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The Solution Space Is Set by a Lot of Stuff
The solution space is set by a lot of stuff. It's set by what interest groups in the sector and like changing the language or making extreme demands does not change their incentives. The problem is within an institution where you're all dedicated to the cause, often what maximizes your personal power as an activist within that institution is being extreme. You want to come up with slogans like Medicare for all rather than single payer even though it's the same thing. And also still not popular, but more popular than single payers.