Under the Sanders proposal, for example, cost control is secured by a global budget and by imposing Medicare payment rates. Blahous, a former Medicare trustee, estimates that under the Sanders proposal, provider payments would be cut by an estimated 40 percent by usingMedicare payment rates. Using Medicare payment rates throughout the entire American health care economy would hurt patients. Already, the Centers for Medicare and Medicaid Services projects that “nearly half of hospitals, approximately two-thirds of skilled nursing facilities (SNFs), and over 8 percent of home health agencies (HHAs) would have negative total facility margins.”

f you’ve been hurt: Articulate it as well as you can. A person can’t address an issue if they don’t know it exists or don’t understand it. Do you know what you need? An apology, space, time, physical contact, reassurance, a commitment to address a certain behavior? Ask for it. If you don’t know what you need, say that. Ask for help finding a solution. Too many arguments move from “I’m sorry” to “that’s not good enough” without ever saying what would be good enough. And maybe nothing is, but if that’s the case it needs to be said. It’s not about them. People aren’t heroes or villains. Calling someone a monster doesn’t address the hurt; it tells them you think it’s inevitable and irreparable that they’ll hurt you. It’s okay to cry. It’s okay to need help. It’s okay to not be able to deal with it right away. When emotions are high, productive conversation can be painful, almost impossible.

If you’ve hurt someone: Apologize. They may not accept it (and they don’t have to), but apologize. Mean it. If you don’t know what you’ve done to hurt them, find out as calmly as you can. “I’m sorry that you feel bad” is not an apology. It’s passive-aggressive. Apologize for the behavior, not its effect. Remember that it’s not about you. If someone is telling you that you’ve hurt them, that isn’t an attack. Defensiveness is a refusal to address the issue. I presume you care about your partners. If you hurt them, focus on fixing the hurt rather than maintaining your ego or denying the hurt exists. People aren’t heroes or villains. Doing something wrong does not mean you’re a horrible person. We all do it. We fuck up or lash out or just don’t know what the hell we’re doing sometimes. These are discrete behaviors. If you’ve hurt someone, it makes sense to feel bad. It’s not so helpful to decide this makes you a Bad Person who should be shunned forever for your unforgivable sin. Acting like that is asking the person you’ve hurt to take care of you, and avoids addressing the hurt.