Kaiser: Majority wants to keep ACA in place

[AggregateDemand]

What is meant by a "Republican alternative"? ObamaCare is the Republican alternative.

ACA is the "Republican alternative", if Republicans were obsessed with arcane, inaccurate wealth redistribution schemes and expansion of Medicaid

A majority of Americans are clinging desperately to the ACA because it's the only major reform Congress has passed in decades, and they are afraid to let it go, even if it makes the country worse.

[AggregateDemand]

They have a plan that throws 1 million people out of their plans and raises the deficit.

It will increase the deficit by $74B over 10 years, and reduce the incidence of employer-provided healthcare plans for 1M people, who the CBO assumes will go onto Medicaid. Clutching at straws.

Healthcare premiums are out of control because we treat employer-provided health insurance premiums as tax free compensation. Everyone wants more tax free compensation. Then one day, millions of Americans lose their jobs, and they realize how stupid they've been.

The Republican plan provides refundable tax credits for healthcare. If someone buys an individual policy for $5,000 in annual premiums, and $7,500 is the individual tax credit, the taxpayer will receive a $2,500 refund. This will put immense downward pressure on costs, and most Americans will be covered in short order, regardless of what the CBO is peddling.

The obvious caveat with Republican refundable tax credits is that people may have an incentive to cut costs too far. Healthcare services and health may decline as a result.

[AggregateDemand]

If it hadn't been just a few weeks since Republicans trumpeted a CBO report showing that Obamacare was going to throw 2 million people out of work, I'd feel more sympathetic to that argument... but I think they've been hoist on their own petard.

I'm sympathetic to allegations of Republican impropriety, but it won't change the economics. ACA is just rearranging the deck chairs on the Titanic so the lower-working classes and chronic patients get a better view of the iceberg. The Republican plan is only risky insofar as it might be too disruptive. Same with single-payer.

[AggregateDemand]

It was certainly the Republican alternative in the 1990s when Bill Clinton was trying to get a more bold single payer plan through. And it certainly was the Republican alternative in the 2000s when Mitt Romney basically wrote what's now known as ObamaCare in response to the Democratic legislature's push for state single payer. And it certainly would have been the Republican alternative in 2010 had Barack Obama tried overreaching for single payer.

Someday, hopefully sooner rather than later, you'll realize that Democrats had a filibuster proof majority in Congress, and when they removed Republicans from the bargaining table, they didn't do so to enact a Republican plan. The new school Democrats had their asses handed to them by the stalwart Great Society liberals, who were not about to relinquish control of Medicaid and Medicare for some new public option or single-payer system.

Democrats had to find a new system so they took Republican healthcare reform, and modified it to make liberals happy. Medicaid was be expanded. A raft of new taxes were placed on cadillac plans and medical equipment. The Republican system of catastrophic insurance was replaced by the liberal concept of comprehensive insurance.

Just because two systems rely on private insurance does not make them the same. Whether something works or whether it ends up like ACA, depends on the details.

[AggregateDemand]

[Democrats] Republican Plan because Obama thought it would make Republicans vote for it and the ACA would go down in history as a bipartisan reform of the health insurance system.

Denial is a hell of a drug. ACA was the macabre compromise necessary to get Democrats to sign off. Old liberals were not going to let Medicaid and Medicare be turned into a public option or single payer system. Most Democrats didn't even want ACA and Congress spent 18 months trying to broker compromises with amendments and modifications, like the Stupak amendment. Changes had nothing to do with Republicans. Democrats couldn't even build a coalition in their own party because representatives and senators knew what was going to happen after passage.

Republicans just sat on the sidelines and watched Dems make a mockery of our healthcare system. The elections in 2010 were predictable.

When it comes to dismantling Medicaid and Medicare, for single-payer or for privatization, Democrats have more allies in the Republican Party than they have in the Democratic Party. Until they accept reality, we are going to be stuck with the Great Society and all of middle-class economic rancor it causes.

[AggregateDemand]

Wait, how would single-payer dismantle Medicaid and Medicare? Single-payer is Medicare for all, no?

Single-payer and Medicare are the same in the world of watered-down political talking points. In the real world, single-payer and public-option are shocks to the system. Shocks create strange bedfellows, like Great Society liberals, non-profits (AARP), and corporate insurance companies working together to scupper single-payer and the public option. Furthermore, the economically viable version of single-payer would hopefully not work anything like the corrupt, inhumane largesse of Medicare.

Most of the problems we face today result from a battle within the Democratic Party over social policy. Failed Medicare and Medicaid vs single-payer. Failed Welfare, SNAP, etc vs. universal income. Failing defined-benefit social security vs. defined contribution social security.

Republicans will only help neo-liberal Democrats when they show signs of intelligent life. To date, Democrats have only attempted to replace the terminal cancer with something worse.

[AggregateDemand]

AggregateDemand has literally no idea what he's talking about. 90% of what he's saying is made-up nonsense that in no way reflects what actually happened during congressional debate. The degree to which Breitbart and Fox News brainwashes people into believing in an alternate reality is terrifying.

President Obama wanted single payer. He didn't get it. Nancy Pelosi wanted a robust public option. She didn't get it. Democrats basically had a 2/3 majority in Congress, and Obama was in the White House. We already spend around $3,300 per capita at the federal level for public healthcare in the United States. Comparable to UK and AUS. We spend around $3,600 at all levels for public care, which is comparable to Canada.

At some point, you will realize that you have no idea what you are talking about. The funding is already there. The Democrats had complete control of the legislature and executive branches. No public option and no single-payer. Why? Because Great Society liberals. Why do you think Clinton started the Third Way? Great Society liberals.

Democrats need to wake up. If you don't want to be free-market capitalists, fine. There are plenty of sensible government options. But you're not allowed to be incompetent anymore. The US middle class cannot endure another 5 decades of firing middle-class government employees (soldiers mainly) and then replacing them 5:1 with welfare ans social security recipients. We've been kicking the can down the road for 30 years with deficit spending, and we've stripped so much money from the middle class they have to borrow their way out of poverty.

Time for the Enlightenment to reach the Democratic cave.

[AggregateDemand]

AD, what is your basis for all this talk about "Great Society liberals" stopping single payer?

The Great Society is a welfare industrial complex within the federal government. Republicans revolted against it from day one with Goldwater, but it didn't catch on until after stagflation, and the rise of Reagan. Clinton also saw the problem during his presidency, when Hillarycare was shot to pieces by the same factions that undermined single-payer and public-option in 2009-2010. Clinton pitched the bipartisan Third Way to eliminate the welfare-industrial-complex. Didn't catch on, but he did sign the Republican welfare reform bill. Bush continued Clinton's legacy of mediocre coalition building. Obama was elected, the Democratic bureaucracy said he was going to be the new Reagan. In other words, build a potent political coalition using the backdrop of economic crisis. The populist coalition would take on the welfare industrial complex, like Reagan did when he reformed Social Security in 1983, the last social security reform to date. Obama was gunning for Medicaid/Medicare.

To overthrow the Great Society liberals and their bureaucracies, you've got to build a coalition amongst: Democrats, Republicans, and private industry (health insurance, in this case). Democrats made the charge of the light brigade, citing their mandate from the electorate. Predictably, they were smashed to bits. Everything they wanted was tossed out, and they held their noses and passed a miserable interpretation of Republican healthcare reform, which led to November 2010.

Republicans generally sit around and borrow as they wait for the political winds to change. Part of me admires Democrats for charging headlong into a bureaucracy with absolutely no chance for victory, but another part of me is dumfounded by their eagerness to suffer a crippling defeat at the hands of the bureaucracies they created over 50 years ago. Did they learn nothing during Hillarycare?

[AggregateDemand]

I don't think we should engage in debate with anybody who thinks SNAP is an expensive program or that Medicare has failed to accomplish it's goals.

You need an education. Entitlements cannot be made sustainable with ignorance.

[AggregateDemand]

When did Obama endorse or promote single payer?

It was back in 2003, but it was clear that he was still operating under the single-payer mindset based upon the cost cutting promises he made. Medicaid expansion and Medicare cuts were a form of backdoor single payer, anyway. He also got in a bit of trouble for telling the AMA in 2009 that single-payer healthcare worked pretty well around the world. He's never really let go of the comprehensive single-payer dream.

Pelosi was quick to contradict him on cost-cutting and she pitched public-option as a way to protect the entitlement state and pressure the private sector. She's an old liberal who protects the Great Society so her actions are not surprising.