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So Much for Fixing the Affordable Care Act Later

From Fire Dog Lake

I remember during the end of the health care reform fight how top Democrats promised activists unhappy with the bill that they would “fix it later.” I remember being told that it was very important to pass a bill despite many serious problems, design flaws and terrible compromises, because it would be easy to fix those issues later.

Well, it is two years later, and the Democratic Party has basically dropped any pretext that they want to seriously improve the Affordable Care Act. Not only has basically every top elected Democrat stopped even paying lip service to the idea of trying to make the law more progressive, but improving it is basically absent from the Democratic platform. As far as I can tell, this is the only mention in the platform that the ACA may need improvements:

At the same time, the Affordable Care Act is not the end of efforts to improve health care for all Americans. Democrats will continue to fight for a strong health care workforce with an emphasis on primary care. We remain committed to eliminating disparities in health and will continue to make sure families have access to mental health and substance abuse services. We will strengthen Medicaid and oppose efforts to block grant the program, slash its funding, and leave millions more without health insurance. We will continue to invest in our public health infrastructure – ensuring that we are able to respond to emergencies and support community-based efforts to prevent disease.

These are relatively minor issues about increasing the number of doctors and coverage of certain conditions. There is no call for a public option or single payer. There are no calls for adding an early Medicare buy in, as was talked about during the health care debate. There’s nothing about drug re-importation or Medicare direct drug price negotiation. There is not even a reference to the idea Obama previously endorsed of speeding up when states can experiment with better systems.

The platform of the Democratic Party is basically that the ACA is great how it is and there is very little need to improve it.

This is an important lesson about legislative fights. Inertia is an overwhelming force in Washington. Things rarely get improved later even when politicians say improvement is needed. That is why it is so important to fight to get the design right to begin with, or we end of living with the design flaws for a very long time. The bad state/federal partnership design element of Medicaid is still causing major issues decades after it was started.

Comments

4 Responses to “So Much for Fixing the Affordable Care Act Later”
  1. jacksmith says:

    “Give me Liberty, or Give me Death!” – Patrick Henry

    What a brilliant ruling by the United States Supreme Court on the affordable health care act (Obamacare). Stunningly brilliant in my humble opinion. I could not have ask for a better ruling on a potentially catastrophic healthcare act than We The People Of The United States received from our Supreme Court.

    If the court had upheld the constitutionality of the individual mandate under the commerce clause it would have meant the catastrophic loss of the most precious thing we own. Our individual liberty. Thank you! Thank you! Thank you! Supreme Court.

    There is no mandate to buy private for-profit health insurance. There is only a nominal tax on income eligible individuals who don’t have health insurance. This is a HUGE! difference. And I suspect that tax may be subject to constitutional challenge as it ripens.

    This is a critically important distinction. Because under the commerce clause individuals would have been compelled to support the most costly, dangerous, unethical, morally repugnant, and defective type of health insurance you can have. For-profit health insurance, and the for-profit proxies called private non-profits and co-ops.

    Equally impressive in the courts ruling was the majorities willingness to throw out the whole law if the court could not find a way to sever the individual mandate under the commerce clause from the rest of the act. Bravo! Supreme Court.

    Thanks to the Supreme Court we now have an opportunity to fix our healthcare crisis the right way. Without the obscene delusion that Washington can get away with forcing Americans to buy a costly, dangerous and highly defective private product (for-profit health insurance).

    During the passage of ACA/Obamacare some politicians said that the ACA was better than nothing. But the truth was that until the Supreme Court fixed it the ACA/Obamacare was worse than nothing at all. It would have meant the catastrophic loss of your precious liberty for the false promise and illusion of healthcare security under the deadly and costly for-profit healthcare system that dominates American healthcare.

    As everyone knows now. The fix for our healthcare crisis is a single payer system (Medicare for all) like the rest of the developed world has. Or a robust Public Option choice available to everyone on day one that can quickly lead to a single payer system.

    Talk of privatizing/profiteering from Medicare or social security is highly corrupt and Crazy! talk. And you should cut the political throats of any politicians giving lip service to such an asinine idea. Medicare should be expanded, not privatized or eliminated.

    We still have a healthcare crisis in America. With hundreds of thousands dieing needlessly every year in America. And a for-profit medical industrial complex that threatens the security and health of the entire world. The ACA/Obamacare will not fix that.

    The for-profit medical industrial complex has already attacked the world with H1N1 killing thousands, and injuring millions. And more attacks are planned for profit, and to feed their greed.

    To all of you who have fought so hard to do the kind and right thing for your fellow human beings at a time of our greatest needs I applaud you. Be proud of your-self.

    God Bless You my fellow human beings. I’m proud to be one of you. You did good.

    See you on the battle field.

    Sincerely

    jacksmith – WorkingClass :-)

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  4. Anonymous says:

    The Affordable Care Act will not work! People will be UNDERINSURED! AND THAT IS NOT INSURANCE FOLKS! YOU WILL STILL BE ONE ILLNESS AWAY FROM BEING BANKRUPT! WHY WOULD THE AMERICAN CITIZENS WANT THAT DEAL????? THE 30- 4O% YOU COULD BE LEFT PAYING CAN BE DEVASTATING! WE DESPERATELY NEED MEDICARE FOR ALL! AMERICAN FAMILIES RIGHT NOW ARE FILING BANKRUPTCY WITH INSURANCE!!! HAVING HEALTH INSURANCE LEAVES HUGE HOLES THAT CAN FINANCIALLY CRIPPLE OUR FAMILIES. I HOPE THE AMERICAN PEOPLE WONT BUY INTO IT!!!!