Obamacare: Alinski in Action?

[Virgil Showlion]

"We will start by reducing premiums by as much as $2,500 per family."
   - U.S. Pres Barack Obama (2009)

"If you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too. The only change you’ll see are falling costs as our reforms take hold."
   - U.S. Pres Barack Obama (2008)

Most posters will hopefully remember these and similar claims during the big pitch for the PPACA in 2008 and 2009. The bill has been the subject of much discussion on our board since, primarily on:

• AgeOfEnlightenmentSCP's serial Obamacare Deathwatch thread, which initially focused on the rocky roll-out of the online exchange but has now grown to 71 pages of varied material (most grievances concern the costs, loopholes, questionable legality, lackluster adoption, and single-payer Trojan horse aspects of the PPACA)
  
• threads about the staggering costs of the bill to both government and consumers here, here, and here
  
• threads about the bill as a single-payer Trojan horse here and here

My own education about the PPACA, much of which was supplied by Angel! (the whole exchange is worth reading as I struggle to understand how and why the bill is supposed to work), concludes with the question:

People have been crowing that they expect their insurance rates to skyrocket, or that they expect their insurance rates to plummet as a result of the ACA going into effect. I don't fully understand either position. My current understanding is that the ACA has basically set rates for people participating in the exchanges, and the government will absorb any change in premiums. And for the people obtaining insurance through their employers, I don't see why premiums (which are a function of risk and expense) would change at all, since the risk and expense haven't changed for a given company. Unless of course ACA opponents are expecting the tide of newly-insured people to overwhelm resources, causing prices--and then premiums of all kinds--to increase through supply and demand, while ACA proponents believe that uninsured people were constantly paying out of pocket for stopgap solutions, and the load on the system will ultimately lighten as they obtain more permanent help. Is this about right?

Three years later, we have the answer. If you'll forgive another set of bullet points (material excerpted from here):

• Single and family average premiums for employer-sponsored health insurance rose 4% this year over last. The average annual premium for single coverage is $6,251, of which workers pay an average of $1,071; the average family premium is $17,545, of which workers pay an average of $4,955. Deductibles have risen more sharply than premiums. ... The average deductible for workers with employer-sponsored health insurance who face a deductible is $1,318 for single coverage this year, up 44% from $917 in 2010. By contrast, over that same period, single premiums are up 24% and wages have risen 10%, just outpacing general inflation at 9%.
  
  
• The average 2016 deductible for a silver plan on the Obamacare exchanges is $3,117 for individual coverage, up 6% from 2015, while the average silver family deductible is $6,480, up 8% from this year, according to a recent analysis by HealthPocket, a technology company that ranks and compares health plans.
  
  
• Pres. Obama pledged to provide insurance for the 30 million uninsured Americans. Circa 2015, there are still close to 30 million uninsured Americans, only they now pay a penalty to the IRS.
  
  
• Estimates of the cost of the PPACA to taxpayers started at $273 billion in 2012 to just under $2 trillion this past January, and the projections continue to soar. My own concerns, repeated several times, lied predominantly in this aspect of the bill.
  

For those here who still openly support the bill, is it not time to concede it's a failure? Premiums are surging, healthy Americans are abandoning exchanges and choosing to remain uninsured, employers are dropping coverage and cutting back employee hours, and the government is slowly (or not so slowly) being bled dry by additional costs. If this state of affairs isn't sufficient to declare the experiment a failure, what is? This isn't a rhetorical question.

Just as importantly: as many Obamacare opponents warned, the federal Democrats seem to be angling to capitalize on the failure of the bill to push universal healthcare (i.e. "single-payer") as a solution to the problem they've created. I know that many pundits, and even some posters here, scoffed at the notion of the PPACA as a Trojan horse for single-payer in the US, but the conspiracy theory seems apt in this case. Classic Alinski: create the problem and then offer a solution for it.

I warn you: single-payer healthcare, although I support it in Canada, is a huge risk for the US. See also this and this. I know from experience that most of you (Americans) simply don't understand how and why the Canadian system works. You assume it can be elegantly, effectively ported to the US, and this isn't a reasonable assumption. Your society, industry, culture, government, and sheer size are fundamentally different from ours.

Single-payer proponent or not, whatsoever you do, don't simply accept it as a solution to a crisis. Bring it in democratically, if/when strong public support exists (Canada had 70%+ popular support when we enacted it), with realistic expectations of the sacrifices and changes that will accompany it. Support only a bill crafted in the light of day. If you don't, and you accept the Trojan horse, I guarantee you will deeply regret it. This is coming from somebody who very much supports the principle of universal healthcare. Do it right. You were duped with the lies and empty promises of the PPACA. Don't let it happen again.

[AgeOfEnlightenmentSCP]

The sooner, the better.  It's over.  It is so unworkable that both the President and the Supreme Court have illegally and unConstitutionally selectively enforced and/or amended it. By any objective measure, it's not really even in force and it never will be because it's such a disaster.

[Tennesseer]

Isn't there already an active thread on this subject?  Why yes there is.  Even the thread author is the same.

'ObamaCare Deathwatch - it's no longer if, but when & how...'

[Virgil Showlion]

Nov 6, 2015 11:10:31 GMT -5 Tennesseer said:

Isn't there already an active thread on this subject?  Why yes there is.  Even the thread author is the same.

'ObamaCare Deathwatch - it's no longer if, but when & how...'

That thread was started by Paul. Its premise is that the ACA is doomed to implode, either by repeal or by attrition. I don't expect either will happen.

I'm more interested in finding out whether posters here are willing and eager to embrace any single-payer proposals Ms. Clinton may bring in during her first term.

[mmhmm]

Nov 6, 2015 11:36:04 GMT -5 Virgil Showlion said:

Nov 6, 2015 11:10:31 GMT -5 Tennesseer said:

Isn't there already an active thread on this subject?  Why yes there is.  Even the thread author is the same.

'ObamaCare Deathwatch - it's no longer if, but when & how...'

That thread was started by Paul. Its premise is that the ACA is doomed to implode, either by repeal or by attrition. I don't expect either will happen.

I'm more interested in finding out whether posters here are willing and eager to embrace any single-payer proposals Ms. Clinton may bring in during her first term.

How can anyone know the answer to that question without seeing what might be brought to the table?

[tallguy]

"If you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too. The only change you’ll see are falling costs as our reforms take hold."
- U.S. Pres Barack Obama (2008)

It would have been better if that statement had not been shortened for a sound bite.  It should have continued with, "unless your insurance carrier changes it."  But there was nothing in the ACA that changed anyone's plan as long as it met minimum standards.  It in fact grandfathered in existing plans, so the statement was technically true in that sense.  You can argue that it was known in advance that the insurance carriers would eliminate a lot of plans, thus impacting many, many people, but that is in fact a different argument.  Trying to spin it as just another lie by the President is disingenuous.

Also, with regard to your bullet points, my recollection from the last time I looked (not recently) is that costs had increased less after ACA than they had been doing before.  And my cost under my employer plan increased by a greater percentage than you state for ACA plans.  Obviously that is not definitive, but it does call your conclusion into question, at least for me. 

That all being said, dem is correct that the ACA is not the best thing we could have come up with.  It is what could be passed in a polarized Congress.  It's biggest problem is that it not only left the insurance companies in place, but that they WROTE much of it.  Get a single-payer system in place NOW, with a secondary system beyond that for those who wish to pay more for better access.  But paying care providers more based on how much they do (whether it is necessary or even helpful) and leaving health-care coverage in the hands of those who have a financial disincentive to pay for it, and who get bonuses for NOT paying for it, is asinine.  Our old system deserved to get blown up.  Hopefully we will finish the job.          

[djAdvocate]

Nov 7, 2015 12:35:07 GMT -5 tallguy said:

"If you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too. The only change you’ll see are falling costs as our reforms take hold."
- U.S. Pres Barack Obama (2008)

It would have been better if that statement had not been shortened for a sound bite.  It should have continued with, "unless your insurance carrier changes it."  But there was nothing in the ACA that changed anyone's plan as long as it met minimum standards.  It in fact grandfathered in existing plans, so the statement was technically true in that sense.  You can argue that it was known in advance that the insurance carriers would eliminate a lot of plans, thus impacting many, many people, but that is in fact a different argument.  Trying to spin it as just another lie by the President is disingenuous.

Also, with regard to your bullet points, my recollection from the last time I looked (not recently) is that costs had increased less after ACA than they had been doing before.  And my cost under my employer plan increased by a greater percentage than you state for ACA plans.  Obviously that is not definitive, but it does call your conclusion into question, at least for me. 

That all being said, dem is correct that the ACA is not the best thing we could have come up with.  It is what could be passed in a polarized Congress.  It's biggest problem is that it not only left the insurance companies in place, but that they WROTE much of it.  Get a single-payer system in place NOW, with a secondary system beyond that for those who wish to pay more for better access.  But paying care providers more based on how much they do (whether it is necessary or even helpful) and leaving health-care coverage in the hands of those who have a financial disincentive to pay for it, and who get bonuses for NOT paying for it, is asinine.  Our old system deserved to get blown up.  Hopefully we will finish the job.          

if even ONE of my own party could have gotten on board for something BETTER, we would have it.

but my party didn't want ANY plan, as far as i can tell.

[tallguy]

That is why I don't belong to a party.  So I never have to either defend or lament them.  

Come on, dj.  Be an independent.  It's where all the best (and most-thinking) people are. 

[djAdvocate]

Nov 7, 2015 12:56:46 GMT -5 tallguy said:

That is why I don't belong to a party.  So I never have to either defend or lament them.  

Come on, dj.  Be an independent.  It's where all the best (and most-thinking) people are. 

there is nobody i want to vote for in the primary, so that is what i plan on doing.  but not this year.
for this year, i am going to enjoy my final days as one of the 5% of my party that identifies as liberal.

[OldCoyote]

Nov 7, 2015 8:33:30 GMT -5 deminmaine said:

For those here who still openly support the bill, is it not time to concede it's a failure? Premiums are surging, healthy Americans are abandoning exchanges and choosing to remain uninsured, employers are dropping coverage and cutting back employee hours, and the government is slowly (or not so slowly) being bled dry by additional costs. If this state of affairs isn't sufficient to declare the experiment a failure, what is? This isn't a rhetorical question.
I do, and I don't believe it is a failure.  First of all, premiums are NOT surging, at least not here.  The increases we have faced since the implementation of the ACA are very small, as insurers compete more in our state market.  Where it does fall short, and it has many shortcomings, it is because it does not adequately encompass the entire healthcare issue.  It also has the challenge of propping up the bloodsucking insurance companies.



Just as importantly: as many Obamacare opponents warned, the federal Democrats seem to be angling to capitalize on the failure of the bill to push universal healthcare (i.e. "single-payer") as a solution to the problem they've created. I know that many pundits, and even some posters here, scoffed at the notion of the PPACA as a Trojan horse for single-payer in the US, but the conspiracy theory seems apt in this case. Classic Alinski: create the problem and then offer a solution for it.

The ACA was a compromise that was passed because it was the only thing that could be passed.  I would love to think it was a Trojan horse (being one who does want USP) but they were not that organized or sophisticated.  The whole process was an exersize of representative government at work; compromise, sweeteners, and more compromise.  They scrambled desperately to put together and hold the coalition that this thing to be cobbled together.  Something was better than nothing.


I warn you: single-payer healthcare, although I support it in Canada, is a huge risk for the US. See also this and this. I know from experience that most of you (Americans) simply don't understand how and why the Canadian system works. You assume it can be elegantly, effectively ported to the US, and this isn't a reasonable assumption. Your society, industry, culture, government, and sheer size are fundamentally different from ours.

You've repeatedly said that, and I find that vaguely insulting, frankly.  We are Americans, and we can do anything we collectively set our minds to.  (notice that commie word, collectively, the same spirit that energized us to win WWII)  We can certainly do Single Payer Universal Coverage.  Right now we have at least three health care systems, the VA, the private sector, and Medicare/ Medicaid, which is more than any other country in the world has.  Being the United States of America, we are the only nation capable of having three health care systems!  I don't care how the little Canadian program works.  We are eventually going to do it our own way, and of course we are going to do it better. 



Single-payer proponent or not, whatsoever you do, don't simply accept it as a solution to a crisis. Bring it in democratically, if/when strong public support exists (Canada had 70%+ popular support when we enacted it), with realistic expectations of the sacrifices and changes that will accompany it. Support only a bill crafted in the light of day. If you don't, and you accept the Trojan horse, I guarantee you will deeply regret it. This is coming from somebody who very much supports the principle of universal healthcare. Do it right. You were duped with the lies and empty promises of the PPACA. Don't let it happen again.

Strong support is here.  When the ACA passed on 45+% of the people supported it.  30+% wanted something more, namely USP.

While the ACA is not a Trojan horse (again, I can't credit them with that level of competence and craftiness) it is a beginning toward a better health care system.  Everyone has acknowledged that since the beginning.  It has many flaws, which was also acknowledged all along.  (Pass this bill; it is hugely imperfect!)

When it is finally replaced down the road it will be for true health care for all.  We can do this, and we will.

 

Have Any of those flaws been fixed?

[Politically_Incorrect12]

Nov 6, 2015 10:44:06 GMT -5 Virgil Showlion said:

Just as importantly: as many Obamacare opponents warned, the federal Democrats seem to be angling to capitalize on the failure of the bill to push universal healthcare (i.e. "single-payer") as a solution to the problem they've created. I know that many pundits, and even some posters here, scoffed at the notion of the PPACA as a Trojan horse for single-payer in the US, but the conspiracy theory seems apt in this case. Classic Alinski: create the problem and then offer a solution for it.

I still think that was the purpose of the bill.  Democrats who don't like it say "it was a Republican bill," but the reality is that you can't really call something a Republican bill when no Republicans voted for it.  Now here  comes the "it was based on a Republican governor's plan" or "the Republicans wanted the same bill back in the 90's;" neither of which is a valid argument because what states decide is best for their citizens is not necessarily is not necessarily the best for everyone in the country and arguing that a party wanted something almost 20 years ago is just a bad argument all around.

I warn you: single-payer healthcare, although I support it in Canada, is a huge risk for the US. See also this and this. I know from experience that most of you (Americans) simply don't understand how and why the Canadian system works. You assume it can be elegantly, effectively ported to the US, and this isn't a reasonable assumption. Your society, industry, culture, government, and sheer size are fundamentally different from ours.


It's amazing how many people think this can be fixed by just giving the government more money. Virgil brought up a valuable point, one that many seem to ignore...pretty much every country with a single-payer system (which isn't even accurate in almost every case because secondary insurance seems to pop up because of the inefficiencies with a single-payer system), none of those countries could sustain it with the amount of people and illegal immigration that the US deals with on a regular basis. If single-payer was so great, most (if not all, but I'm sure somebody can find a country with no health insurance companies somewhere) of those countries wouldn't have a market for private secondary insurance. Even with Medicare in the US, there is a reason medicare supplements are so popular (it's because Medicare doesn't cover a lot of things).

Single-payer proponent or not, whatsoever you do, don't simply accept it as a solution to a crisis. Bring it in democratically, if/when strong public support exists (Canada had 70%+ popular support when we enacted it), with realistic expectations of the sacrifices and changes that will accompany it. Support only a bill crafted in the light of day. If you don't, and you accept the Trojan horse, I guarantee you will deeply regret it. This is coming from somebody who very much supports the principle of universal healthcare. Do it right. You were duped with the lies and empty promises of the PPACA. Don't let it happen again.

I want to say Canada has a secondary health insurance system, I think there are many that romanticize the idea of a single-payer system being like Medicaid in many states that have very few limits with access or care of health insurance.  I think there are many that have a misguided notion that a single-payer system will not have many of the same limits as the current system we have in place; but just like insurers set limits in order to cut down on cost, the government will have to ultimately do the same and I have a feeling that many of the same people complaining about health insurance companies doing it will not complain so loudly about the government doing the same thing.  It's also strange that people want to take away choice in different matters.  For instance if I don't like some of the stipulation my insurance company has (i.e. they won't pay for X unless I do Y), I can try and find another insurance company that doesn't have those same stipulations...but with a government system, you really don't have that option.  So in essence you have be ok with the government controlling what you can and can't do with your healthcare.  Far to often people only look at today, and don't bother thinking about where it can lead to tomorrow.    


Just for arguments sake, lets take an extreme example from a car insurance company in the US that offers to give cheaper rates if you let them plug a device into your car to monitor your driving.  If you are a "safe driver," you can get cheaper rates; but the device is not supposed to increase your rates.  Other than the privacy issues or concerns that people might have with it; lets take it to the health insurance side of things.  Imagine if a company offered cheaper rates if people would have medical chips implanted into them that would make it easier and faster to obtain more accurate past medical history in the case of an emergency or when going to the doctor.  By doing so, the health insurance company could offer cheaper rates to those individuals.  If I don't want a medical history chip implanted into my body for whatever reason (religious, concerns for privacy, etc), I can find another insurance company of simply not opt into the program.  However, if the government was the only option, it gives them much more power to force the issue.  You can call it a conspiracy theory, you can call it crazy, you can call it whatever you want; but when you only have one option it increases the power of that one option because there aren't really any other alternatives (i.e. the reason monopolies are not supposed to be allowed).  

[Politically_Incorrect12]

Nov 7, 2015 8:33:30 GMT -5 deminmaine said:

Just as importantly: as many Obamacare opponents warned, the federal Democrats seem to be angling to capitalize on the failure of the bill to push universal healthcare (i.e. "single-payer") as a solution to the problem they've created. I know that many pundits, and even some posters here, scoffed at the notion of the PPACA as a Trojan horse for single-payer in the US, but the conspiracy theory seems apt in this case. Classic Alinski: create the problem and then offer a solution for it.

The ACA was a compromise that was passed because it was the only thing that could be passed.  I would love to think it was a Trojan horse (being one who does want USP) but they were not that organized or sophisticated.  The whole process was an exersize of representative government at work; compromise, sweeteners, and more compromise.  They scrambled desperately to put together and hold the coalition that this thing to be cobbled together.  Something was better than nothing.


I warn you: single-payer healthcare, although I support it in Canada, is a huge risk for the US. See also this and this. I know from experience that most of you (Americans) simply don't understand how and why the Canadian system works. You assume it can be elegantly, effectively ported to the US, and this isn't a reasonable assumption. Your society, industry, culture, government, and sheer size are fundamentally different from ours.

You've repeatedly said that, and I find that vaguely insulting, frankly.  We are Americans, and we can do anything we collectively set our minds to.  (notice that commie word, collectively, the same spirit that energized us to win WWII)  We can certainly do Single Payer Universal Coverage.  Right now we have at least three health care systems, the VA, the private sector, and Medicare/ Medicaid, which is more than any other country in the world has.  Being the United States of America, we are the only nation capable of having three health care systems!  I don't care how the little Canadian program works.  We are eventually going to do it our own way, and of course we are going to do it better. 



Single-payer proponent or not, whatsoever you do, don't simply accept it as a solution to a crisis. Bring it in democratically, if/when strong public support exists (Canada had 70%+ popular support when we enacted it), with realistic expectations of the sacrifices and changes that will accompany it. Support only a bill crafted in the light of day. If you don't, and you accept the Trojan horse, I guarantee you will deeply regret it. This is coming from somebody who very much supports the principle of universal healthcare. Do it right. You were duped with the lies and empty promises of the PPACA. Don't let it happen again.

Strong support is here.  When the ACA passed on 45+% of the people supported it.  30+% wanted something more, namely USP.

While the ACA is not a Trojan horse (again, I can't credit them with that level of competence and craftiness) it is a beginning toward a better health care system.  Everyone has acknowledged that since the beginning.  It has many flaws, which was also acknowledged all along.  (Pass this bill; it is hugely imperfect!)

When it is finally replaced down the road it will be for true health care for all.  We can do this, and we will.

 

1) Which means that 65% of people didn't think the ACA was a good bill, but I'm sure you'll attribute that to "bad information" while claiming the people that supported it were "better informed."  That 30%+ that wanted something was already included in the % of people who "supported the ACA," and not all of those 30% would support a single-payer system.

2) The VA coverage itself depends on a number of factors to include income, disability related to military service (which unfortunately gets abused far to often and makes it more difficult for the people who need it to get through the system), and it does take private insurance coverage if the person has it in order to cover some of the cost.  You also have short-term memory if you've forgotten that it wasn't that long ago people complained about the VA coverage.

3) I've already mentioned that many of the countries that people champion as examples of a single-payer system have secondary insurance programs (probably similar to our Medicare supplement programs here).

4) Medicaid is probably the one that covers the most with the least out of pocket. In some ways that is what frustrates many people in that Medicaid seems to cover more than private insurance covers. Of course I don't see being poor enough to qualify for Medicaid as a trade-off I would want to make, but make no mistake that in a single-payer system, it would probably cover much less than Medicaid.

[fishy999]

Just did my open enrollment today- not going to complain- going to cost me $14 a month- or $140 if I do not do the biometric screening- guess I will cave.  They 'claim' the employer does not get individual results- well I hope not.  

Still bugs me with an aggregate report- if your workforce is heavily tilting towards high risk factors then they have all of the incentive in the world to get rid of older workers- I hate to be complicit in that kind of data collection- but why not- Obamacare is going to explode into single payer anyway right?  Might as well help it along

[weltschmerz]

Nov 9, 2015 10:12:32 GMT -5 Politically_Incorrect12 said:

Nov 7, 2015 8:33:30 GMT -5 deminmaine said:

Strong support is here.  When the ACA passed on 45+% of the people supported it.  30+% wanted something more, namely USP.

While the ACA is not a Trojan horse (again, I can't credit them with that level of competence and craftiness) it is a beginning toward a better health care system.  Everyone has acknowledged that since the beginning.  It has many flaws, which was also acknowledged all along.  (Pass this bill; it is hugely imperfect!)

When it is finally replaced down the road it will be for true health care for all.  We can do this, and we will.

 

1) Which means that 65% of people didn't think the ACA was a good bill, but I'm sure you'll attribute that to "bad information" while claiming the people that supported it were "better informed."  That 30%+ that wanted something was already included in the % of people who "supported the ACA," and not all of those 30% would support a single-payer system.

2) The VA coverage itself depends on a number of factors to include income, disability related to military service (which unfortunately gets abused far to often and makes it more difficult for the people who need it to get through the system), and it does take private insurance coverage if the person has it in order to cover some of the cost.  You also have short-term memory if you've forgotten that it wasn't that long ago people complained about the VA coverage.

3) I've already mentioned that many of the countries that people champion as examples of a single-payer system have secondary insurance programs (probably similar to our Medicare supplement programs here).

4) Medicaid is probably the one that covers the most with the least out of pocket. In some ways that is what frustrates many people in that Medicaid seems to cover more than private insurance covers. Of course I don't see being poor enough to qualify for Medicaid as a trade-off I would want to make, but make no mistake that in a single-payer system, it would probably cover much less than Medicaid.

Check your math again. It's simple addition.

45% plus 65% is 110%.

[Politically_Incorrect12]

Nov 10, 2015 5:14:57 GMT -5 weltschmerz said:

Nov 9, 2015 10:12:32 GMT -5 Politically_Incorrect12 said:

1) Which means that 65% of people didn't think the ACA was a good bill, but I'm sure you'll attribute that to "bad information" while claiming the people that supported it were "better informed."  That 30%+ that wanted something was already included in the % of people who "supported the ACA," and not all of those 30% would support a single-payer system.

2) The VA coverage itself depends on a number of factors to include income, disability related to military service (which unfortunately gets abused far to often and makes it more difficult for the people who need it to get through the system), and it does take private insurance coverage if the person has it in order to cover some of the cost.  You also have short-term memory if you've forgotten that it wasn't that long ago people complained about the VA coverage.

3) I've already mentioned that many of the countries that people champion as examples of a single-payer system have secondary insurance programs (probably similar to our Medicare supplement programs here).

4) Medicaid is probably the one that covers the most with the least out of pocket. In some ways that is what frustrates many people in that Medicaid seems to cover more than private insurance covers. Of course I don't see being poor enough to qualify for Medicaid as a trade-off I would want to make, but make no mistake that in a single-payer system, it would probably cover much less than Medicaid.

Check your math again. It's simple addition.

45% plus 65% is 110%.

I know how to add, and with the 5 or 6 right next to each other; it happens.

[djAdvocate]

we've been through this a billion times.

roughly 1/3 of Americans like the ACA as it is.
roughly 1/3 of Americans want it repealed.
roughly 1/3 of Americans want it expanded.

if you EXPAND the ACA, it gets 2/3 support.

you don't get to 2/3 any other way, other than assuming those that love and hate it do so for the same reason, which is absurd.

[Politically_Incorrect12]

Nov 10, 2015 11:09:46 GMT -5 djAdvocate said:

we've been through this a billion times.

roughly 1/3 of Americans like the ACA as it is.
roughly 1/3 of Americans want it repealed.
roughly 1/3 of Americans want it expanded.

if you EXPAND the ACA, it gets 2/3 support.

you don't get to 2/3 any other way, other than assuming those that love and hate it do so for the same reason, which is absurd.

I highly doubt that the 1/3 who "like the ACA as it is" would all like a single-payer system.  Of course one has to wonder of those who like it, how many actually have to pay for it.  Of the other 1/3 that want it expanded it doesn't mean they all want it expanded to a single-payer system.  I've also already said that far too many people who complain about the insurance companies really don't understand that they government in a single-payer system would have to also have similar limits to care and coverage.  Federal government coverages already have limits to what they will cover, and expanding it won't change that issue.  There is a reason secondary insurance is so popular in so many of those countries with single-payer systems; and there is a reason that even in the USA, Medicare supplements are so popular to cover what Medicare .  Even if a single payer system were implemented, the drastic increase in taxes that would need to accompany it (probably income and VAT) would most undoubtedly cause an adverse affect on the economy, so it would need to be phased in instead of just all of a sudden started.  If you were going to phase it in, the smart thing would be expand government coverage to all veterans (not just based on disability and income) and government employees.  Of course doing that would most likely be cost prohibitive.  

[djAdvocate]

Nov 10, 2015 13:36:46 GMT -5 Politically_Incorrect12 said:

Nov 10, 2015 11:09:46 GMT -5 djAdvocate said:

we've been through this a billion times.

roughly 1/3 of Americans like the ACA as it is.
roughly 1/3 of Americans want it repealed.
roughly 1/3 of Americans want it expanded.

if you EXPAND the ACA, it gets 2/3 support.

you don't get to 2/3 any other way, other than assuming those that love and hate it do so for the same reason, which is absurd.

I highly doubt that the 1/3 who "like the ACA as it is" would all like a single-payer system. 

valid point.  i don't HIGHLY DOUBT it, but i think there is reasonable doubt to sustain that objection.

i am sure it has been surveyed, but as i said before, i really have to go.

edit: jooc- do you think that ANY of the 1/3 that want it repealed want single payer? (to use your logic)

[Politically_Incorrect12]

Nov 10, 2015 13:56:36 GMT -5 djAdvocate said:

Nov 10, 2015 13:36:46 GMT -5 Politically_Incorrect12 said:

I highly doubt that the 1/3 who "like the ACA as it is" would all like a single-payer system. 

valid point.  i don't HIGHLY DOUBT it, but i think there is reasonable doubt to sustain that objection.

i am sure it has been surveyed, but as i said before, i really have to go.

edit: jooc- do you think that ANY of the 1/3 that want it repealed want single payer? (to use your logic)

Any...I can't say no, but I would think that those who want a single-payer system would be in the "want it expanded group" over the the want it repealed group.

[Politically_Incorrect12]

Nov 10, 2015 14:07:30 GMT -5 deminmaine said:

Cost Prohibitive

What is cost prohibitive is what we are doing now!

Three   parallel health care systems make no sense at all. Really, it doesn't .   Our current system is absurd. 

We don't really have 3 systems, we basically have 2 (government and private)...the VA falls under government insurance, just like Medicare.  Medicaid is government too, but state controlled.  

[Tennesseer]

My employer-provided (retired) medical insurance is going down $160 a month for 2016 with an optional new plan to retirees.  Slightly higher deductible (not much), and a smaller number of PCPs to select from (my current PCP is one of the listed doctors) who have agreed to work with the insurance company and employers to keep costs down was the reason for the monthly reduction.