People are still fighting Obamacare?

Who among us (or anyone) claimed single payer is a small tweak?

Robear wrote:

Who among us (or anyone) claimed single payer is a small tweak?

Well Bill and you both used the term "tweak" though not "small" or "minor". Norman is saying that there are no tweaks that could possibly redeem the ACA, only a single payer system, which he obviously thinks was far more than a tweak.

Personally I actually liked the ACA largely because I saw it as the best--or at least smoothest--pathway to a single payer system, or at least one close enough for my tastes.

1. Current ACA
2. All companies, no matter the size, are allowed to go through the ACA, or let their employees go their independently, reimbursing the employees for a decent portion of the amount of money they'd pay in premiums otherwise.
3. Add a public option to the ACA in every state.
4. Remove all requirements and tax benefits for companies paying for their employees healthcare.

We have now completely cut off the employee/employer/life saving medicine relationship. Everyone has the public option available to them, and from this point we can decide to move solely to that public option at any time, if the private plans on the ACA prove to be unable to compete with the public options. More likely they would just die on the vine if people are correct that no for-profit company can compete with a comprehensive public option.

Whether several small to medium steps like that arbitrarily count as "tweaks" or not I don't particularly care. I see a clear pathway, and I think that pathway was incredibly necessary. Since WWII the US has become entirely dependent on employer provided health care. Making that switch immediately would be incredibly disorienting and you'd never get the buy-in for it. The ACA is exactly how you go from where we were 5 years ago to where we need to be.

Again, the idea was that the legislation would be changed to deal with challenges that come up, not changed wholesale into single-payer, because that would not fly with Republicans. It's a huge bill, there are thousands of small changes that could be made as needed, if Congress actually supported it. Things like the initial funding amounts for the systems to run the sign-ups, or changing standards of care, or the amount of doctor's reimbursements.

But it should be obvious that ACA --> Single Payer is not anyone's mind a tweak or a small change. The ones you describe are not small either, Yonder, they involve massive policy changes and would require new legislation that's well out of the original scope of the Act (steps 3 and 4).

Norman created a straw man out of what I said, that's all.

I'm for a single payer system.

Robear wrote:

Norman created a straw man out of what I said, that's all.

Oh - after reading how the Republicans were to blame for the pending failure of Obamacare, I just assumed we were all strawmanning.

Robear wrote:

But it should be obvious that ACA --> Single Payer is not anyone's mind a tweak or a small change. The ones you describe are not small either, Yonder, they involve massive policy changes and would require new legislation that's well out of the original scope of the Act (steps 3 and 4).

Oh absolutely, I didn't mean to imply that no legislation would be necessary for any of those steps. My point was just that the framework of the ACA: healthcare.gov, the state exchanges, and in general one cohesive place to get non-employer provided healthcare was a framework that could stay more or less intact throughout the transition I described.

Nomad wrote:

I'm for a single payer system.

Me too. High-five.

That being taken off the table by Democrats (with no concessions from Republicans) was a major mis-step, in my view.

NormanTheIntern wrote:
Robear wrote:

Norman created a straw man out of what I said, that's all.

Oh - after reading how the Republicans were to blame for the pending failure of Obamacare, I just assumed we were all strawmanning.

I look forward to the GOP regaining it's sanity - and for you to have positive policy positions to advocate again.

Dimmerswitch wrote:

That being taken off the table by Democrats (with no concessions from Republicans) was a major mis-step, in my view.

The only concession the Republican leadership was looking for in 2010 was Obama resigning (or, failing that, making sure he was a one-term president).

The concession Democrats got was that they passed the ACA, warts and all. And ten million plus people got health care coverage.

Had the Democrats held out for a single-payer system in 2008 and 2009 then the ACA would have been a repeat of Clinton's 1993 attempt at reform: a lot of talk, some fancy plans that went no where, and then no significant change to the health care system for another decade or two.

OG_slinger wrote:
Dimmerswitch wrote:

That being taken off the table by Democrats (with no concessions from Republicans) was a major mis-step, in my view.

The only concession the Republican leadership was looking for in 2010 was Obama resigning (or, failing that, making sure he was a one-term president).

The concession Democrats got was that they passed the ACA, warts and all. And ten million plus people got health care coverage.

Had the Democrats held out for a single-payer system in 2008 and 2009 then the ACA would have been a repeat of Clinton's 1993 attempt at reform: a lot of talk, some fancy plans that went no where, and then no significant change to the health care system for another decade or two.

And let us not forget that the ACA WAS the GOP alternative to Clinton's 1993 health care proposal. The fact that they are running against it now is the biggest demonstration that they had and have never had and never will have any sincere intention of reforming health care.

OG_slinger wrote:

The concession Democrats got was that they passed the ACA, warts and all. And ten million plus people got health care coverage.

I'm not sure about characterizing this as a "concession", since no Republicans voted for it.

Maybe a concession to the Democratic moderates, that works.

Paleocon wrote:
OG_slinger wrote:
Dimmerswitch wrote:

That being taken off the table by Democrats (with no concessions from Republicans) was a major mis-step, in my view.

The only concession the Republican leadership was looking for in 2010 was Obama resigning (or, failing that, making sure he was a one-term president).

The concession Democrats got was that they passed the ACA, warts and all. And ten million plus people got health care coverage.

Had the Democrats held out for a single-payer system in 2008 and 2009 then the ACA would have been a repeat of Clinton's 1993 attempt at reform: a lot of talk, some fancy plans that went no where, and then no significant change to the health care system for another decade or two.

And let us not forget that the ACA WAS the GOP alternative to Clinton's 1993 health care proposal. The fact that they are running against it now is the biggest demonstration that they had and have never had and never will have any sincere intention of reforming health care.

Or that they were so huge of hating Obama and literally anything he stood in support of that they were willing to repeatedly torpedo and malign policy, even if they came up with it, just because it was HIM.

NormanTheIntern wrote:
OG_slinger wrote:

The concession Democrats got was that they passed the ACA, warts and all. And ten million plus people got health care coverage.

I'm not sure about characterizing this as a "concession", since no Republicans voted for it.

Maybe a concession to the Democratic moderates, that works.

I have a feeling history books will debate this issue in the future. Some scholar in 2145 will probably win a prize of their book examining official recorders, personal correspondence, and the like to really figure out what happened.

NormanTheIntern wrote:
OG_slinger wrote:

The concession Democrats got was that they passed the ACA, warts and all. And ten million plus people got health care coverage.

I'm not sure about characterizing this as a "concession", since no Republicans voted for it.

Maybe a concession to the Democratic moderates, that works.

No Republicans voted for it because they couldn't appear to be working with Obama because blaaaaaaaaaargh! So they walked away at the last second.

They were, however, invested in the creation of it and its finished product was a series of compromises between the Democrats drafting it and Republican input.

But if that doesn't count, then sure, no compromises were made at all.

NormanTheIntern wrote:

I'm not sure about characterizing this as a "concession", since no Republicans voted for it.

I was taking issue with Dimmer's statement that Democrats could have struck some kind of political deal with 2008/2009 Republicans and gotten single payer instead of the ACA.

Getting the ACA passed--flawed as it was--was the best the Democrats could manage. It was either pass the ACA or pass absolutely nothing.

Single-payer was dead from the very beginning and there was absolutely nothing Obama could have offered to the Republicans that would have made it a reality.

OG_slinger wrote:

Single-payer was dead from the very beginning and there was absolutely nothing Obama could have offered to the Republicans that would have made it a reality.

How could the Republicans have stopped it?

NormanTheIntern wrote:
OG_slinger wrote:

Single-payer was dead from the very beginning and there was absolutely nothing Obama could have offered to the Republicans that would have made it a reality.

How could they have stopped it?

By coming to power and destroying it before it had a chance to flourish and impact people's lives.

Obamacare pissed some people off, but not enough for Obama to lose the Presidency. Actual socialism might have done just that. As it stands, the ACA has been in effect for a while now and even Republican local politicians are reluctant to do too much to hamper it in their areas as citizens see its effect and it helps them lead healthier lives.

KY's new governor ran on a platform, at the start, of destroying Obamacare in Kentucky to the best of his ability. A lot of Kentucky voters realized that'd mean zero health insurance again and they weren't having it. Bevin pivoted from that, saying he would take steps to make sure anyone currently benefiting wouldn't be impacted (because who cares about that program helping anyone ELSE as long as you got what you need).

Of course, since then, Bevin's broken that promise and looks to be going full steam ahead on f***ing over his constituents, but that could very well be his downfall next election cycle.

NormanTheIntern wrote:

How could the Republicans have stopped it?

Republicans actually worked with Democrats on the ACA in 2008 and 2009. And then they realized it make for a great issue for the 2010 midterms and began universally opposing it.

So, sure, in some alternative universe in which Obama knew the Republicans were going to f*ck him from the beginning and never stop Democrats could have designed the ACA to be single payer and then just rammed it through. But they didn't. Because politics is about compromise.

OG_slinger wrote:

Because politics is about compromise.

I think the Republican party has spent the last decade or so testing the hypothesis "What if it wasn't?"

NormanTheIntern wrote:

Oh - after reading how the Republicans were to blame for the pending failure of Obamacare, I just assumed we were all strawmanning.

I wasn't. You're welcome to argue that Republicans haven't done everything in their power to obstruct the ACA at the State and Federal levels since before it was passed, but you'll just be embarrassed...