know about!
George II
(67,782 posts)QC
(26,371 posts)George II
(67,782 posts)QC
(26,371 posts)since we don't often see Skinner get that, um, emphatic with people. He's generally a very patient man, after all.
R B Garr
(16,950 posts)actually said. It was just a random bookmark used for divisiveness.
QC
(26,371 posts)that Skinner has addressed in the TOS and in a number of exchanges in the ATA forum.
The subject of the thread is whether single player should be a litmus test, or whether other approaches, like those in Germany and France, are worth investigating. Do you have anything to say about that?
R B Garr
(16,950 posts)George said. I see you're using this as another opportunity for divisiveness, though.
QC
(26,371 posts)business in an earlier post.
It's time to let go of 2016, my friend.
In the real world, next year's election is vastly more important than last year's message board drama.
Now are there any issues, policies, or ideas you would care to discuss?
R B Garr
(16,950 posts)bring it up as much as you do.
Your sudden shift to issues is interesting. But it's also nice to see Sanders' now saying that good DEMOCRATS shouldn't be criticized over a litmus test for single payer since no Democrat has criticized him for the lack of single payer in Vermont. Issues of political realities are also "issues". Ideas only get you so far in the real world of politics.
BainsBane
(53,031 posts)that he doesn't see progressive Democrats being attacked?
FairWinds
(1,717 posts)a democrat? Takes a lot of nerve, I would say.
Many of us backed Bernie in the primaries because
he was carrying on the legacy of FDR.
And I'll take Bernie any day over the country club
Democrats who run our local party here in North Central Ohio.
George II
(67,782 posts)...(that's CAPITAL D!)
The legacy of FDR is almost 90 years old. FDR's policies and programs would not work in the United States in the 21st century.
FairWinds
(1,717 posts)Are you even a Merriken? Or like George II are you a "largely absent monarch"?
Sure wish we had an NDP like you guys in the Great White North - they're
very similar to FDR.
And I've been an active Dem for fifty years, how about you?
Seriously, give us you Dem Party street cred . .
BainsBane
(53,031 posts)EllieBC
(3,013 posts)If you didn't vote for the DEMOCRAT in the GE, you helped Trump. Is that so hard to understand?
George II
(67,782 posts)Last edited Tue Aug 29, 2017, 09:30 PM - Edit history (1)
....it's none of your fucking business. Questioning my citizenship is offensive, obnoxious, and quite Trumpian. Surprised you haven't asked to see my birth certificate.
........
Edit: I laid out my "Dem party street cred" for you, but decided to delete it. Your attack, insults, and insinuations aren't worth you knowing anything about MY "street cred" or loyalty to the Democratic Party.
Now, how about your "street cred"?
BainsBane
(53,031 posts)before you get locked up in a tent city for a year.
George II
(67,782 posts)FairWinds
(1,717 posts)that led me to question whether you are a democrat.
"FDR's policies and programs would not work in the United States in the 21st century."
Dude, they are working now . . . today . . . as we write
Only a non-Dem could write anything so at odds with both reality and what the party stands for.
I don't think you have the slightest notion about FRD's "policies and programs" and
what they have meant to this country.
Cred - My Democratic county chair here in Ohio is Amy Grubbe, who is yours?
George II
(67,782 posts)...questioning my citizenship, my party affiliation, etc.
I originally took this out of my post because none of this is your business, but here's MY "street cred" (you can see it in the edit history).
Once again, it's none of your fucking business, BUT, to soothe your ill-directed concerns, I AM a "Merriken" (another offensive comment), I was born in NYC and have lived in the US for all 69 of my years.
"Dem Party" (i.e., DEMOCRATIC Party) street cred?
I've been a Democrat for fifty years myself, and have been an officer of my local Democratic Committee for more than 12 years. I've been elected for local office four times as a Democrat (and lost twice), have served as a Democratic town official since 2005, and have been Treasurer for ten Democratic candidate committees.
I've been a delegate to our Democratic State Convention for 12 years, and have been a delegate at our Democratic Congressman's Nominating Conventions for eight years, and delegate for various Democratic state candidates over the years.
Good enough for you?
PS - just because you know the name of an Ohio county Democratic chair, that's "street cred"?
FairWinds
(1,717 posts)If you are from NYC you should know all about FDR.
Suggest you visit Warm Springs State Park in GA, his summer
White House.
They have great displays of his almost countless accomplishments . .
This list is by no means exhaustive.
https://learnodo-newtonic.com/fdr-accomplishments
This is his PROGRESSIVE legacy that Bernie and others of us
stand for.
George II
(67,782 posts)....the world was totally different - politically, economically, and technologically.
We were in the midst of the Great Depression (unprecedented unemployment, failing banks, the dust bowl) and global war was brewing in Europe and Asia.
Many of the things FDR implemented back then were successful (SS, FDIC, etc.) and are still successful mostly because the country and world were in such dire straits in the 1930s. That would not be possible today.
PS - your apology is gratefully accepted....
R B Garr
(16,950 posts)echo FDR. It's not like Bernie Sanders is the only person to honor what the Democrat FDR did 70 years ago. That's the easy part. Actually getting things done is what counts.
FairWinds
(1,717 posts)In fact, both FDIC and SS were EXPANDED AND STRENGTHENED
decades after the Great Depression.
And they "are still successful" only because of what happened 80 years ago?
Whaaaaaa?
That makes no sense.
Cary
(11,746 posts)Seriously, dude? You have no cause.
lapucelle
(18,249 posts)He's made it clear that, while he may caucus with the Democrats, he is not a member of the party.
Doremus
(7,261 posts)Some, maybe most, are still reeling from the election. Many blame Bernie Sanders for the loss and now equate anything 'progressive' with being anti-Democrat and/or 'divisive'.
Of course they all deny that and will spin all day about how it's not true but that's how it looks from my vantage point in the corner as a (mostly) lurker.
FairWinds
(1,717 posts)They will do anything but look in the mirror.
HughBeaumont
(24,461 posts)Exactly how is it our fault . . . people who voted for Hillary in the GE, but Sanders in the Primary . . . that Hillary lost to the absolute WORST presidential candidate in American history?
You can say "Theft", which is plausible . . . but why was it even CLOSE???? Why was it so CLOSE against a Cheeto-skinned 80$ Fascist re-hash?
BainsBane
(53,031 posts)It was always going to be close. Anyone who doesn't know that much isn't in a position to be dispensing political advice.
R B Garr
(16,950 posts)Prolonged attacks on Hillary were meant to make her unacceptable to many voters. Why would people do that??
BainsBane
(53,031 posts)What is the lesson? I'm going to guess it relates to my basic right to vote, something you think I should relinquish to you, so that your vote counts more than those of the poor, people of color and women who fail to back your favorite member of the political elite?
And how is it that a thread on single-payer got to be about your resentment at people who don't share your priority on Bernie Sanders? Is there any point at which policy matters? Or is it all about how superior "progressives" are to the rest of humanity?
Are we going to see some concern for progressive policies at some point? Or is proclaiming yourselves superior all that matters?
Eliot Rosewater
(31,109 posts)BainsBane
(53,031 posts)Clearly single payer isn't a concern, since your comment and the one you respond to doesn't deal with that at all. Is there any issue that actually matters, or is it only about Bernie?
JHan
(10,173 posts)By their logic , sanders' comments makes him a "centrist" , but he doesn't get the label because........whothefukknows..
.actually is it possible to keep up with the shifting goal posts?
BainsBane
(53,031 posts)Even in a thread about single payer, they make it all about us vs. them. It's astounding that no matter what happens in America, no matter who is attacked by neonazis, when floods are killing dozens, the only thing that ever matters is how "progressives" are persecuted by Democrats who fail to recognize their inherent superiority.
geek tragedy
(68,868 posts)who use his name to raise money for themselves
joshcryer
(62,269 posts)Still I can't disagree with his positions on anything. Unlike his "supporters".
Tom Rinaldo
(22,912 posts)harun
(11,348 posts)Yo_Mama_Been_Loggin
(107,919 posts)It doesn't have to be single payer. Germany and Switzerland have such with private insurance however the insurance industry is highly regulated.
Hoyt
(54,770 posts)If public option is as good as we think/hope, people will gravitate toward it. For those who just can't stand idea of a "government" health program, they can stick with whatever they want and likely pay extra.
HughBeaumont
(24,461 posts)The public domain driving the costs rather than the corporate domain and hospital Chargemasters.
BainsBane
(53,031 posts)What about that?
Yo_Mama_Been_Loggin
(107,919 posts)It was pretty successful when Howard Dean made it a goal.
BainsBane
(53,031 posts)works with a 50 state strategy? You can't simply just say you want a 50 state strategy and then expect candidates from red districts to support what is popular in deep blue districts.
Yo_Mama_Been_Loggin
(107,919 posts)Please reread what I wrote in the thread.
Single payer is not necessary for universal healthcare. There are countries like Germany and Switzerland who accomplish this with private insurance companies.
BainsBane
(53,031 posts)My apologies for that mistake. Yes, I agree that there are many different ways to run on universal heatlhcare that could accommodate regional differences.
BainsBane
(53,031 posts)but I will say I didn't care for previous comments (whether by him or attributed to him, I'm not sure) indicating that single payer was a litmus test but reproductive rights weren't. Because without reproductive rights, there is no "medicare for all." It's medicare for about 25% of the population who are not women or children.
I'm glad to see him clarify himself on the matter.
If you cannot stand up for the medical rights of half the population, you have lost me.
ucrdem
(15,512 posts)Right now the fight is to save PPACA. Sanders can march to his own drummer all he wants for the cameras but respecting the current challenges facing Democrats he seems very much NOT part of the solution.
Julian Englis
(2,309 posts)It's way past time for him to choose to join the party and place practicality and progress over personal ideological purity.
alarimer
(16,245 posts)Maybe the simplest thing to do is to tightly regulate insurance, including price and cost controls, like they do in some other countries.
Whatever the ultimate solution, having one insurance system that applies nationwide should be the goal. None of this in-network, out-of-network nonsense. Everyone is in the network and everyone is on the plan, whatever it may be.