Dianne Feinstein managed to botch talking about Single Payer *and* the CSR issue at the same time.

Watch the 4-minute clip above and weep.

If you can't hear it, here's the transcript of California Democratic U.S. Senator Diane Feinstein's response when asked how (not if, mind you...how) she would support moving to a Single Payer healthcare system:

She starts out by making an incredibly tone-deaf and inaccurate statement about single payer:

"If by ‘single payer’ you mean that it’s going to be a complete takeover by the government, of healthcare, then I am not there.

Um...no, Senator Feinstein. Single Payer healthcare does not mean a "complete takeover by the government of healthcare". That would be Universal Socialized Medicine, along the lines of the UK's National Health Service. In the U.S., the VA/TriCare is an example of socialized medicine, although it's obviously not "complete" since they only apply to those currently/formerly in the military and their families. "Single Payer" generally refers to the government taking over payment of healthcare providers via tax revenue, more along the lines of Canada. You've been in the U.S. Senate for a long time, Senator; I would hope you would know this by now.

The correct response to the question (assuming you really aren't in favor of going Single Payer) would've been something like, "I support every American having the right to quality, affordable healthcare. I understand that there's a growing movement towards a single payer healthcare system, but there are other ways of achieving that goal which I feel would be more practical and achievable, such as..." (and go on to explain why you feel improving/beefing up the ACA is the better way to go).

While this was the quip which got the headlines yesterday, the rest of her response was even more disturbing to me:

“If Single Payer healthcare means trying to work out some of the problems existing...we’ve got immediate problems that I just learned about coming up...it’s a “cost responsibility” issue...and there was a House court case...and the House won the court case...and this is gonna cost insurers, in a month...$7 million for 6 million people...who get extra help between $11,000/year and $29,000/year. This may be what Trump was waiting for, to show that this program can fall apart...at least the individual premium part of the program. The Commonwealth… um...what’s the name of the group that just came out with this...they just sent the memo, I have it here (looking)...I just saw it last night...(can’t find it)...I can get it for you, I think it’s a very important memo...I’d like you to take a look at it and get back to me on it...because Trump may refuse to make the payment...which means that 6 million would get robbed, if insurers quit. It’s something that’s out of the blue, I did not know that there was a suit against...and I did not know that the House won the suit on the first level (?). So this is...the existential issue, no doubt about that.”

Holy crap. She tried to change the subject to the CSR crisis. I understand what she was trying to do ("We can't talk about single payer right now, first we have to put out this far more immediate & urgent CSR crisis to ensure the 2018 market isn't destroyed!"), but this is...awful.

First of all, it’s not $7 million for 6 million people...it’s $7 BILLION. Seven million would have amounted to slightly over one dollar per person, which wouldn't exactly be worth wringing our hands over.

Secondly, it's "Cost Sharing Reduction", not "cost responsibility", although she might've been trying to say something about "the government having a responsibility to pay these costs" or similar and mangled the wording. I'll give her a pass on that one, however; it's more of a semantic quibble.

More importantly, she claims that the House lawsuit is ”out of the blue”, which is nonsense—the court case was originally brought by John Boehner nearly 3 years ago and has been making headlines periodically ever since as it’s wound it’s way through the court system. More to the point, the potential CSR cut-off threat has been written about by not just myself but numerous other healthcare writers, publications, etc. for several months now.

I’m not saying that Feinstein should know the exact details of every pending lawsuit about every issue, but this is a pretty high-profile one; to claim it’s “out of the blue” is ludicrous, as is her claim that she didn’t even know the suit existed or that the House won the suit (which it technically hasn’t yet...it won an initial ruling, but there’s been a hold placed on that ruling).

Even if she hadn’t bungled talking about the CSR issue (and spent so much time fumbling around looking for the memo from the Commonwealth Fund)...the way she shoehorned it into the response was painful to watch.