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ACA to the ballot box
The ACA Debate Isn’t Going Away

Two years ago, the White House, tired of defending the Affordable Care Act against from challenges in court, Congress, and the ballot box, popularized a hashtag for its signature legislative achievement—#ItsTheLaw—intended to convey that the debate had been settled. Despite Democratic exasperation, however, we shouldn’t expect the debate over Obamacare to cease anytime soon—both because major components of the law haven’t been implemented yet, and because, even if the law limps along without any new unpleasant surprises, it will not solve the underlying unsustainability of our healthcare system. Ben Domenech has a perceptive piece in the Daily Beast arguing that Obamacare could end up being a key political issue in the 2016 election:

Don’t look now, but the president’s signature domestic policy, his namesake health care law, is doing very poorly. It just received its worst news yet, when the nation’s largest insurer, UnitedHealth, broached the possibility that it could exit the health insurance exchange due to its inability to find profits.

Its losses from participating in the exchange were simply impossible to maintain. If other insurers follow suit, those left behind will likely raise their rates even more. […]

Once Obamacare launched, it was supposed to be a political boon for Democrats. It was supposed to give them the ability to count on a newly engaged group of Americans who saw the government as providing them significant and helpful subsidies that prevented them from being concerned about their health coverage. Instead, its mismanagement and failure to live up to President Obama’s promises has given Republicans an opportunity they intend to exploit.

Domenech is likely right. As we’ve written before, “the Affordable Care Act is looking more like a clown car than an emergency rescue vehicle,” and Republicans are not going to miss the opportunity to point to the failures of politicians that set it in motion.

That doesn’t mean that the law will be repealed—especially as the GOP itself is short on solutions for the America’s health care dysfunction. Rather, it means the debate will stay alive, and it will be fueled by persisting anxieties about the cost of health care. Many voters are finding that healthcare costs are consuming a larger and larger share of their budgets, and the rising cost of insurance is slowing the growth of their incomes.

Solving this problem will require major, market-oriented reforms, coupled with new innovations in the private sector (we’ve listed a few potential avenues for future reform). If politicians want to really meet voters where they are on healthcare, they need to do more than point out the health care crisis; they must think creatively about ways to make U.S. healthcare delivery cheaper, faster, and more affordable. The 2016 presidential contenders should have their staffs looking closely as the subject as well—because as Domenech points out, this issue is not going away.

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  • Andrew Allison

    ACA is about health insurance, not health care. Making U.S. healthcare delivery cheaper, faster, and more affordable is a very important goal, but don’t confuse it with insurance issues..

    • Jim__L

      Solving the health care issue will make the health insurance problems far more tractable, and should be (should always have been) the priority.

      ACA makes that problem more difficult to solve, so… #RepealTheLaw.

      • FriendlyGoat

        Would it be too much to ask if we just go ahead and “solve the health care issue” BEFORE we dwell on “repeal the law”?

        In other words, OF COURSE “solving the health care issue” is a dandy idea, sooooo let’s first tell each other what those solutions are, then implement them, and THEN get rid of the presumably-superfluous ObamaCare, in that order.

        • Dale Fayda

          Why get rid of Obamacare at all? You’ve been telling us all along that “it’s working”, remember? I can vividly recall numerous arguments we’ve had on this topic.

          Well, is it “working” or not? If it is, then there is not need for repeal, right? And if it isn’t, why isn’t it?

          Forward! Ha, ha, ha, ha!

          • FriendlyGoat

            If the “health care issue” was “solved” for people, we would not need the ObamaCare approach. Once you and Jim get that done for us in a way that does not expose the lower half of the people to bankruptcy every day of their lives, we can dispense with the current law you don’t like. In the meantime, of course, since the “issue” IS NOT otherwise “solved” for millions of people, ObamaCare IS WORKING better than having done nothing at all.

          • Dale Fayda

            Well, there you go then. What’s this “debate” non-sense? Obamacare is “working”, as you just emphatically told me and if there are any tweaks to be made to it, Obama will just do it with his “pen and phone”, that you very much. Any opinions to the contrary are racist, sexist, homophobic and smack of white privilege.

            Forward!

          • FriendlyGoat

            C’mon, Dale. You know I am touting the imperfect ObamaCare in the ABSENCE of other talked-about-but-never-implemented “solutions” to health care financing.

      • Andrew Allison

        You’ll get no argument from me that the US health care system is a cost-ineffective disgrace providing inferior outcomes for twice the cost of other developed nations. Unfortunately, the special interests are so entrenched and the visceral reaction to any hint of socialized medicine, that doing so will be a long, hard slog. Meanwhile, we have the disaster of the ACA insurance program, for which premiums and deductibles are sky-high not directly as a result of the cost of health care, but because of the coverage requirements. What I suspect is already happening is that group insurance and deductibles are going up to subsidize the money-losing ACA policies. The cost of health could be reduced overnight by introducing real competition, i.e., by eliminating State barriers to entry and allowing catastrophic insurance (when people figure out that ACA is, in reality, very expensive catastrophic insurance, premiums will fall.

        • FriendlyGoat

          When you allow any company from any state to write coverage for which claims are low, then premiums will fall. That entails tailoring policies to not cover “very much” so that premiums can be not “very much”.

          I will compliment for giving some kind of nod to “socialized medicine”.

          • Andrew Allison

            No, it involves introducing competition by allowing the market to decide what sort of policies should be offered. I am adamantly opposed to socialized medicine (don’t confuse insurance with care, sigh).

          • FriendlyGoat

            Well, since there is no advanced country on earth where an un-regulated health care market is delivering good outcomes at sensible prices, I guess we would need you to explain what you ARE for.

            The competition you want to “introduce” is that of citizens doing the competing for the benefit of the insurers and employers. I have told you an absolute “truism” that policies which don’t cost much don’t cover much. You are not so dumb as to think something else. PEOPLE need to keep control of the policy provisions, not the “market”.

          • Andrew Allison

            You confuse “un-regulated [sic] heath care with single provider healthcare. Furthermore, all health care is regulated. There are several advanced countries which mandate either single provider (with optional private insurance) or private insurance insurance and private health care (all of which provide markedly better outcomes that the US disgrace).
            You are also wrong about the competition. Given the impossibility of achieving the economies of scale of single-provider insurance, a.k.a. Medicare-for-all, what I want is free and open (and ferocious) competition by insurance companies for the premium dollar.

          • FriendlyGoat

            There really isn’t any good reason we have not already done single payer. There are reasons, but none of them good.

          • Andrew Allison

            My God, we agree on something at last [grin]

          • FriendlyGoat

            Actually, we’ve been here before and—to my continuing astonishment—-we are in agreement on this. Unfortunately, though, I have never felt you would otherwise prefer the domination of government by the sufficient numbers of liberals it would take to get this one thing done. Am I wrong? (grin)

          • Andrew Allison

            Um, I seem to recall that it was a 100% “liberal” vote which passed the Abominable Care Act. They didn’t take the opportunity because they couldn’t: The sad truth is that our reprehensatives on both sides have been bought-and-paid-for by the care pharma complex which actually wrote ACA.

  • Fat_Man

    The GOP may not have solutions. But, they can, and will if they take the White House in 2016, repeal the mandates, including the coverage mandates. Then we will watch the rest of it implode of its own weight.

  • FriendlyGoat

    “That doesn’t mean that the law will be repealed—especially as the GOP itself is short on solutions for the America’s health care dysfunction.”

    Before we have another “debate” about this spilling into the 2016 election, it would be nice to stipulate that the ONE actual idea the Republicans ever had——selling insurance across state lines—–absolutely IS SUBJECT to what we could now call the UnitedHealth rule. The insurers ARE NOT going to sell you something other than products in which they “find profits”. Those profits come from YOU, dear voter, not from anywhere else.

    • Dale Fayda

      What’s to “debate”? The official position of the Obama regime and of the Democrat party is that “it’s the law of the land” and that “it’s working”, is it not? According to the DNC, et al, Obamacare is a smashing success and will be a huge boon for the party in the next election, just like it was in 2014, right?

      Personally, I see no need to “debate” Obamacare at this point – after all, didn’t all of its selling points turn out to be 100% accurate and isn’t the electorate overwhelmingly in favor of it? [Sarcasm…]

      • FriendlyGoat

        Okay, sarcasm duly noted. Now can we move on to something more substantive?

        • Dale Fayda

          Substantive? Not a chance!

          Obama and the Jonathan Grubers of this world will never admit that there is anything wrong with their “signature achievement”, so it will be left to rot on the vine as is. At this late stage of the game, everything Obama does is about the “narrative” and his “legacy”. You don’t think that Obama is going to accept any “substantive” changes to it now, regardless of who proposes it, do you (pause for hysterical laughter…)? No, as long as Captain Transparency is in office, this piece of offal will be left to rot on its own, with the Democrat party strenuously pretending that its stench of failure is the sweet smell of success.

          And what you and I do on this site is just idle conversation, so nothing “substantive” is going to happen there either.

          • FriendlyGoat

            Not tonight, apparently.

          • Dale Fayda

            Ok, ok, don’t get so sore.

            You want “substantive” – here it is: http://chicago.suntimes.com/politics/7/71/1147693/health-spending-report-2014. Lots of substance for us to dig into…

            And to further illustrate my previous point, shortly after this HHS report came out, Obungo said the following: ” “The Affordable Care Act is working and is fully integrated into an improved American health-care system.” “Discrimination based on pre-existing conditions is a thing of the past. And under the law, health-care prices have grown at the slowest rate in 50 years, benefiting all Americans.”

            So, there you go, straight from the “smartest man to ever hold the Presidency” – it’s “working”.

        • CosmotKat

          What would be more substantive in your view?

          • FriendlyGoat

            A serious discussion on how to provide adequate medical care to people of all income levels without paying double what we should (like is happening in America) or bankrupting most people (like we would be without employer group plans, Medicare, Medicaid and ObamaCare).

          • CosmotKat

            That would be a worthy discussion, but do you really believe this can be accomplished in an era and in a climate where one party, Democrats, harbor a sense of moral superiority and hate toward those they disagree with? The employer group plans were the brain child of the FDR administration and it worked reasonably well. How many people were truly bankrupted under the employer based plan. I think if you look at the data it was not a very large percentage of people. What we have now is an IPAB death panel who would arbitrate who dies and who gets care and how long they wait and how much it will cost? Current thinking on the left is anything short of socialized medicine is a non-starter and the right prefers options, freedom to choose and less government oversight and regulation which helps jack up costs for everyone. How do you start that discussion in an environment where the Democrats would not be willing to scrap their egregious law and do it right this time?

          • FriendlyGoat

            You START by admitting that the one idea at the center of every Republican “plan”——selling insurance across state lines (from the least-regulated GOP state)—–is a Trojan Horse to lower the standards of all health insurance, including employer group plans and THAT ONE is off the table. After that, most everything else can be on the table. You say Dems are “one way”. Try stipulating that one thing to Republicans and see what happens. They will be first speechless, then combative, because they do not have ANY other comprehensive idea.

          • CosmotKat

            I think you are misrepresenting what I wrote since I said nothing about what you claimed I wrote. Please reread and try again. Knock what off?

          • FriendlyGoat

            You asked how to start talking across the political divide at this time and I told you how to start. “Selling insurance across state lines is off the table. Everything else is on the table”. It’s pretty simple.

          • CosmotKat

            That’s not a starting point that’s a demand to accede to your point of view and it’s not the question I posed. Another of your typical progressive two-faced political arguments.

          • Andrew Allison

            You’ve made a couple of inaccurate observations about UnitedHeath, which is the largest company in the health insurance field. It has apparently decided that it can’t make money (remember, it’s a public corporation whose shareholders expect it to do so) selling ACA policies, a small proportion of its overall business. Like all other insurance companies, it suffers the unnecessary overhead of being individually licensed by each-and-every-one of the 50 States across all its lines of business. You also continue to insist that increased competition doesn’t reduce costs. We agree on what the solution should be, but given that it ain’t gonna happen, the next best thing is increased competition. Ditto for doctors and hospitals.
            .

          • FriendlyGoat

            Golly, Andrew, if we agree on a liberal solution and we agree it is very difficult to get enacted, do we HAVE TO then do a 180-degree turn and actively support the exact opposite as an alternative? Today I wrote a comment elsewhere against “selling insurance across state lines”. Here it is:

            When it comes to replacing Obamacare, there is only going to be ONE over-riding idea from Republicans that matters to them. It will be fast-mumbled along with a bunch of other minor ideas which don’t amount to anything, but here is the ONE thing they will want to “put over” on you, hoping you’re not looking and NOT THINKING:

            They want to “sell health insurance across state lines” and they will tell you this is necessary to get insurers into “competition” for citizens’ benefit. The actual effects will be as follows:

            1) Republicans will first want to repeal federal standards for health insurance policies as exist now in Obamacare and return all regulation of policy provisions and consumer protections TO THE INDIVIDUAL STATES.

            2) Republicans will want any policy defined and approved by ANY state government to be allowed for sale in ALL states, This is the essence and meaning of “selling insurance across state lines” and has the following practical effects:

            3) Citizens of 49 states will lose complete control of defining policy standards in their states because the worst policy provisions from whatever 50th least-regulated state will suddenly be available to both individuals AND EMPLOYER GROUPS from “across state lines” by definition.

            4) GOP-controlled states (and there are MANY of them) will be put into a race to see which one can reduce policy standards and consumer protections to the lowest level in policies to be sold nationally from whatever then turns out to be the least-regulated place in the country. This race could go on for the rest of our lives—-downward.

            5) Whether it’s Mississippi, Oklahoma, Utah or some other place of perpetual and glowing-RED politics, the Republicans of the state which wins the race to the bottom will define health insurance standards for the country. Employers will absolutely fall over each other converting their group plans to new lower standards—–first the small employers, eventually all of them. Citizens of 49 states will be powerless to stop it.

            This one little teeny-tiny detail—-to be sold to YOU on the harmless-sounding idea of increased competition—–is a gigantic hazard for families everywhere. LISTEN UP. You will not hear ANYTHING from Ryan and Company in either 2016 or 2017 that does not include this concept. Please have the discernment to know what it entails.

            For those who profess to believe in STATES’ RIGHTS, you need to know that this is a coup to absolutely NEUTER the rights of citizens in 49 states to decide their state-level health insurance standards. It’s a “big dang deal” and it will be ironically sold to you under the guise of supposedly increasing your state-level rights when it will actually be killing them deader than dead

          • Andrew Allison

            Nope, it’s the best alternative to the impossible dream. Furthermore, it’s not up to the citizens to decide their state-level health insurance standards — ACA has (at enormous cost to both the insured and the taxpayer) done that for them — but to choose among the offerings of companies in the business.

          • FriendlyGoat

            Well, I would have liked to believe you about your preference for single-payer, but your “alternative” recommendation doesn’t fit it. So, I guess we’ll go back to our normal positions of liberal me vs. conservative you.

          • Andrew Allison

            Oh, please. We’re agreed that Medicare for all is the sane solution to the insurance problem. The question is, given that it’s at best improbable, what’s the best alternative. And for the umpteenth time I’m a proto-Jesuit, not a conservative.

          • FriendlyGoat

            Well. then why on earth are you wanting to give away citizens’ health care financing TO the one plot conservatives now want most?

            You may imagine that I just copy my ideas in from HuffPo or somewhere. I don’t. My opinions about “across state lines” are independent ones and any resemblance to the writings of others on that subject is pure coincidence. Republican leaders absolutely KNOW that there is no “competition” coming from insurers in any states which can or will much affect the costs for employer groups. They are being asked to deliver an arrangement where citizen expectations of health care coverage can be dramatically lowered, and “across state lines” is it—–as surely as the sun shines. It is an utter Trojan Horse and that is the reason it is and will be insisted upon by the GOP at all costs. It’s all they’ve got as an idea, it can deceptively be made to sound “plausibly beneficial” to citizens when it isn’t, and not really suitable for proto-Jesuits or anyone else not cool with misrepresentation of the goals of a plan.

    • CosmotKat

      Why do you see profit as a bad thing? We all could be paying a lot less and United Health care would find profit if not for the intervention of this administration into transforming health into a welfare like entitlement. When so much of the tax payer money that government obtains in what they call revenue (only Democrats would call it that) is skimmed off the top to pay over bloated agencies, graft, and political pay offs. What’s left floats into the market thus necessitating even higher premiums and more taxation leading to more federal agencies, government employees, graft, and political pay offs. When does this cycle end and why do you see corruption more appealing than the profit motive? The profit motive in a capitalistic society has done more to reduce poverty, increase standards of living than corruption in any time in our history.

      • FriendlyGoat

        Thirty-three years ago I led an accounting department for a private company with about 500 employees which had been purchasing a group health insurance plan from a traditional for-profit insurance company. We made a decision to hire a third-party administrator, write our own “plan” and go “self-funded”—-paying our own claims instead of buying insurance (and thinly covering our top-end exposure with a “stop-loss” policy for claims above a stated level which was so high we never hit it.)

        This was a business which decided that it (we) no longer wanted to pay a margin of “profit” to an insurance company for writing health insurance. It (we) saved a lot of money each year for the following decade that I stayed at that company. Was my employer either nuts or some kind of evil “socialist” for doing such a thing? Were we guilty of seeing the former insurer’s profit as a “bad thing”?

        Would we individuals be nuts or evil now for having a similar inclination to not want to enrich the shareholders of UnitedHealth if we don’t have to?

        (Yes, I already know that HSA’s with a catastrophic-coverage policy over the top are designed to do a similar thing for individuals, and they are okay for people who have enough earnings to fund them. As a society, though, we have to remember that about half our people don’t—-so HSA is only sensible for the upper half and the lower half requires help such as ObamaCare and Medicaid.)

        • CosmotKat

          What was the motivation for your plan change? Lowering your own costs, providing better access to health care for your employees, and in turn raising the company bottom line. That’s the essence of freedom to choose what’s best for you, the company, and your ability to create corporate value. The win-win is better health care cost and more money for the company bottom line. Profit motive lingers in your explanation.

          • FriendlyGoat

            The exact motivation for the plan change was to MAINTAIN very high-quality health insurance for the employees and their families in the face of ever-rising premiums. The goal was not to enhance the company’s bottom line. I worked very closely on this with the company president and majority owner. He was not at all interested in spending less. He was interested in not having to charge employees anything or cut benefits as costs went up annually. It was a VERY generous plan coming out of “the old days” of the 1970’s (union days) when generous plans were more of a norm. In our particular case, NO premiums were charged to employees for either their own coverage or that of their families if they had families, AND the deductibles and co-pays were very low.

            The irony of this, CosmoKat, is that you are trying to argue that my company then trying to cut out the profits of a UnitedHealth (it a was actually another carrier of the same for-profit type) was a good thing—–but that a mere citizen interested in cutting out the profits of a UnitedHealth today would be a bad thing. Remember asking me “Why do you see profit as a bad thing?”

          • CosmotKat

            There is no irony in my comments at all. I asked you a question and suggested three outcomes that represent the fundamental goals of a free market. Whatever argument you are trying to make looks like the typical progressive two-faced political argument marinated in intellectual dishonesty.

          • FriendlyGoat

            Well, I guess I could call you a liar and a jerk too. How about that?

          • CosmotKat

            That’s fine, but who is the liar? Not me? Who’s the jerk? Well you’re the one making the two-faced political argument. But feel free to be a juvenile and lash out by calling names. It seems like that would be your most coherent thought.

          • FriendlyGoat

            Nice try. No sale.

          • CosmotKat

            Nice try. Who cares.

          • FriendlyGoat

            You do. That’s why you are bothering me here, but I wish you weren’t.

          • CosmotKat

            Wrong, I find you amusing. Like a Kat playing with a mouse or perhaps in your case a rat.

          • Anthony

            FG, excuse the interference but this is your most recent exchange I located. So, here’s a considered opinion on another matter you take seriously: http://www.thenation.com/article/how-the-roberts-court-undermined-sensible-gun-control/

          • FriendlyGoat

            Thanks #1 for “interfering” with my exchange here with CosmoKat. It was devolving to another junk-exchange with another perma-nut.

            Thanks #2 for the link. In retrospect of some of the awful things done by the five conservatives of the Roberts Court acting alone in their 5-4 decisions, I have concluded privately there is only one strategy for “containing” their right-wing activism. That is to mount a public-awareness campaign that NO decision should ever again be made exclusively by the five justices which are from one party (Republican), one gender (male) and one church (Catholic). We need Americans to find something “inappropriate” in that sort of jurisprudence and to talk about it every day from the rooftops until the five justices themselves are shamed out of voting together and against the others in ANY case on ANY matter for the sake of “appearances”.

            I have advanced this idea in comments before and have been accused of Catholic-bashing, when actually what I want is simply to USE the wedge in front of our eyes to stop Scalia, Roberts, Alito, Thomas and Kennedy from getting away with Republican decisions made all on their own. The same argument would apply if they were five of a kind Methodists, Baptists, Mormons, Jews, Muslims or any other denomination.

            A public backlash against a Court of “one party, one gender and one church” (any church) is a powerful tool we neglected to mount when we SHOULD HAVE—-before Heller, Ledbetter, Citizens United and a host of other disasters. But there are important future cases, and it’s not too late right now to “influence” those with the one tool available, forcing the issue of “appearances” in a BIG PUBLIC WAY. Net, net, if we split the votes of those five, we get a better decision on ANY matter.

          • Anthony

            FG, though I understand your discouragement and sympathize with your sentiment regarding 5/4, we are a country of laws. The Majority decides in Supreme Court docket cases. Now, I agree 100% that public (everyone) needs to be made more aware of importance of Jurist nomination and selection to the High Court of Land – potential ramifications thereof. And quite welcome #s 1&2.

          • FriendlyGoat

            Well, certainly we are all concerned about who is appointed in the future to the Supreme Court, and that’s a function of presidential politics. But we have the justices we have, and maybe for a long time to come. Five of them have caused several different catastrophes and I think we ought to be looking for the key to keeping them from continuing to make more messes. Shaming them on appearances is worth a try compared to alternatives of living with their bad decisions, no?

          • Anthony

            External pressure is what you imply (focusing attention on their judicial leanings and potential decisions going forward). How does that change their inclinations to decide, as we both know institutional structure? Short of composition change FG, will alternatives in your mind change many decisions (The Supremely Political Court)? We certainly don’t have an insentient Court – and never have. Just have to stay in the fight FG (I remember a professor saying “we are under a constitution but the constitution is what the judges say it is.”).

          • FriendlyGoat

            Well, we WANT the Constitution continually interpreted for modern times, because—–despite claims by originalists to the contrary—–the thing simply does not address many modern issues directly.

            We just don’t want bad decisions on guns, corporations, campaign finance, voting rights, gerrymandering, labor relations and a host of other poorly-decided cases, virtually all of them coming from the same five. My personal opinion is that the more we “help” society notice that the particular opinions we received exclusively from the gang of one party, one gender and one church coincide with poor jurisprudence, the LESS of it we will have going forward.

            The idea that these men are above being swayed by implied (or explicit) accusations of fraternal impropriety to me just does not hold water. The good Catholics should be profoundly embarrassed by the social side of some of these decisions from THEIR guys and the good non-Catholics should be saying, “Whoa, why is this all associated with just the members of one doctrine anyway?” Meanwhile, that level of Court is ALWAYS concerned with “appearances”, and we the citizens, seem to be the only ones ignoring that facet.

            More cases are coming. Many of them are of substantial import.
            Are we to stand by and do nothing after our experience with a decade of judicial assault from the right? I think we could do a lot better and all that is needed is the “talking cure” about the curious equation of One Party + One Gender + One Church = Junk Rulings—–for about a decade. It’s time to STOP IT.

          • Anthony

            There is “nothing” in error with the above; I think you are correct; the public needs to do more talking (at least those most affected and most vulnerable – generally the less engaged). But, I always remain conscience that the Supreme Court is something of an aristocratic branch (its members are appointed rather than popularly elected; their tenures are lifetime and there exist no formal accountability once in office). Yet, I truly recognize your anguish.

            “Judicial activism that appears to strengthen authoritarian and corporate class interests is acceptable. Judicial activism supposedly that defends democratic working-class rights and social equality invites attack. This double standard should remind us of the underlying and inescapable nature of class politics – even for those who claim to represent more elevated principles.”

          • FriendlyGoat

            Since you have correctly observed that the justices face no “formal accountability” once on the bench, I am suggested a minor lever to exert some informal accountability. We are not Marxists for questioning Citizens United and McCutcheon, not to mention dilution of voting rights. We are more nearly just acquiescing to Fascism by allowing those cases to transform our elections in a democracy. When corporations buy the government and government (via the Supreme Court) returns the favor to corporations, what else are we to call that?

            Karl Marx was a nutcase and does not inform my philosophy, BTW.

          • Anthony

            I know you’re not a Marxist; perhaps you thought you were addressing someone other (I used analogy because it came to mind; perhaps I should have said the established authority rather than the rebel). Meanwhile, I will not take liberty and call Karl Marx anything beyond 19th century exponent of a view of capital and its European impact.

            I am in accord with exerting informal accountability vis-a-vis Court. And questioning as well as working to overturn represents Democracy as struggle. Regarding Fascism, well you know how it starts.

          • FriendlyGoat

            Well, knowing you as I do, I did not believe you were calling me a Marxist—–but you seriously wouldn’t believe how many other people do on a regular basis. So, when Marx comes up, I always disavow him and the entirety of collective economics in his name.

            The question I saw quoted recently which more nearly resembles my economic thought is this: How much improvement can we achieve
            WITHOUT a “revolution” and WITHOUT pretending to unseat capitalism and upend the social order? We don’t want rid of liberty and free enterprise. We just want to make those work for people all over the spectrum. Our conservatives of the Supreme Court have not been helping.

          • Anthony

            FG, you get no argument from me. Regarding the labeling, remember it says more about the one doing the labeling than it does about your view/perspective/ideas/etc. If anyone has paid attention, you write in support of capitalism frequently (nuance sometimes escapes) And there’s nothing wrong at all in wanting it to work (ALL of US or NONE). I reread Othodoxy Chapter 5 (G.K. Chesterton) recently for perspective on internet commentary – reread it when you get a moment.

        • Jim__L

          There you are again, saying the Federal Government needs to step in to make sure everyone is above average.

          • FriendlyGoat

            You have appeared to claim affiliation with pro-family politics. Health care is where the rubber meets the road on that claim. You can suggest that poor people’s babies are “below average” if you want.
            I think you’re about to be off in the weeds.

          • Jim__L

            No one’s babies will have a decent future if the government goes bankrupt making more promises it can’t keep, and alternative ways to distribute social services (churches, charities, etc) keep getting pushed out of business by leftist government takeovers and social agendas.

          • FriendlyGoat

            Churches and charities are still exempt from taxation. The only thing that pushes them out of relevance to do good work is to reduce the income and estate taxes of their contributors, causing donations to them to be less attractive.

          • Jim__L

            Catholic Charities have been pushed out of the adoption business after (literally) millenia, to further a political agenda that needs Biblical teaching to be sidelined for its own ego.

            These charities are catching further flak for having a conscience about abortion.

            It is not a good thing for Government to be involved here.

          • FriendlyGoat

            And just when I thought we were talking about health care in general.
            Nope, apparently we’re off to abortion and gay marriage. Oh, well.

          • Jim__L

            The totalitarian agenda of the Left mean that you can’t separate them.

          • FriendlyGoat

            To get even with disdain for abortion and gay marriage, the church people need to assault health care for half the population? Please tell me I’m “stretching” the position of your church or any church with that question..

          • Jim__L

            It’s not assault. It’s presenting alternatives.

    • Jim__L

      Please note, unlike pharmaceutical companies, health insurance company profits have always been modest (5% or so). While that sort of rate would be really, really wonderful for me to have on my savings and checking accounts, it really isn’t usurious by any stretch of the imagination.

    • bannedforselfcensorship

      HSA’s were also a Republican idea. So are tax credits for health insurance.

      McCain’s plan would have been simpler, easy to implement and probably achieve what the ACA achieved without so much strum and drang.

      I would suggest those who prefer statist systems to fix the VA and make Medicare solvent rather than constantly ask for Single Payer. VA is single payer…fix it. Show us how awesome it will be. If you can’t…that means single payer isn’t very good.

      • FriendlyGoat

        HSA’s are a dandy idea for people with money to put in them and who can benefit from deductions. That is the nature of Republican ideas. As for the VA and Medicare, please don’t pretend those are better in a free-market setting. NO ONE wants to sell “affordable” insurance for profit to veterans with pre-existing conditions from military service and old people who are OLD and will all die with “end of life care”. You are asking me to prove that all-government solutions are inferior to imagined alternatives which, in fact, do not exist and never did. Both programs are financial life savers for millions of people AND their down-line families. Don’t imagine you can sell me on the idea they are some kind of “mess”. They are not.

  • JR

    Obama had to lie a lot, like a LOT to get this passed. Now that people are realizing they’ve been had, they are pissed off. Seems pretty reasonable.

  • CosmotKat

    The obvious revealed? The usual refrain that Republicans have no or are short on ideas is a false narrative, but why let a bit of misinformation get in the way of yet another article pointing out the mess this administration has made of the health care system. The only people benefitting are those with subsidies and the elites who get to avoid the morass, like the politicians who gave us their nightmare, and the vast array of cronies who get their palms greased by Democrat patronage.

  • Ivar Ivarson

    “its inability to find profits” or even cover insurer’s outlays.

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