Quote Originally Posted by Seamus Fermanagh View Post
I have always conceived of the ACA as a health care plan more or less designed to fail in such a manner as to generate huge groundswell for the adoption of a national healthcare system along the lines of Canada or possibly of Germany. The extant insurance and healthcare system that obtained at the outset of the ACA was not and is not capable of absorbing the healthcare need and, despite good intentions, will have to jack rates on the insured etc. until people reach a point where they are deeply angry at the whole thing. At the same time, the expanded medicare rolls will be receiving coverage that is apparently cheaper and seems [may in fact be] no less effective than that being received by the increasingly high premium insureds. When the crisis hits, medicare will be expanded into some form of national health program.

With this defeat, I think this is now more or less inevitable. The within-the-system conservatives under Ryan never really expected to have to legislate on this -- figuring they would lose the White House and knowing they would never be veto-proof in the Senate -- so NOBODY took the precaution of having someone design a "what if we actually have to govern and live up to our campaign promises" plan to deal with healthcare despite having at LEAST six years to do it. The inside-the-system conservatives want to try to keep the good parts and get rid of the bad, but this will be difficult at best and unworkable at worst.

The ardent conservatives wanted the healthcare bill to have the following text: "The Patient Protection and Affordable Care Act of 23 March 2010 is hereby repealed." They then want subsequent legislation that gets rid of most if not all federal oversight of healthcare, returning those decisions to the control of the states while allowing U.S. citizens to purchase healthcare across state lines. They very much see healthcare changes as something that happens AFTER the ACA is repealed. Repeal and replace, to them are separate activities that should happen in that sequence -- and their replacement approach would be far different.

Oddly enough, despite their mosaic construction of competing bases of support and regardless of political exploitation of some of those bases of support by party leadership, the Democrat party is the group with the consistent position on nationalizing healthcare and making it government apportioned to all. And they have been shockingly consistent in this over the years, with this being their goal for at least the past 30 years (with elements of the party having supported this goal since the turn of the 20th).

The GOP is divided against itself, the Dems have reason to hang together, and each year under ACA rules exacerbates the crisis and does so in a fashion that will yield the true-to-their-hearts goal.

Oddly enough, this may well mean that the Quixotic campaign of Bernie Sanders -- one of our few true Socialist Democrats -- may end up winning after all. His campaign damaged the Hillary "inevitability" mystique; that siphoning of belief in Hillary may well have kept some of Hillary's support home and given Trump just enough of an edge to win in the Electoral College. Without Hillary in the White House, the Dems can unify around defending Obamacare WITHOUT a Clinton trying to "improve" on it and unifying the GOP opposition. If the GOP cannot unify on this issue -- an issue on which many of them campaigned -- they will effectively allow the bill to accomplish its real purpose of nationalized healthcare. Once healthcare is run by the government, I think it unlikely that government will be prevented from nationalizing university education as a right....thus Bernie Sanders' policies become the ultimate success of his campaign.


I suppose I should be content that we are the last in the West to go this route, championing the individual over the collective (neither is perfect of course, but that is another thread). The march of history has been against us in this as more and more states turn to state oversight and control across the board --and I cannot even fault the intentions of those efforts. Earthly glory passes.
You are reading far too much into the future. Even if this does wind up leaving us with a national healthcare system, education is a separate battle altogether and nothing about these alternative systems championed by progressive Dems should be construed as a battle between "the individual" and the "collective".

Quite frankly, I think that kind of talk is demeaning to the history of the united states, where citizens have had to rise together as individuals in order to obtain the type of system we have today. The problem with viewing politics through such a Presidential centric lens is that you mistake the policy goals as top down directives that were passively accepted by the public once they got their free goodies.

While LBJ passed legislation, there were race riots. When FDR passed Social Security, elderly were dying of starvation. And the wave of new government intervention as ushered in by Teddy Roosevelt and Woodrow Wilson went hand in hand with the 50+ years of labor riots and outright warfare in the streets.

National health care will be the law of the line not because of Obama or any other Democrat conspiracy. It will be because individual people will recognize that their best option is the government option and they will express that very loudly to their representatives.