The New York Times ran an op-ed on April 18 highlighting Sen. Sanders' dismissal of the outcomes of southern states, and the role that they play in the primary race, bringing to light for example the following quotes:

“Secretary Clinton cleaned our clock in the Deep South. No question about it. We got murdered there. That is the most conservative part of this great country. That’s the fact. But you know what? We’re out of the Deep South now. And we’re moving up.” -- Sanders on CNN

“Well, one can argue — people say, Why does Iowa go first? Why does New Hampshire go first? — but I think that having so many Southern states go first kind of distorts reality as well.” -- Sanders on The Nightly Show

There are a couple of problems with this logic, which the author Charles Blow brought to light. For starters, three of these southern states that he lost -- North Carolina, Virginia, and Florida -- are key states in which the Democrats hope to be strong contenders (North Carolina being the most conservative of the three and plagued by voter ID problems, and the other two voting for Obama in both 2008 and 2012). Secondly, in southern states, a large share of the Democratic primary voters are African American, a demographic group with which Sanders continues to struggle. 

Sanders and his supporters have made (especially in the context of discussions about superdelegates) rhetorical flourishes about Sanders' successes in caucus states such as Wisconsin and elsewhere have reflected a surge in support and the "will of the people." It is undeniable that Sanders has vastly outperformed what many expected of him, and for that he should certainly be proud. But given the demographics of the states in which he has been successful (e.g., Wisconsin, New Hampshire, Alaska, Idaho, etc., as opposed to the more diverse states in which Clinton has been successful such as Virginia, Florida, North Carolina, Texas, etc.), it is nevertheless difficult to accurately characterize such outcomes as the will of the people, much less the will of the Democratic Party overall, which relies on the support of the African American community. Moreover, while Sanders touts his average campaign contribution of $27 -- and indeed it is admirable and impressive to have garnered such financial support from so many small contributions -- he has sharply criticized Clinton for taking larger contributions and for benefiting from large fundraisers from such people as George Clooney, despite much of the money going toward not Clinton herself, but to the Democratic Party and down-ticket races, suggesting potentially a broader engagement in the Party and its supporters. 

Part of the reason why we should take Sanders' support with a grain of salt comes down to the nature of the primary system. Much of Sanders' support has come from caucus states, which many have characterized as undemocratic given, for example, the logistical challenges posed for lower-income workers, families without child care, students, and seniors (all demographic groups that he argues that he represents), in addition to the generally haphazard nature in which votes often are cast and counted. Further, and applying to both Clinton and Sanders, not only are primary elections low turnout relative to the general election, but political scientists have noted that primary voters tend to be more ideological than are general election voters. Thus, there is for all states a problem of representativeness. 

With this caveat of less-than-representative subsets of the American electorate determining the Democratic nominee for president, Nate Silver notes that Clinton is doing far stronger in states that more closely resemble the national Democratic Party. Not only do the states in which Clinton boasted victories have large populations of African American and Hispanic voters, both central to the Democratic Party if it will be successful, but Silver argues that North Carolina, Virginia, Florida, and Texas (all supporting Clinton) "are among the most demographically representative of the diverse Obama coalition that Clinton or Sanders will have to rely on in November."

There are demographics in which Sanders has been more successful than Clinton -- notably, young voters and in particular, 18-29 year-old women -- and Clinton will need to ensure that they turn out in November given that young voters tend to be less reliable voters. Sanders has also scored well with independents, which may prove important in an election in which there is so much uncertainty with respect to the Republican Party nominee. However, for Sanders and his supporters to argue that his recent successes represent the "will of the people" or a tidal wave of support that should be noted moving forward to the convention is indeed misleading. Sanders may indeed prove valuable in working to bring new people into the party. But if key demographic groups for the Democrats continue not to "feel the Bern," and if he fails to address this limitation in his mobilization, he will continue to face an uphill battle.

 Much of the debate over Clinton versus Sanders has centered around the question of ideals versus experience. The idea of what should be versus what can be, particularly given the realities of persistent divided government and thus limitations on what the president can himself or herself achieve. Clinton called attention to this in the recent debate in New York, holding that "it's easy to diagnose a problem, it's harder to do something about it," with Sanders' policies being discussed far more in broad strokes than in achievable policy particulars.

But one day ahead of the New York primary, it is also important to consider whether, in the unlikely scenario that he becomes the Democratic nominee, and in the even less likely scenario that his policies are carried into effect as he wishes, would it be good for the country? A number of economists have said no, but I wanted to dig deeper.  

I have not been one to vote my pocketbook. I believe that taxes are an important contribution that we as citizens need to make in order to invest in public schools (from which I benefited, both in secondary school education and in higher education, go bears), roads and public transportation (which I use daily), environmental protection (a global imperative), and the like. But efficiency in those allocations of funds is important (as is one's ability to pay for rent and groceries), and looking between the Democratic candidates, both of whom support those policies, with whom would a middle class person such as myself benefit? 

The focal point of Sanders' campaign has been income inequality. Make the people on Wall Street accountable and protect those on Main Street. Prevent the rich from getting richer, the poor from getting poorer. That's all well and good. This tool can help one to calculate their change in tax liability under the four frontrunners for their party nominations (Trump and Cruz on the right, Clinton and Sanders on the left), given income level, marital status, and number of children. I am single, have no children, and have a current income of $45,000. According to those numbers, I would benefit from a tax perspective under the Republicans, I would pay $40 more with Clinton, but I would pay $4,880 more under Sanders. This is with an income that is incontrovertibly middle class. 

I then looked to see whether the benefits under Sanders would kick in if I were at or around the poverty line, so I entered an income of $15,000 (holding constant marital status and children). Still, I would be paying more under Sanders, with an increase in tax liability of $20 under Clinton and $1,630 under Sanders. Even if earning $15,000 per year with two or more dependents, I would be paying $990 more under Sanders while breaking even with Clinton. Even more absurdly, with a marital status of married and with two or more dependents, one would need to make under $5,000 to benefit under Sanders' tax plan (under $10,000 year if single with two or more dependents). And while it is true that his policies absolutely hold millionaires and billionaires accountable at a higher rate, the fact that those on the middle and lower ends of the income distribution are feeling such a pinch -- in some cases to a debilitating extent --is inconsistent with his rhetoric of concern about the middle class disappearing and the desire to combat income inequality that benefits the wealthy at the expense of the poor. In fact, a recent poll revealed that Sanders supporters are willing to spend only an additional $1,000 more on taxes, vastly exceeding that which his policies would require of them.

It is consistent with the challenge that the Sanders campaign has faced throughout, which is that talking about policies and problems is an easier task than is implementation. Short of careful, deep thought about how to combat these economic and political struggles, he has devised an economic plan whose specifics appear to go against the positions for which he purports to stand. I do not in any way believe that this is the result of any nefarious work on the part of the Sanders economic advisors, but it should give New Yorkers and Americans across the country pause before endorsing these policies. ​

​ 
For many Democrats, one of the more cringe-worthy moments of the 2004 election cycle is John Kerry’s notorious “I was for the war because I was against it,” which led to ample attacks from the right with respect to his supposed “waffling” on the issues. That said, sticking stubbornly to unpopular policies carries a number of costs as well, particularly within the domain of issues deemed important in the eyes of voters.
 
The April 14 debate reminded us of this tension that candidates face when public opinion shifts with respect to issues on which one has voted or made public statements, or when new information comes to light which might have informed that behavior. In particular, the issue that appears to repeatedly haunt Sen. Sanders is that of gun control, on which he has voted more consistently with his home state of Vermont, which is more pro-guns than is the national Democratic Party.
 
Sanders has voted to give gun manufacturers immunity from liability when those guns are used toward illegal ends, an issue that has been particularly heated in the context of such events as Sandy Hook. He has shifted a bit on the matter, indicating that Sandy Hook victims should be entitled to sue, though overall he has stuck by his record and its purported consistency, touting his adverse record by the National Rifle Association despite Clinton’s attacks on Sanders for not working to hold gun manufacturers accountable (particularly given his emphasis on corporate accountability), and despite the fact that the NRA had backed his candidacy in 1990. Admitting that he may have been wrong on the issue of guns is not a statement that we have seen from the Sanders campaign.
 
Admitting to being wrong – whether on guns, on war, or even on a narrower issue – does not come easily, in particular given the spotlight under which the candidates are operating in presidential election season. However, the cost-benefit analysis leaves a lot of questions as to why Sanders would not back away from his (prior?) positions on gun control, if for no other reason than strategy.
 
A number of southern states (e.g., Georgia, Texas, and Virginia) whose elections were held earlier this year rated gun control as important (sometimes even more important than the economy and ISIS) and an issue on which they must agree with the Democratic candidate for whom they vote. These are all states in which Hillary dominated. They are also all states in which the Democratic base is more notably minority, communities in which gun violence is a prevalent concern and communities in which Sanders is struggling to gain ground relative to white voters.
 
A recent survey of Americans on gun ownership reveals not only a widening partisan division in gun ownership and support for gun restrictions, but also a notable disparity between whites' and non-whites' rates of gun ownership, with 40 percent of whites owning guns compared with 14 percent of non-whites, and notable racial division in support for gun restrictions as well. In fact, these divisions over gun ownership are at their highest since 1977. Moreover, deaths from gun violence vary dramatically by race, both in number and by type, with whites more likely to die by suicide and African Americans more likely to die by homicide. 
The African American community has been a reliably Democratic voting demographic, indeed being characterized often by political scientists as “captured.” However, it is not news that despite progressive politics, black voters have not been feeling the Bern. Part of this is attributable to Clinton’s solid record in challenging racial discrimination and issues disproportionately affecting minority communities (e.g., poverty, crime control). But part of it has to do with Sanders. For starters, while reliably Democratic, black voters are not always as socially liberal as are many of the white voters who Sanders has mobilized under his self-described “democratic socialist” policy agenda. And second, in a time in which mass shootings and other incidents of devastating crime, the issue of gun control remains all the more salient, leaving Sanders vulnerable when the issue comes up in debates and other campaign settings (which Clinton would be right to continue to address). With recent investigations into the institutional racism within the Chicago police force, we can reasonably expect the issue of crime and guns, and the relationship to racial tensions, to remain at the forefront for many voters.   
 
Sanders has the misfortune of representing a state to the right of the country where gun control is concerned, and as a sitting Senator running for president, he is caught between the multiple constituencies that he seeks to represent. (And indeed, it is relatively easy to be pro-guns in Vermont, a state in which there is very little crime). The fact of the matter is, Clinton’s position on gun control in this period of racial tension and mass shootings is more in line with the national Democratic Party’s mainstream, and it is evidenced by the large states that she as won, Clinton voters’ priorities as indicated in exit polls, and the demographic groups that she continues to win over. While there are certain liabilities in shifting a public position, admitting to a more pro-gun control stance than he has supported in the past – whether out of growth as a politician or as a result of reflecting a broader set of public preferences and seeking to be responsive in turn – would likely serve him well moving forward. 

​I don’t make it a general quest to attack members of my own political party. Indeed, I am notably tight-lipped in most cases and in general elections need to know only whether a D or an R follows the name of the candidate, but Sanders supporters have officially put me to the test. Sanders does too, and I have written previously on his frustrating positions on guns and on mental health (which he unfortunately discusses often in conjunction with one another), but his followers seem even more extreme than he, with as many as one in four Sanders supporters now saying that they would not vote for Secretary Clinton in the general election should she get the Democratic nomination. Sanders’ recent attack on her lack of qualification is, however, a new blow, especially given Clinton’s status as “one of the most broadly and deeply qualified presidential candidates in in modern history” according to the New York Times.
 
I know the pain and frustration of losing in a primary race (dare I say, “I feel your pain”). In 2004, I spent much of November and December writing letters to Iowa voters on behalf of Howard Dean through coffeehouse meet-ups, telling them of the importance of caucus participation and why I believed that Dean’s progressive agenda was what the nation needed in that time of war and economic depravity. We all know how that ended. I loved Wes Clark’s expertise on the Republican-owned issue of national defense, though I knocked on California doors and made nation-wide calls on behalf of the most populist message of John Edwards. When John Kerry became the presumptive nominee, I was not my most satisfied, though I liked him and his strong environmental and foreign policy credentials (not to mention affection for Springsteen),and I worked anywhere from 15 to 30 hours per week on his campaign – making calls, knocking on doors, registering voters, putting up signs, helping with house parties and the coordination of events at which he or Edwards (or even Clinton himself) would speak, and turning out the vote tirelessly during GOTV (later dubbed GOTMFV) until the minute that the polls closed. I had my second drink ever while curled up in a ball on the floor crying that night, dismayed by the Ohio voter disenfranchisement at the hands of Ken Blackwell and devastated that our hard work and faith had not been rewarded but rather left us with a second Bush Administration that turned out to be worse than the first, which we had not at the time imagined possible.
 
In 2007 and 2008, I worked locally on behalf of Hillary Clinton, believing her to be the most electable and qualified candidate, with a policy agenda whose progressivism exceeded that of her husband. I made calls on her behalf and had booked a flight to Iowa for GOTV, though unfortunately had to forgo the opportunity on account of emergency wisdom tooth extraction. I twisted the arms of Nader 2000 voters who I claimed (rightly!)  that they owed me and owed the nation for their prior poor reckless judgment as to throwing away their votes. When Obama became the presumptive and then official nominee, I returned to house party organizing, door knocking, and phone banking, and took an overnight Greyhound bus from Washington, DC to Winston Salem, NC, where I mobilized voters in housing projects and other poor communities and ran Election Day Phone banks for over 50 precincts in a state that Obama won by a mere 25,000 votes. I did the same thing in State College, PA at Pennsylvania State University in the 2012 election cycle, which garnered a more substantial statewide victory, despite winning the county by only 100 votes. Do not let anyone tell you that your vote does not matter.
 
The point here is not to flaunt my campaign experience (which for the record I have vastly abbreviated), but rather to emphasize the valuable work that can be done for one’s own party even if not working for one’s candidate of choice. After all, despite my love for politics, my primary record is not the best as I have just shown you. The fact is, if we array candidates on an ideological spectrum from -1 to 1 in keeping with NOMINATE ideological space (McCarty, Poole, and Rosenthal), where -1 is the most liberal and 1 is the most conservative and our dream candidate is located at -.88, to sit out the election is in effect one less vote for a candidate who is at -.70 and who is being made electorally vulnerable and susceptible to letting the election go to a conservative candidate whose ideal point is at, say, .72, thus a radical rightward shift from the status quo policy location.
 
The reality in a separation of powers system is that presidents rarely obtain policies are actually at their actual ideal points. Politics is the product of compromise with Congress (currently controlled by the party opposing the president) as well as considerations about the courts and interest groups, and thus a president’s platform is rarely a 1 to 1 mapping with policies ultimately produced. Rather than holding uncompromisingly to the particulars of certain policies to which one holds dear, one should consider broad-based policies and values – pro-environment versus supporting environmental deregulation, pro-choice versus pro-life, pro- or anti-Affordable Care Act expansion, civil rights protection, business regulation, tax policy (especially with respect to the wealthy), etc. – and the political tenacity and bargaining power to accomplish the maximal degree of that policy agenda. The extremism espoused by Susan Sarandon and others epitomizes the narrow-mindedness of those on the far left (and to be sure, there are equivalents on the far right with respect to Trump) that leads to an unproductive campaign of misinformation and intra-party squabbling that can produce outcomes vastly contrary to the preferences of those spouting that very all-or-nothing ideology that is nothing short of immature (if not negligent). If people insist on being so vocal in their political convictions, they should consider more squarely the longer-term consequences of their public statements, so as not to mobilize ill-advised non-participation in politics or else participation contrary to the principles for which they purport to advocate. 

​I’m going to do something unusual now: I’m going to defend a Republican. Not on policy, mind you, but because of the personal nature of one of Trump’s recent attacks, in this case targeting Heidi Cruz for her history of depression.  
 
The gendered nature of this election cycle has not escaped anyone, from the obvious point that the leading Democratic contender is a woman, to Trump’s notoriety for sexist remarks on the campaign trail. Most recently, he tweeted to his opponent Ted Cruz regarding Cruz’s bout of depression approximately ten years ago.
 
Despite ongoing (and increasing) attention to mental health issues, along with discussion of the remarkable prevalence of mental illness (approximately 1 in 5), there remains persistent stigma attached to these diseases. Part of the reason is that it is difficult for those on the outside to understand. Though scientists are developing better diagnostic criteria, there is not an easy blood test, not everyone is responsive to medication, the symptoms are not as visibly physical (relative to, example, bleeding or breaking bones), and powering through the symptoms of depression is not nearly as easy a feat as one might believe. Celebrities’ “coming out” about their own struggles (or more sadly, their suicides) arguably promotes more open conversation about these challenges, and in turn facilitates people viewing it as more acceptable to seek out help. Patrick Kennedy and Tipper Gore notwithstanding, however, we see little firsthand discussion of this in the political sphere, making the Cruz case noteworthy.
 
Heidi Cruz said, “When I came out of Washington and the White House, I didn't feel that there was really a glass ceiling in the administration ... and Texas was very different,” with the “traditional culture” and social environment less hospitable and perpetuating her feelings of depression. She was reportedly found in 2005 by an Austin police officer, appearing to be a danger to herself. Her transparency on the matter is noteworthy. A Cruz advisor responded to the Trump attack by saying, “About a decade ago, when Mrs. Cruz returned from D.C. to Texas and faced a significant professional transition, she experienced a brief bout of depression. Like millions of Americans, she came through that struggle with prayer, Christian counseling, and the love and support of her husband and family.”
 
Apart from the question of whether candidates’ spouses should be fair game for attacks, in particular of such a personal nature, there is the fact that it frames the issue of depression as something to which one must “confess” and can be “accused of,” rather than a medical condition for which she appropriately sought treatment. Such a characterization of depression only further reinforces people’s sense of shame, reticence about symptoms, reluctance to reach out for help, which can be dangerous and even fatal depending on the severity of the condition.
 
There are many grounds on which to criticize the political extremism of Ted Cruz or even Heidi’s political influence in his campaigns. However, reinforcing the closeting of depression by attacking Heidi on these grounds is a major (and dangerous) setback in the treatment of mental health conditions. 

 One takeaway from the last few election cycles is that the Republican Party has not done an effective job of reaching out to women voters, particularly salient given that they currently make up just over half the population and are more likely than men to turn out to vote. We can point to a number of explanations for this difficulty in reaching out to such a key demographic group, from pro-life stances that in some cases go as far as opposing family planning services and access to preventive care, and the politicization of more basic policies such as equal pay for equal work, largely supported by the Democrats and opposed by Republicans. From "binders full of women" to adding Palin to McCain's ticket in hopes that women's solidarity would trump policy preferences, the Republicans have made a number of moves that have not served them well. 

The so-called "war on women" is particularly salient this year given that the Democratic Party's presumptive nominee is Hillary Clinton, and Donald Trump has not been known for his sensitive comments toward women, quite notably in his battles with Fox News' Megyn Kelly, who may or may not have had "blood coming out of her wherever." Indeed, Huffington has even catalogued hard-to-believe things that Trump has said about women, from marginalizing the importance of sexual assault in the military, referring to breastfeeding as "disgusting," to characterizing women as a "manipulative" sex, to speaking often to the importance of looks in politics and entertainment. Trump's latest attack on Cruz's wife only adds not only to the GOP's struggle to garner the support of women, but also to the animosity between the two main remaining Republican presidential candidates. 

Trump's charge: his wife Melania (a retired model) is more attractive than Heidi Cruz (depicted unflatteringly), with the caption, "The images are worth a thousand words." This was in conjunction with allegations that Cruz had cheated on his wife. Admittedly, it is not uncommon for the families of presidential and vice presidential candidates to be "vetted" as well as the candidates themselves. 1992 saw numerous GOP attacks leveraged at Hillary Clinton and Tipper Gore, characterizing them as "radical feminists" with women not actually wanting to be liberated from their home/kitchen. Tipper Gore was challenged for her campaign against violent and sexually explicit lyrics on record albums. The Palin family came under extensive scrutiny as well in the 2008 election cycle, showing that it is not solely a partisan matter. 

Trump's comments may not be surprising to those who have followed him closely, and his transparency in the way of discussing the importance of image over substance (resulting in a 70% unfavorable rating of Trump among women, with even a 39% unfavorable rating among Republican women). They also allow Cruz an opportunity to defend women, because while women do vote more Democratic (52 vs. 36% according to a 2015 Pew study), Republicans cannot win the election without some women on their side. Cruz retorted that spouses and children should be off bounds with respect to partisan attacks. What remains to be seen is to what extent he will stick with that language moving forward. Will we see a resurgence of Bill Clinton's extramarital affair(s)? Will we see other personal attacks? Is it only personal when it is personal to them? 

While Trump's comments certainly underscore his continued assaults on women (and many others), for example, his characterization of Hillary Clinton as "very shrill," it would be hard to construe Cruz's defense as much more than defending his wife. Cruz, after all, has opposed abortion even in cases of rape and incest, and opposes the provision of plan B. And while abortion is only one of many issues of gender (in)equality at play, Cruz has also expressed that equal pay for equal work is already law, and voted against the Paycheck Fairness Act. That Cruz defended his wife as beautiful and a wonderful wife and mother should not be mistaken for a position in favor of women more generally. Whether Cruz stands by his charge that the families of candidates should be off grounds for personal attacks remains to be seen. 

Unabashedly opportunistic though it is, the tragic attacks in Brussels gives Clinton an opportunity for her foreign policy experience to shine, showing herself the most competent candidate from among both fields to navigate the complexities of this international attack and helping nations to coalesce toward a solution. This is not a traditional "women's issue," which is to Clinton's advantage in a sense because she cannot be marginalized as caring primarily about such issues as women's rights and social programs (areas in which she also shines politically), but also national defense and security, which are issues in which the Republican Party tends to dominate more and which have been more "owned" by the Republican Party. 

Accounts of unfavorables on both sides of the political aisle have been documented, and part of the dissatisfaction that the Democratic voters have had with Clinton is her more moderate approaches to policymaking. In truth, her policies vary only marginally from those of Sanders, but she has the more pragmatic and admittedly less "sexy" approaches to these political problems -- wear and tear in the Senate and other offices have given her realistic expectations -- which Sanders supporters have ben keen to characterize as being less progressive.

There are a few realities with which they must both contend and one that only Clinton must  contend. First, making radical changes at the national level may founder, leaving the Democratic Party highly vulnerable in taking the fall in the 2018 midterm elections. But that would be an unlikely scenario to arise because it is contingent upon even getting to the implementation stage. Which brings us to the second problem. Having a likely still divided government  scenario (the Democrats will assuredly move the Senate median to the left, but not necessarily enough to gain control) requires some measure of compromise and conciliation which is hampered by designation as a self-described socialist, and by the stubborn promotion of positions too far to the left and too uncompromising to garner needed moderate Republicans' support. 

The Clinton-specific challenge is that of being a woman operating in a man's world, and thus needing to appear stronger, tougher, more in command, and let's face it, deal with slanders that our culture rightly abhors in the racial context and yet somehow accepts in the analogous cases where gender is concerned. Such is consistent with years of American history, with African Americans gaining suffrage far earlier than did women of any color. And concessions to emotion by women immediately confirm biases that women "may not have what it takes" to be the leader of the free world. There is no question that if Nancy Pelosi cried publicly as much a did John Boehner, we would not have heard the end of it. Boehner got a free pass, except for his name of course. 

Part of what we are seeing in Hillary is her effort to play this man's game, but until we change the gender dynamics of the United States, it will be a necessary evil, and a necessary condition for winning elected office not to mention prevailing in bargaining conditions upon electoral success. In a wonderful "West Wing" episode titled "Let Bartlett Be Bartlett," in which the main players choose to set loose the progressive Jed Bartlett with whom they had all fallen in love in the primary campaign. Hopefully one day we will be able to "Let Hillary be Hillary," but as long as she and her staff know well, you have to play the rules of the game in order to get in the door and begin to win the real fights. In the meantime, I hope that the Democratic voters have the patience to let her show her true colors as a bona fide progressive and champion of rights as Madame President. We just need to elect her first. 

In the interest of full disclosure, my (strong) personal preference is for Hillary Clinton to be the next President of the United States (#ImWIthHer). But even absent this personal preference, at this point in the campaign there are innumerable reasons for Sanders to concede to Clinton in the race to the White House and not merely in the individual states in which she outshines him (sometimes very modestly as in Missouri, other places much more dominantly such as in Virginia). 

Whether or not you like superdelegates (definition: an unelected delegate free to support any candidate for the presidential nomination at the party's national convention), they change the delegate math in a way that makes the nomination virtually unattainable for Sanders. While one needs 2,382 of the 4,763 delegates in order to win the Democratic nomination, Clinton currently has 1,119 to Sanders' 813. But among superdelegates, Clinton currently has 467 to Sanders' 27, making the delegate gap much larger. To be clear, this is not a case in which the superdelegates are going against the preferences of the rest of the delegate population. Clinton leads in both subgroups. But the superdelegate differential reinforces the upward climb that Sanders would face, an upward climb that is moving steadily from challenging to futile. 

And yet he still has ample support, and there are arguments of representation in American politics that can be made in support of his continuing to represent those preferences (which admittedly from a policy standpoint differ only minimally from the preferences of Clinton, who emphasizes experience and pragmatism in implementation of a similar core agenda). There are also cases in which candidates can serve important roles to put on the agenda issue items that mainstream candidates will not, but maybe should at least think more critically about, or promote some dialogue in the media and among the voters themselves. Kucinich's campaign in 2004 serves as a salient recent example. And despite apparent determination to take the nomination battle to the convention, we have seen some rhetoric from Sanders that echoes the inclination to put issues on the agenda, to force discussion of issues, as opposed to battling for those ideas to be put into practice. 

The problem is, when treating the race as hotly contested (and it is being hotly contested in a number of states, though keep in mind that New York has not yet voted), Sanders is -- as does any candidate -- making a number of attacks on Clinton. It has been argued that his becoming an "attack dog" is the only winning strategy he would have left in order to succeed. And that is certainly his right given that she is his opponent. But given the high probability that she will indeed win the nomination, battles on the nuances of policy and personal attacks leveraged among Democrats become ammunition come the general election. Sanders is in effect writing attack ads for the Republicans or shortening the amount of time they need to do on opposition research. And that isn't for the good of the Democratic Party. (Indeed, it has not gone unnoticed that some are attracted to both Sanders and Trump given their anti-establishment rhetoric, in addition to going after Hillary on the issues on which the GOP will be focusing going into the November general election). What it shows is that, like any human and particularly like any politician, he has self-interest and is acting on it, even to the detriment of the policies that he so vigorously defends. 

Sanders has come much farther than many (even he) thought possible, and it was going to be a difficult road no matter what (not aided by his being a self-proclaimed Socialist, which is a label unlikely to play well among Blue Dog Democrats, independents, and moderate Republicans feeling that their party's candidates are out of step... also not aided by his failure to garner support among key Democratic constituencies such as the African American community, or the fact that he does not hail from a key state). He should feel proud of what he has accomplished, both in delegate counts and in promoting discussion of a progressive vision of what America can and should be. But that is where is should end, lest he help facilitate a change in presidential partisan control and in turn the (potentially far) rightward direction of American social, economic, and foreign policy.

​On March 12, 2016, Hillary Clinton said of Sanders at a campaign rally in Saint Louis, “I always get a little chuckle when I hear my opponent talking about doing it. Well, I don’t know where he was when I was trying to get health care in ’93 and ’94, standing up against the insurance companies, standing up against the drug companies.” Thanks to the depth and breadth of political records, we know that Sanders was not with Clinton during this battle, but rather ​was continuing to advocate for a single-payer, universal health care system.
 
To be clear, this was not to say that Sanders was standing back on the health care fight, but rather fighting a different fight. In this case, neither won particularly. Hillary’s Health Security Act garnered 103 cosponsors (Sanders not among then), but Sanders’ fight here represents his continued disconnect from the pragmatic realities that one faces when taking policies from a small state like Vermont to a national context.
 
The fact is, most of liberal Democrats would be thrilled to see the passage of a single-payer, universal health care system that is more emblematic of what we see in parts of Europe. Of course, the advantage of many European countries is their size: granting greater benefits with greater efficiency is easier with a more finite population than the United States has. And at the end of the day, pragmatism isn’t just an advantage at the negotiation table – it’s a necessity of governance (not to mention election to get in the door in the first place).  
 
Were it not for the candidates both fighting for the Democratic nomination, they would be on the same team. They share a commitment to expanding health coverage for more Americans and making it easier to draw on the coverage that they have, with one candidate espousing the more realistic vision in a conflictual partisan environment and the other putting forth more liberal ideals whose implementation are less realistic. The problem is that if you ask for too much, you may get nothing. If you make a realistic request, you’ll probably get something. And that something will make the difference in who is able to see their doctor about a suspicious lump that could be malignant, for an endoscopy to rule out gastric cancers, for therapy that can help one to manage depression before it leads to suicidality and medical disability.
 
What we also know is that pragmatism isn’t sexy in an election season. There are times when Hillary comes off like the parent constantly having to tell her children “no” to their lofty goals, even though she is most often right. Her plan is the stuff of one who has weathered many storms and knows what can (and must) be done: expand the Affordable Care Act, reduce rising out-of-pocket costs for obtaining medical treatment, crack down on rising prescription drug costs, and protect reproductive choice. These are not game-changers, but they are necessities, and her battle scars come with the evidence of her ability to weather this storm.
 
There is something to be said for aspiring to greatness, and in the absence of those aspirations to greatness it becomes unlikely to achieve it. Indeed, one of the great political inspirations of the Democratic Party, Bobby Kennedy, held famously, “Some people see things as they are and say, ‘Why?’ I dream of things that never were and say, ‘Why not?’” Indeed, we should with more frequency be asking ourselves “why not?” and to Sanders’ credit, he is pushing for more of that discussion. The problem is when it interferes with the ability to achieve good governance in the face of a party working to undo all of the progress on which Clinton and Sanders both hope to build. Clinton has both the tools and the wisdom to deliver when we most need it. 

​While the fight for the Democratic nomination is not over, Hillary Clinton’s commanding victories in South Carolina and on Super Tuesday solidified her support with a number of key Democratic constituencies, and notably winning with those reporting in South Carolina exit polls that they cared most about health care and among those reportedly caring most about income inequality.
 
Battles for party nominations – especially long and protracted battles as in 2008 and 2016 – are often characterized by rhetoric aimed at setting candidates apart from one another in policy substance, experience, and/or ability to execute the given policy vision. Yet there are questions as to how different candidates ultimately are on the issues.
 
In many cases, the answer is that there are far more similarities than not. Indeed, at the heart of much of the Clinton versus Sanders debate is the issue of experience: supporters largely fight for the same issues, but Sanders supporters think in terms of expected benefits, while Clinton supporters think in terms of expected values (that is, both expected benefit and the probability of obtaining that benefit, which in a conflictual partisan environment requires some measure of pragmatism). The Washington Post reported that Senators Clinton and Sanders voted alike 93.1% of the time, with Clinton overall more aligned with the Democratic majority.
 
However, there is a key vote on which they disagreed, which strikes at the heart of the campaigns’ core messages: while Senator Clinton joined 73 other Senators to vote in favor of the Paul Wellstone Mental Health and Addiction Equity Act of 2007, Senator Sanders joined 9 Democrats and 15 Republicans to vote against it.  
 
Hillary Clinton’s emphasis on health care issues has been long-recognized, from her work with the Children’s Defense Fund to her less-than-successful efforts to revamp health care in the 1990s to her advocacy in favor of protecting and expanding on the Affordable Care Act. Sanders likewise has spoken vociferously in favor of expanding the right to health care, advocating for Medicare for all Americans. Both candidates have welcomed the opportunity to talk on the campaign trail about mental health, an issue that affects an estimated 1 in 5 Americans in a given year. So what is this vote that divided them?
 
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is aimed centrally at preventing health insurance companies from giving lower benefits for mental health and substance use disorders than for medical or surgical benefits. The issue was raised at a Portsmouth, New Hampshire town hall, with a woman addressing the challenges of navigating insurance coverage for her son’s mental health treatment, to which Clinton asserted her determination to ensure that parity laws are properly enforced.
 
To be sure, Senator Sanders has spoken in favor of protecting coverage to mental health services, though his discussion of mental health only in the context of gun violence in the October 2015 Democratic debate met with mixed responses. Yet when we rely in no small part on candidates’ records in office as evidence in support of the policies that they profess to support as president, this nay vote on the parity legislation is important not just to mental health policy but also to broader issues of underinsurance and income inequality, which has been central to the Sanders message.
 
While parity laws provide that physical health and mental health issues be treated equally by state insurance providers, the laws are inadequately enforced and insurance denials for mental health care remain high amid challenges to “medical necessity.” Despite ample attention to expanding the number of people who are covered by an insurance plan, a pervasive remaining problem is that of underinsurance, which according to the Commonwealth Fund in May 2015 had risen to 31 million Americans, a figure doubled from estimates in 2003. Such individuals, given exceedingly high deductibles, copayments, and coinsurance, are either unable to use their health insurance at all (leading to complications from potentially otherwise treatable conditions) or who face financial despair because of their medical costs. This is all the more prevalent in the context of mental health care, with over 50% of respondents in a 2013 survey citing cost as the reason for not obtaining mental health treatment, even if they had health insurance.
 
There are at least two reasons why this issue of underinsurance is particularly relevant to mental health coverage. First, a recent report found that 72% of American adults feel stressed about money, and that financial stress is among the main issues people cite as a source of stress and depression. Thus, limiting the feasibility of utilizing health services perpetuates the need for drawing on those services, both medical and mental health, with many interactive effects between the two.
 
Second, underinsurance is perhaps most acute within the domain of mental health, with many insurance plans limiting the number of therapy sessions that may be covered for certain conditions, and fewer and fewer psychiatrists seen taking Medicare and private insurance as in-network providers (an estimated 55% in 2015, compared with 93% in other medical specialties). This leaves patients, if they can obtain an appointment, to face potentially arduous reimbursement processes for low reimbursement rates in many cases.  Thus, there is an inextricable link here to the pervasive income inequality of the American economic system, with many most in need of these medical and mental health services unable to obtain them, even irrespective of their having obtained some level of health insurance.
 
For all of the idealistic rhetoric that typically accompanies presidential campaigns, improving the American health care system will not happen overnight. Important first steps toward progress will include tackling the problems of underinsurance in medical and mental health care, and ensuring the enforcement of existing parity legislation, on which the Democratic candidates’ voting records have in at least one key instance diverged. The Sanders campaign would do well to reconcile the inconsistency between this vote and its rhetoric on the trail.