Obamacare

When Will Liberals Answer for Obamacare's Failures?

Blaming Republicans not going to cut it.

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These days, there's been a lot of discussion about conservative media's culpability in creating unrealistic expectations and warped priorities among Republican voters. It's a reasonable critique. My question: When are we going to have this conversation about the other side—you know, the one that enabled the passage of a massive partisan health care reform law that's failed to deliver on almost all its promises?

No doubt, you'll remember all those romantic charts and stories from the liberal smart set predicting Obamacare's affordability and success. Remember the jeering aimed at conservatives who argued that state-run markets inhibiting genuine competition and increasing regulations would only spur costs to rise? "Lies," liberals said.

In 2014, the Washington Post's E.J. Dionne asked a valuable question: "Is there any accountability in American politics for being completely wrong?" The answer: Of course not. Not for conservative talkers—and definitely not for liberal pundits who keep modifying the meaning of success.

At the time, Dionne argued that the Affordable Care Act was doing exactly what its supporters had predicted, "getting health insurance to millions who didn't have it before." In reality, that was only one piece of Obamacare's promise, and even that accomplishment has been retroactively simplified to create an impression of unqualified success. Far from it.

Of course mandating and subsidizing health insurance will decrease the number of uninsured. Yet punditry on the left seems to be under the impression that coercing people to participate is revolutionary policymaking. Countless times in 2009, the president promised that exchanges would offer those newly insured Americans more quality "choices" and "affordability" and push down rates overall. (He promised the rest of us that health care premiums would fall by $2,500 for a family of four. Instead, they've risen by over $4,800.)

New administration data released this week find that Obamacare premiums will spike an average of 25 percent across the country for benchmark plans in 2017. Americans will be forced to forfeit plans they like or lose insurance altogether and accept a tax or fine—or whatever liberals are calling their state-enforced mandate these days.

But don't worry; consumers on exchanges will also have far fewer choices. The number of health insurance carriers in the exchanges will drop from 298 this year to 228 in 2017. In five states—Alaska, Alabama, Oklahoma, South Carolina and Wyoming—there will be only one insurance company providing plans in 2017. It's one too many for many on the left.

Obamacare is working so well that Democrats are now pressuring Republicans to fix it and Hillary Clinton is arguing that to save it, we need a "public option"—a euphemism for a government-run insurance program. You can't save contrived marketplaces, because they never work. They don't work even when you allow cronyistic insurance companies to write policy. They don't work simply because technocrats massage numbers and cram them into a line chart.

Even as he was boasting about his signature achievement this past week, President Obama conceded that six years after passage, Obamacare is still experiencing "growing pains." You know, it's just like a "starter home," he said. "You hope that over time, you make some improvements."

Rest assured, those "improvements" never mean opening up markets or loosening restrictions. In other words, health care reform was exactly what many Republicans feared it would be: a way to incrementally socialize the system.

"We think they will ultimately be surprised by the affordability of the premiums, because the tax credits track with the increases in premiums," Kevin Griffis, assistant secretary for public affairs at the Department of Health and Human Services, reassured exchange users after the rate hikes were announced.

There are about 10 million customers who purchase their health care through HealthCare.gov and state-run offshoots. With no effective national reform in sight, that number will most likely grow. Although these consumers will have fewer choices, they will still receive financial assistance to offset the rate hikes. A spike in rates on the benchmark plans means more subsidies. Someone has to pay for what turns out to be little more than a new welfare program.

Unlike the media seers who saw Obamacare paying for itself—magically bending the cost curve in the right direction and creating vibrant pretend marketplaces that offer uninsured Americans an array of affordable choices—I can't see the future. The trajectory of the law, though, offers us two choices, broadly speaking.

Republicans could let the law die. They could then reform the health care system by allowing it to function more like every other successful market in the country—with minimal interference from politicians. Or we could all accept another giant unfunded liability, higher taxes and further socialization of our health care system. The only question will be how quickly it will happen. One thing's for sure, though. Despite all evidence, liberal cheerleaders of Obamacare will continue to act as if the law has been an awe-inspiring success.

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  1. They’ll never admit to its failures. They’ll blame it on the fact that the government doesn’t have enough control of healthcare yet. They will clamor for more government.

    1. Exactly. Double down the clear stupidity of ObamaCare.

  2. When Will Liberals Answer for Obamacare’s Failures?

    You all are expecting an answer ?

    HAHAHAHAHAHAHAHA!!!

  3. Rand Paul will fix it in 20/20. (And fortunately since Hillary will be president we will still have a country in 4 years.)

    Jill Stein approves this message.

    1. Slow your roll. Jill thinks Hiliary will start WW3 so the idea the country will still be here in 4 is arguable. Hiliary will lose and thus will finally have something in common with her supporters and predictors of her victory….being huuuuge losers.

  4. Being a socialist means never having to say you’re sorry.

    They were trying so hard to do the right thing with other people’s money. So, so hard.

  5. Obamacare’s affordability and success is makes a good discussion in between people. I don’t think if a leader don’t get a support from other people he cant follow to its success. Obamacare is working so well that Democrats but some problem makes in its service. I read this in Cheap dissertation writing services uk as part of my study.

    1. A better translation service would improve your spam results.

      1. Not much goodly was the English spoke?

        /bot

    2. That made as much sense backwards as it did forward for me

    3. Huh, on a quick check of mentally diagramming a few sentences, the thing seems to be speaking in good, correct sentences, all the spelling seems correct. He/she/it even provided some sort of link, which is good manners when referencing some fact and did it as a clickable link, showing the intelegence to actually use the HTML of this comment board, something that’s still beyond me.

      Yet, despite all that, I have no idea what is actually being said.

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  7. It’s all the fault of the conservatives because they didn’t warn the lefties hard enough that the plan was a clusterfuck of biblical proportions.

    1. It’s all the fault of the conservatives because they didn’t warn the lefties hard enough that the plan was a clusterfuck of biblical proportions. exist and are easy to use as a scapegoat.

    2. It is the fault of conservatives because they did not join the Democrats in their lemming march and have their fingerprints on ot as well.

  8. That’s just the point. Liberal don’t have to answer for anything anymore.

    1. We have lots of answers xD. No one agrees with us though…

      1. Unfortunately you lot have a large portion of the population who misguidedly agree with you.

        1. Funny how that works out

          1. Yeah, you and your pack of ignoramuses hoping for free shit.

            1. Would this be easier for you if I just screamed about taking your guns and raising taxes?

              1. “Would this be easier for you if I just screamed about taking your guns and raising taxes?”

                Why? A fucking ignoramus is presumed to be in favor of those, and you’re proven to be a fucking ignoramus.

    2. Liberals don’t have to answer any more because their cult understands that there were unintended consequences resulting from their leaders’ good intentions that will simply require more money and less Republicans to solve.

      Simply squeeze the evil undeserving rich person for some more tax dollars and extract any additional liberty as needed/desired for maximum control of the outcome. Easy peazy.

  9. If the aim was to end up with single payer (it was) then the ACA is working (it is).

    1. Bingo.

      Unfortunately

  10. Improvement number one – remove all exemptions of the coverage requirement, starting with congress and their staffs.

    1. Letting everyone who inflicted it get the same treatment good and hard is certainly appealing.

  11. Ignorance is strength
    Freedom is slavery
    Total fucking systemic meltdown is working

  12. The Republican solution to Obamacare will be Romneycare – giving the states an unfunded mandate to provide the same unworkable system but run on the state level. Republicans at the national level are such jackasses that they were easily defeated by an overgrown umpah lumpa whose ignorance of nearly everything makes Sarah Palin look like a genius.

    1. The Republican solution is to repeal ObamaCare.

      1. How is that a solution? Love it or hate it, the ACA happened because healthcare reform was in dire need.

        1. the only reform needed was to get the government out of heath care.

        2. “How is that a solution?”

          It gets rid of a disaster.

        3. the ACA happened because healthcare reform was in dire need.

          It’s a “solution” that doesn’t take into account the cause of the problem in the first place. It simply reacts to rising healthcare costs as if the rise in costs has no cause and is just a fact of nature. All it does is spread the costs around, and increase them in the process.

          So in sum – it doesn’t lower costs at all, it simply conceals them, and actually increases them.

          It’s exactly the same dynamic that leads city planners faced with skyrocketing rents to place a moratorium on new residential construction along with a rent control law and then wonder why rents starting going up even faster.

          The ACA can’t be defended as “we had to do something” when the something made the problem exponentially worse and didn’t address it’s cause.

          1. “It’s exactly the same dynamic that leads city planners faced with skyrocketing rents to place a moratorium on new residential construction along with a rent control law and then wonder why rents starting going up even faster.”

            And here’s where all that goes:
            “Streets empty due to strike after Venezuela’s Maduro orders 40% wage hike”
            http://www.upi.com/Top_News/Wo…..477663336/

            40% more of something that’s worth 10% of what it was not long ago, but hey, they’re all equally poverty-stricken.

        4. The existence of a problem does not mandate a government solution.

          Or, put more succinctly, fuck off slaver.

        5. mortiscrum is trying to make a funny.

        6. Rising healthcare costs are partly due to government intervention (medicare/medicaid) and over-regulation.

          If people paid cash for everything minor and had catastrophic health insurance for major stuff, the medical industry would be forced to compete, be innovative and keep costs as low as possible.

          Everything you are on health insurance and you say, fuck it I will have that or take that drug because my insurance pays, that makes this problem worse.

  13. He promised the rest of us that health care premiums would fall by $2,500 for a family of four. Instead, they’ve risen by over $4,800.

    The whole fallacy of the ACA was that forcing everyone to buy health insurance would lower the real cost of healthcare because it would increase the pool of payers. It never addressed the root cause of the costs, which are the fees charged by medical providers. And even getting the subsidies (because the cost of the premium is the cost, irrespective of the subsidies provided) can be a bureaucratic nightmare, so it doesn’t increase personal convenience either.

    Imagine forcing State Farm and All State to write a check for homeowners after their house has burned down and you’ll have a good idea of how the ACA operates.

  14. Remember when the Democrats were for slavery and the Republican Party fought against it? So Lincoln was really a Democrat. At some point the parties switched, and it was right after Obamacare was “passed”. So the modern GOP is a direct descendant of that racist Democrat Party of the past, essentially it was every congressional Republican that voted for Obamacare and today’s GOP is solely responsible for its disastrous result.

    1. I can’t tell you how many times I’ve read that the problems with the ACA were because of the republican stonewalling even though they had nothing to do with it, and more ironic is when they use this excuse they are admitting that it is a failure.

    2. I remember that the Democratic Party was/is the party of slavery.

      1. It was called the Democratic Party, but it was actually the Republican Party. And the Republican Party was the Democrat Party. Everything you think is good was always the Democrat position, even when it was called the Republican Party, and what is or was objectively bad was the Republican position, even when they were called Democrats. It’s really quite simple.

        1. It was the Democratic Party and it was full of Democrats.

          The Republican Party was formed to fight the Democrats wanting government to control people (slavery). The modern slavery is government wanting to control the economy (Socialism), people’s lives (Nanny-State) and the Police State.

  15. There is no ‘answering for failures’ with lefties. The locust horde has moved onto the evil red states that didn’t take the free-Medicaid-for-a-few-years bribe, at least that was excuse last I checked on Slate.

    And that brings up interesting point, Obamacare is not fully ‘implemented’ yet; we’re currently in sunset of the alleged ‘carrots’ phase, the ‘sticks’ part of the operation (setup for after Barry’s gone of course) is yet to arrive.

  16. It’s not failing at all. It is a massive success. The goal is to move to single payer. So the more it fails, the closer it gets to the real goal.

    1. Single Payer is the “tweak”

      1. You notice that the progressives don’t discuss the veterans health system when single payer is mentioned? The VA health system is single payer and it is not good.

        Plus, did you all see that 88% of VA employees donators were sent to Hillary? Military member don’t support Hillary or Obama like that, yet the persons who care for veterans love politicians that send troops off to get maimed.

        Job security, I guess.

        1. Broken links because I am retarded.
          https://reason.com/blog/2016/10/18/ va-clinic-leadership-reform-really-just

    2. They passed the ACA without any R votes. If they wanted single payer, they could have passed that.

      1. You think so? I think there would have been too much public outrage for that to happen.

        1. That is why they didnt take the time to read the laws or actually discuss them. They knew they had to pass it NOW or it would never pass. They could not read single payer just as easily as they could not read the ACA.

          The reason the original ClintonCare failed was it became public. They werent going to make that mistake again. But if you are going to do it in secret, you can put anything you want in it.

          1. I suppose.

            1. On the other hand, you are probably right, as they couldnt have got the votes from the Ds if it had been single payer.

              The Ds feared single payer would cost them the next election. Of course, if they had known the future, they might have gone ahead with single payer, as they were going to get voted out of office either way.

              1. This.

                They expected a few left wing Republicans to peel off and vote for passage. That sort of ‘bipartisan credibility’ would then be used to justify ‘corrections’ to Obamacare, further moving it towards single payer.

                But that didn’t happen and now they wish they had taken the whole apple.

              2. Yeah, the democrats fuck that up because ObamaCare cost them quite a few seats in the House and Senate. Single payer would have been a Democrat loss of seats bloodbath.

      2. At the time single payer would have destroyed the insurance companies loosing thousands of jobs they couldn’t do that so the next step after a few more insurers fail, due to over regulation, is to make them all public utilities like electricity and phone companies are. In the past they were also private entities.

    3. Either it works or it breaks what is left of the previous structure. It was a no lose scenario from their perspective.

  17. “Blaming Republicans not going to cut it”

    Why? What’s changed?

  18. definitely not for liberal pundits who keep modifying the meaning of success.

    Just look at the “it was just an even worse than we thought!” defenses of the unemployment rate being higher than the projected “disastrous” do-nothing scenario even when they spent a trillion dollars.

    1. To which I usually respond that that simply proves that Democratic economic advisors were utterly incompetent. Which raises the question why we should trust them again to run the economy now.

  19. What failures? If you think Obamacare is failing, you’re spreading right-wing lies. Anyone who has seen their premiums and deductible go up while access to the care they actually need has gone down is suffering from false consciousness. Everybody knows the premiums were going up 100% per year every year before the ACA was passed, and millions of people were being denied healthcare due to pre-existing conditions. Also, every smart insurer is not only making money off exchange plans, but is expanding their operations. You’ve got more insurance than you’ll ever know what to do with, for less than ever before!

    … did I miss any talking points?

    1. How could I forget?

      It’s not failing, but if it is failing, it’s because of Republican obstruction.

    2. Repeating what a prog friend said on the subject…

      Do you recall that ACA was passed through reconciliation because not a single GOP Senator would vote for it? Many of the flaws in the legislation came about because they were trying to get at least one GOP Senator to sign on. Conservatives worked overtime to make sure not a single GOP vote was given to the legislation. What were the Democrats supposed to do? There was not a single thing that could be done to make it better, such as a single payer option on the exchanges, without Republicans signing on. Something to offer competition to these insurance monstrosities. So if you want to look at why this bill is flawed, don’t look to the left. Look at the conservative Senators who tried to kill the reform in the cradle, and to the Republicans that have worked to weaken the law since its implementation. Those are the impediments to fixing the glaring problems in a law that was formulated to attract people who do not care about the sick, the uninsured, or people like you who are trapped in difficult financial circumstances.

      See, even though the Democrats had a Senate supermajority, a House majority, and the White House, Obamacare’s failings are clearly the Republicans’ fault.

      1. I love how the idea of, you know, not passing a bill you don’t fully understand is totally out of the question. Or how one of Obama’s few vetoes was used to stop the Republicans from fixing (not repealing!) the ACA is completely absent from this individual’s analysis.

      2. Intentions are magic.

      3. So they wrote in these compromises to try and get the GOP on board, even though they 1) didn’t get any GOP votes on board and 2) didn’t need the GOP votes anyway.

      4. So the prog argument basically boils down to “party line votes are bad, especially when we do them.”

        Okay.

    3. You forgot all the money being siphoned off to rich people in the form of insurance company profits. If government ran health care it would be significantly cheaper because government doesn’t waste money on immoral profits to the rich.

      1. Someday, a good many of these people will understand the importance of profit.

        While they’re standing in bread lines with empty stomachs.

        1. Profits are the price you pay for efficiency and innovation. People who only know how to ask permission and obey orders will never understand that.

          1. Profit as a price to pay has a negative connotation. It’s the reward for successful innovation and efficiency.

            1. To the person paying the profits it isn’t a reward. People need to understand that they’re going to pay anyway. They can pay profits and get innovation and efficiency, or they can pay government workers and get inefficiency and stagnancy. Though even when it is put that way, a lot of people would choose government, because government is the people while profits go to the rich.

              1. Plus, you can avoid to paying a company by not buying what they offer or buying a competitor’s product/service.

                Its much harder to avoid paying the massive Nanny-State.

              2. and we all know the government people are not rich.

                1. Not HRC and Co.; she’s broke.

        2. Progressives will always see those who give in because of something like empty stomachs as traitors. Using the coercive power of government to force individuals to make sacrifices for the greater good is what being a progressive is all about. If you’re someone who pulls back from that because the government forced you to make a sacrifice, then you’re part of the problem. You’re the enemy of progressives, not a progressives yourself.

          Progressives want to use the government to force gun owners to sacrifice their guns. They want to force you to stop consuming petroleum for the good of the environment. They want the government to force Christians to sacrifice their beliefs so that homosexuals will feel included in society. They want to force millennials to buy health insurance–specifically because they don’t need to use it.

          Forced sacrifice isn’t an unintended consequence of progressive policy. Forced sacrifice is the goal. Virtue in the progressive universe is being willing to sacrifice–sacrificing with enthusiasm.

          There are plenty of examples of this kind of thinking in anthropology–whole societies and tribes where the bigger the gift you give, the more prestige you get.

          1. In this case, the bigger the gift the more fucked you and all of us are.

            1. Well, yeah.

              I’ve seen progressives advocate a Chinese style one-child policy.

              The motivation is to save the environment, but the sacrifices they want to use the government to force on us are intentional.

              At the hearts of every progressive policy I can think of, there’s the government forcing individuals to make sacrifices for the greater good.

              Intentional forced sacrifice is their defining characteristic.

              I should differentiate between those progressives who genuinely believe that economics is alchemy and those who just see it as evil, but how do you tell them apart?

              There are naive progressives, too, who vote for progressives and call themselves progressives for the same reason they grow hipster beards, but those people aren’t the enemy. They’re the battlefield.

              1. Then when I comment that government force can always lead to the citizen dying, in worst case. They just do not know what to say.

                I guess they think force means Cool Whipboarding and paper mache glitterbombs.

          2. Too true.

    4. While the below also works, I meant to copy and paste this from the same person.

      I think that is another benefit of this law. It has pulled these massive rate hikes out of the shadows. It used to be people only said their rates went up. Now every year, we’re forced to see exactly how much. Do Americans take this as impetus for reform, though? Of course not. They want to use it as a reason to go back to a situation that was even worse, but was only even worse for people who are not them.

      1. Yeah, problem is, the number of people benefiting from the ACA is vastly dwarfed by the number of those hurt by it. You can’t get something for free, and people are generally averse to paying for things they don’t get any benefit out of.

        1. You can get away with that if the cost is small.

          “Sure this program only benefits a small number of people, but it only costs $1 per taxpayer, so no big deal.”

          With ACA a small number are helped and a large number get crippling cost increases.

    5. exactly my insurance when down by $4500.00 under Obama care, of course never mind that I no longer have insurance. I wonder where the extra money went I should be richer.

  20. Is this question a joke?

    They’re already blamed greedy insurance companies, extremists and the GOP for its failures.

    It has NOTHING to do with the piece of crap that it is. NONE.

  21. For progressives to acknowledge the failure of their economic program, they’d first need to judge their economic program in market terms–and progressives will never fault their leaders for failing to do that because ignoring and defying market forces is what being a virtuous progressive is all about.

    Refusing to acknowledge market failures to a progressive is like Jesus refusing to kneel down before Satan to a Christian. You don’t fault Jesus for refusing to do that. Jesus refusing to do that is what made Christian salvation possible, and progressives refusing to acknowledge market forces is the very thing that makes progressives virtuous to each other.

    1. All leftists understand is intentions. Their economic program was put forth with good intentions, so any disagreement or criticism is born of bad intentions. When their programs fail it isn’t the fault of the program, because the people who created the program had good intentions. The cause must be someone else with bad intentions.

      1. They like good intentions, but like I wrote above, the resulting sacrifices that are made are intentional. They want to use the government to force you to make sacrifices.

        We shouldn’t pay too much attention to what Obama says. He’s a master of the Noble Lie.

        If you look at what he did and if you understand his philosophy, the intention of ObmaCare was to expand Medicaid for the poor–and make the middle class and the wealthy pay for it through higher premiums, higher deductibles, less care, and less quality care.

        Think of two aspects of ObamaCare from the beginning.

        1) Extreme Tax on New Medical Devices

        Obama wanted the health care system to stop spending money on better care for the middle class and wealthy people and spend it on more hospital beds for the poor instead.

        2) Cadillac Health Plant tax.

        1. I don’t know why this got cut off:

          2) Cadillac Health [Plan] Tax

          The purpose of which was to force companies to stop giving excellent benefits to their employees–so that the middle class and wealthy would consume fewer health care resources–and free more resources to be used for the poor instead.

      2. ObamaCare was meant to force companies to stop offering health insurance benefits that were significantly better than average–so that middle class and wealthy patients consume less health care resources and those resources go to the poor instead.

        Those are just two examples, there are others. The point is that the sacrifices progressives inflict with their policies are not unintended consequences. They’re the goal.

        The purpose of progressivism is to use the coercive power of government to force people to make sacrifices for the common good. When people are forced to make sacrifices by progressives, it is not an unintended consequence of some other objective. They’re not always plainspoken about their objective being forced sacrifice, but forcing sacrifice is their objective, and oftentimes they do say so.

    1. Yup. Great article about the progressive charade.

      Look at those comments. The progressives were foaming at the mouth about that revealing story.

    2. I heard that douche interviewed on NPR just the other day, explaining how Obamacare isn’t failing. He’s “John Gruber,’ now, and apparently some of his expertise has grown back.

    3. He was on CNN the other day saying Obamacare is working as designed. In a sense that may be true, but I wish that the moderator would ask, “You’ve bragged before about lying to the American public about Obamacare before. How can we believe a word you are saying now?”

      1. That would be journalism.

        We know what happened to journalism.

  22. From the article –
    “Even as he was boasting about his signature achievement this past week, President Obama conceded that six years after passage, Obamacare is still experiencing “growing pains.” You know, it’s just like a “starter home,” he said. “You hope that over time, you make some improvements.”

    Headline: WHEN ARE LIBERALS GOING TO ADMIT IT HAS PROBLEMS!?!?!

    Yeah, the guy who’s name is on the legislation, the guy who’s legacy rest on the success of the bill, he just admitted it needs work.

    1. A more apt question would be, “When are liberals going to admit that the problems have been caused to government interference in the marketplace?”

      The only “fixes” that are possible for the ACA at this point is going to a single-payer system (barf) or making the penalty for not signing up for health coverage exceed the real costs for them to actually sign up for it. Even then, the penalty would have to be scaled to increase every single year.

      Government run healthcare won’t work in the United States.

      1. Single-payer would be fine by me. Allow the government to put in to place some type of basic coverage, available cheaply, that puts on a floor on coverage. Let companies go after the people with money who want better coverage.

        I agree that increasing the penalty is quite unpalatable, but it would be a very functional way to correct the system.

        Government run healthcare would work fine in the United States, if we collectively want it to work. If people want universal care, they need to accept tax increases. If people want to stick to the free markets but don’t want insurance companies being the gatekeepers to healthcare, they need to get on board with buying insurance whether they want it or not. Currently, we want the benefits but don’t want to pay the costs. Shockingly, it doesn’t work that well.

        1. if we collectively want it to work

          And that’s your problem, right there.

          The US is too big for this. Maybe single-payer could work on the scale of, say, California, or New York. That would be comparable to the systems they have in the UK or France.

          The left in this country needs to be reminded that the EU does not have “national health care.” This is not something that has ever been successful on anything like the scale that is being attempted in the US, and it is doomed to failure for that reason alone, all other ideological or market-based objections aside.

          If the idea of single-payer is even to be seriously entertained (which it shouldn’t be), it can only be entertained on a state level, not federal.

          1. Why do you think that is the case, though? Geographic area? Population? What is it about single-payer that doesn’t let it scale?

            Or is it possible that it’d work, it just wouldn’t look exactly like what other countries have. That it’d take a dedicated, good-faith effort from a variety of players. That to me seems to be the barrier, not some inherent flaw of universal healthcare or single-payer.

            1. “Why do you think that is the case, though? Geographic area? Population? What is it about single-payer that doesn’t let it scale?”

              I really don’t care. I’m tired of lefty econ ignoramuses fucking up the economy with their stupidity and ‘good intentions’.

            2. Why do you think that is the case, though? Geographic area? Population?

              Yes.

              What is it about single-payer that doesn’t let it scale?

              That it’d take a dedicated, good-faith effort from a variety of players.

              You answer your own question.

              Aside from macroeconomic questions about funding a single service from a single point across a broad geographic area over which the value of the dollar differs, you don’t have a quorum, so to speak, nationally on what this should look like and how it should work. There’s not enough common culture between, say, Massachusetts and Oklahoma, for them to want to have a universal health care system shared between them – what works in MA doesn’t necessarily work in OK, and vice-versa.

              Secondly, the larger an organization gets, the less efficiently it functions and the less able it is to respond to needs of particular individuals. This is already a problem in systems the size of the UK’s NHS.

              Even if there were a universe where 300,000,000 people across such a broad geographic and economic area could all “collectively” orient themselves toward the same goals and assumptions, that’s probably not square one in an attempt to “reform” healthcare, given that it’s more likely than not to fail catastrophically.

              1. Square one should be for the federal government to realize that the “problems” in healthcare correlate exactly with federal involvement in the healthcare system (dating back to the early 1960s), and they should at least consider getting their grubby mitts off of it and letting states tailor their own systems to their own needs.

                1. “…(dating back to the early 1960s)…”

                  I’m going with late ’40s, when Truman refused to unlock wages and companies started offering ‘free’ insurance as a proxy for higher wages.
                  Presto; you now ‘didn’t pay’ for your healthcare, so who cares what it costs?

                  1. That’s probably more correct – having “healthcare” become some vague benefit you receive that’s disconnected from the actual cost undermines the price controls on demand. You naturally are going to try to make the outcome be that you get more care than you pay for, and you’re going to create more demand than your contribution can cover.

                    Rather than address the source of this dynamic, Obamacare just tries to force people to pay into the system without using it, as if people who are now forced to pay for insurance aren’t going to just find little ways to use it in order to justify the cost – for example, a 25-year old who normally would just ride out the mysterious fever and cough in confidence that they’ll get better is now more likely to go ahead and go to the ED because, why not?

              2. What would you think of a system wherein Federal money was allocated to states with the purpose of setting up a state-wide healthcare market/system? The Fed would watch over it and make sure that certain baselines were being met (or something – the first thing that comes to my mind is ensuring widespread coverage), but the states would be largely free to design their own system for their citizens.

                1. Stop asking the libertarian/conservative contingent on this board what we all think of one kind of government solution or another.

                  The answer is: we don’t. We think the solution is to return medicine to the free market. End of story.

                  So why don’t you take that solution and give it some thought, instead of trying to continually fit a square peg into a round hole and proving yourself the very epitome of the classic definition of insanity?

                  1. We saw what that looked like, and we didn’t like it. You have some serious rose-colored glasses for healthcare prior to the ACA. Millions had no coverage at all, people died of completely preventable things for lack of coverage, thousands went bankrupt from medical costs.

                    I’m willing to accept the drawbacks of universal coverage – taxes will certainly be higher, and the average quality of care might well be lower. But, I think these costs worth it in if everyone gets a basic coverage they can count on, without having to fight with insurance companies.

                    You however are refusing to admit to the giant holes in free market healthcare system. The people who can pay get excellent care; the rest? They’re just SOL, I guess.

                    1. Millions had no coverage at all, people died of completely preventable things for lack of coverage, thousands went bankrupt from medical costs

                      And the ACA has changed nothing about any of that. It’s only made it all astronomically more expensive.

                      And you’re talking about healthcare post-2000. The system was already in a deep mess at that point, because of exactly the sorts of factors Rational Exuberance points to below.

                      As an example, in about 2005 I needed a minor procedure done, but I didn’t have insurance. When I told the doctor I had seen I didn’t have insurance, they suddenly found they could reduce the price by 50%.

                      The more it gets to be the case that people aren’t paying out of their pockets directly, the more the price floats free and is not connected to actual cost, market forces, or anything other than what the doctor can get the insurance to agree to based on what the insurance company can recover through premiums.

                      I had a mole removed about a year ago on my insurance, and it took two doctors, a number of expensive injections, a private room, some high-tech equipment, etc. I had the same thing done in the 70s in 10 minutes with a scalpel and a single Novocain shot.

                    2. Prior to the government messing up the healthcare market, you didn’t really have these problems that you’re talking about – people could get healthcare, didn’t need insurance, and weren’t commonly bankrupted by it.

                      It’s modern, government-regulated medicine that is too expensive for people to be able to afford. Government regulations have essentially forced non-profit and charity hospitals out of existence and created the for-profit health industry progressives now want the government to save us from.

                    3. We didn’t have a free market health care system prior to the ACA.

                    4. “You however are refusing to admit to the giant holes in free market healthcare system.”

                      When was that?

                2. What would you think of a system wherein Federal money was allocated to states with the purpose of setting up a state-wide healthcare market/system?

                  Why?

                  The Fed would watch over it and make sure that certain baselines were being met

                  And why is the Fed assumed to be the most qualified party to do that?

                  I’m reminded of the saga of Oakland CA’s failing school system. About 15-20 years ago, the district was performing so poorly, that the State of CA took direct management on the principle that “bigger branch of government = better qualified and more trustworthy.”

                  Of course it also means “further removed,” “less directly accountable,” “less responsive to local concerns,” “more expensive,” and “unwieldy and slow to react to actual conditions.”

                  So the school system in Oakland actual got way worse under state management. So bad that the federal government “had to” step in, for the reasons mentioned above.

                  For the reasons also mentioned above, the situation has only gotten worse. Rinse, repeat.

                3. “What would you think of a system wherein Federal money was allocated to states with the purpose of setting up a state-wide healthcare market/system?”

                  I’d think you’re a fucking ignoramus for proposing it.

            3. Or is it possible that it’d work, it just wouldn’t look exactly like what other countries have.

              Other countries have single payer systems that control costs by limiting what pharma companies and doctors can make, and by making the lives of patients miserable. Neither American lobbyists nor American voters would stand for that. And it only works in Europe because European voters are sheep and most European countries don’t have much of a domestic pharmaceutical industry.

              An American single payer system would be like other entitlements in the US: its spending would be out of control because American voters want free crap and because American doctors and pharmaceutical companies have huge and powerful lobbies in the US.

              So, it would indeed not “look exactly like what other countries have”; it would simply not work.

              That it’d take a dedicated, good-faith effort from a variety of players. That to me seems to be the barrier, not some inherent flaw of universal healthcare or single-payer.

              For any political issue, taking “dedicated, good-faith effort from a variety of players” is an inherent flaw; that is, it can never happen, and whatever it is will get distorted into a massively corrupt crony capitalist scheme.

              1. An American single payer system would be like other entitlements in the US: its spending would be out of control because American voters want free crap and because American doctors and pharmaceutical companies have huge and powerful lobbies in the US.

                ^ This.

              2. In one paragraph you say that American citizens wouldn’t stand for the limits that would be necessary in a single-payer system cause they’re not sheep. In the next paragraph, you deride American citizens as a bunch of freeloaders. Should I conclude from this that Americans are the most demanding, out of touch electorate in the world? I’m not saying this to dismiss your argument BTW, I just thought it was funny.

                You make a fair point about political viability. Another way to say what I said is “if only we didn’t have the political grandstanding and gridlock that have defined American politics for 25 years, we’d all be better off!” That’s like, well DUH.

                Still – if that is the main flaw of single-payer, than I must conclude that the idea itself is still a reasonable one, and it’s the political system – the process of implementing it – that gets in the way.

                1. “Still – if that is the main flaw of single-payer, than I must conclude that the idea itself is still a reasonable one,”

                  That’s because you’re an ignoramus.

                2. Should I conclude from this that Americans are the most demanding, out of touch electorate in the world?

                  No. It’s simply 300 million people behaving fairly rationally under the US political system.

                  Still – if that is the main flaw of single-payer, than I must conclude that the idea itself is still a reasonable one, and it’s the political system – the process of implementing it – that gets in the way.

                  The main flaw of single payer is the same flaw as any other central planning: it doesn’t work. The fact that the US political system has such a hard time pushing this bullshit onto Americans is a benefit of the US political system.

        2. Single-payer would be fine by me. Allow the government to put in to place some type of basic coverage, available cheaply, that puts on a floor on coverage.

          We don’t need laws for that; in a free market, you could get basic coverage for less than a cell phone plan, and even welfare recipients could pay for it in cash.

          The entire debate about health care reform has been about giving people top-of-the-line medical coverage regardless of income. That is, everybody is supposed to have access to the very latest technologies, most expensive surgeries, and premium-priced name brand prescription drugs regardless of income or risk or behavior.

          Of course, no other health insurance system in the world works that way. The European single-payer systems, such as they are, strongly limit what they will treat and pay for, and like all such systems are actually very expensive for the poor service they provide.

          1. The entire debate about health care reform has been about giving people top-of-the-line medical coverage regardless of income. That is, everybody is supposed to have access to the very latest technologies, most expensive surgeries, and premium-priced name brand prescription drugs regardless of income or risk or behavior.

            ^ Also this.

            When I was a child in the 70s, we didn’t have health insurance, and went to what you might call “middle shelf” medical services. They were OK, but they were in dingy buildings, you had to wait, the doctors weren’t necessarily super friendly, etc.

            I had friends who were lower on the income scale than my family (people whose parents were employed only intermittently), and they went to crappy little clinics that used to be in strip malls. They were dingy and crowded, you had to wait a long time, the staff was generally pretty rude, they didn’t have magazines and toys in the waiting rooms, etc. BUT, you could see a doctor – an actual doctor for about $40.

            Now every medical facility, in CA at least, looks like the lobby of a major tech company, and is full of tens of millions of dollars worth of the highest-tech equipment available, and this is the minimum standard to which medical facilities in CA are built.

            The trouble with socialism the way it is conceived in the US is that it’s not “a package of Ramen in every pot and a Yugo in every garage,” it’s “fillet mignon and Ferraris by order of law.”

            1. LOL.

              I sure hate to be one of those ” ‘member berry” kinds of people, but seriously, how is it that my solidly lower middle class parents (my father was a butcher, my mother a housewife) could afford health care for me and my brother when we were growing up (like you, in the 1970s)? Between the two of us continually falling off and out of things, breaking bones playing sports, and getting just about every childhood illness there was to get that we weren’t vaccinated against, my parents should have been dead broke by the time we left the house.

              But I don’t remember anyone every complaining about not being able to pay the doctor.

              1. There is nothing wrong with discussing your past or historical record.

                Remember: member berries are only bad according to Trey & Matt if they lead to memories that are offensive to progressives.

                My lower middle-class family was able to afford my medical in cash and they made sure that they got their money’s worth.

                1. Please keep your “member berries” in your pants. Thank you.

                  🙂

        3. Of course, single payer would be fine for you. You’re a slaver.

          It must be for the good of progressive-kind.

          1. Of course, single payer would be fine for you. You’re a slaver.

            I have consistently spoken out against single payer.

            It’s morons like you who can’t follow two paragraphs and then attack fellow libertarians who are responsible that this kind of bullshit keeps happening.

    2. I always thought they called it a starter home because you knew you were going to get out of it as soon as possible

  23. All of the prog talking points work because most Americans are deathly afraid to be labeled SELFISH.
    You are warned not to be selfish in church, by columnists, by your parents, by the teacher, etc. etc. etc.
    Selfishness is a badge of honor when the alternative is the envious sending armed men to enforce compliance with their wishes.

  24. When Will Liberals Answer for Obamacare’s Failures?

    Why should they? Liberals have told me authoritatively that anything that’s wrong with Obamacare is the fault of the Republicans: Democrats were forced to create legislation that had serious problems in order to get the Republican votes they needed in order to pass ACA. You know, all zero Republican votes. In different words, according to my liberal friends, the problems with ACA are really due to Obama’s bipartisanship and willingness to compromise that Republicans took advantage of.

    I’m sure they blame “the stupidity of the American people” too for making their wonderful legislation fail. Just ask Gruber.

  25. Well yes, but you never actually see “conservatives” cutting anything either. Most of the republican plans I’ve seen are just different variations on universal coverage. Obamas most important legacy is gonna be moving the overton (sp?) window of healthcare policy, I believe. I mean important as in consequential, unfortunately its a consequential step towards stopping medical innovation in its tracks. Something like 95% of new drugs come from america, and while socialized medicine has had some success in Europe, its only ever existed coincidentally with at least one huge capitalist country letting markets work their magic with someone else’s money. Medicine is, like, pretty important to quality of life. And this century, with supercomputers and the gsequenced genome, more people etc, should be innovating exponentially faster than we’ve ever seen, but some people seem really determined to freeze healthcare in its current state. Were so damn close to medicine being somepething you could design on your cell phone and print in your garage

    1. Well yes, but you never actually see “conservatives” cutting anything either

      Conservatives are just socialists that worship Jesus instead of Marx.

  26. RE: hen Will Liberals Answer for Obamacare’s Failures?

    Never.
    Socialists can do no wrong.
    That’s been proven time and again in history.
    What’s wrong with you people?

  27. Failure of the ACA is success for those who want socialized medicine.

  28. Start working at home with Google! It’s by-far the best job I’ve had. Last Wednesday I got a brand new BMW since getting a check for $6474 this – 4 weeks past. I began this 8-months ago and immediately was bringing home at least $77 per hour. I work through this link, go to tech tab for work detail,,,,,,,
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  29. When will Reason answer for helping Hillary Clinton get elected?

  30. The only difference between Republicans and Democrats is that Republicans blame Obama for everything that’s wrong in the world and Democrats blame Republicans for everything that’s wrong with Obama.

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