Originally Posted by brokencycle
The far Left, the Bernie Sanders of the world, wanted this so it would fuck up and they could get single payer. They didn't actually want this system, but they pushed for it anyway because their solution was unpalatable for the majority of Americans.
I liked some of the provisions of Obamacare, but as it started reached the final version, that's about where I settled. I was hoping it would be more or less functional, but still bad enough that we needed to fix it. Unfortunately it looks like the result will be the the Democrats emerge terrified of touching healthcare again and the Republicans are only going to expend enough energy to kill this and go back to the old system (if even that much). We're probably
better off than without it, but it's not at all obvious. Some people came out a lot better than others.
With that being said, there have always been people on the Right arguing for tort reform and shopping across state lines for health insurance which I think would have far greater impact on the cost of health insurance than forcing people to buy it.
The insurance marketplaces are a good idea, especially as they start functioning better.
I'm not sure how well shopping across state lines would have worked. I feared a rush towards the lowest common denominator. It worked ok for credit cards, but I don't think letting health insurance companies all cluster in the least regulated states would have been a good model. There just weren't enough meaningful safety nets for health care at the national level.
We need to decouple insurance from employment, but people are happy with it generally, except when they change job or get some kind of illness that then locks them into their job.
Yup. Absolutely no argument there.
I am not against changing the system, and I think what piob talks about using a Bismark style system. From what I've read on the system, places like Japan and Hong Kong where most tax dollars go to covering basic and emergency care while people still get private insurance for everything else (or the flexibility to go to additional hospitals). Although these types of options are never discussed.
The last line seems to be the important part. Big ideas don't even get talked about these days.
Even with a better fundamental system (and I like that one too), I think we need to start addressing the amount of care we consume. We've got a messed up culture on medical care, both from the consumer and supplier end. This is especially true for the oldest and sickest people, where we spend most of our health care dollars. It's not just the fatties costing us money, it's Grandma getting emergency surgery at 91, staying on life support for three weeks, then dying anyway.