It certainly does seem like President Obama learned from Clinton's mistake in 93 and will instead try to systematically install a "Euro-like" national health care system. ACA is just a bridge to that outcome. Maybe not this year and maybe not even under Obama; but I think it will be an inevitable part of the democratic platform. Perhaps, ironically, Hillary will flip that switch in 2016?
However, when I personally throw all the rhetoric out the window and just think about this issue in terms of dollars and cents I'm left with this: Like most folks, I have my health care through my employer. Right now, with premium payments and my FSA Account, I'm spending about 6K a year on my health care (pre-tax federal) - and that's only if nothing goes wrong with anyone in my family. I have to wonder. How much would my taxes go up to support a single payer system? One thousand dollars? Two thousand? How about Three Thousand? Hell, I'd still be wayyyy ahead of the game with plenty of money left over to put back into the economy instead of throwing it into this gigantic bureaucracy that stands between myself and the medical industry.
And before you talk about not being able to choose my own doctor or long waits - we're already there. My current plan makes it virtually impossible to go out of network without bearing almost all of the expense myself. I've had private insurance through various plans and various employers since 1994 and I've watched services deteriorate and cost go up to the point where the **** bags at my current provider are now offering separate insurance for my out of pocket expenses that they no longer cover - an "insurance for my insurance" if you will. So then I'm inclined to ask - why wouldn't a single payer system benefit me?
I've seen this in my own experience as well.
Some FDR-worshipping folks like Lyndon LaRouche can actually remember the old community-based hospital system. There were doctors all over the country, in rural areas, who were indeed helped by the Federal government in getting equipment and/or facilities for their local areas with Federal handouts, and it did improve the level of care available. Poor people also got care even if they couldn't pay, at least in some cases. . . . I'd never say there aren't people who just get nothing from any sort of top-down assistance plan. And there were in some, perhaps many, cases where local charity efforts pitched in significantly.
Democrats of the Hubert Humphrey mold are sympathetic characters to me, because you can take their sincerity to the bank, so to speak. What they did was meant to help the poor.
I've seen hospitals corporatized in my lifetime, with "shareholder value" based on profits become the whole point of having "hospitals", and I think there is a problem in that. Insurance started out as a sort of "cooperative" effort to pool risks and enable people to get care when they needed it, and I'm good with it in that sense. But Insurance companies have also gone purely corporate, and driven by the short-term profit equation, and I see that impacting day to day decisions that undermine the long-term issue of getting the care that will be most economical, and most life-saving, in the longer view. It produces decisions like I described above in this thread, where a new approach is denied "until it becomes the standard" of care, which delays implementation and deters innovation.
My most serious unhappiness about the ACA is that it seems to cut people out of the process in many ways. Yes, we were lied to, and yes it's going to cost more than we are willing to pay, and yes the corporates are all going to go to the bank with the money, and no, we won't get the care we really need, or the care we want. The "Act" was indeed written by industry insiders, and our politicians did indeed get big campaign donations for enacting it.
