# What is your ongoing opinion of the Affordable Care Act? (Title Edited) **URL:** \ **Category:** Politics & Elections\ **Created:** [January 17, 2013, 11:21pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561 "2013-01-17T23:21:39Z")\ **Posts on this page:** 20\ **Page:** 180
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 27, 2015, 1:27pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3582 "2015-06-27T13:27:07Z")
> [@RTFirefly](#): > > I wasn’t saying anything - just correcting your claim that Medicare and Medicaid are essentially the same program. They’re not. And I was correcting the claim that we’d have “Medicare for all” instead of “Medicaid for all”. The lower Medicaid payment rates were chosen for ACA for a reason. We can’t afford Medicare for all. > [@](#): > > But you are saying that single payer through the Federal government is pretty radical. Funny, most Americans would disagree that Medicare is a radical program. But it’s single-payer, through the Federal government, for the over-65 crowd. Limited population, and so we can spend lavishly on them. > [@](#): > > While I’m posting, I’ll note that you still haven’t explained why going from Obamacare to single-payer in, say, 20 years would be a heavier lift than getting Obamacare passed in the first place. WEll first, you have to get Democrats in control of the government again. Then you have to convince all the Blue Dogs to commit political suicide again. The next time Democrats convince Blue Dogs to run in red states they won’t be useful idiots like Ben Nelson and Mary Landrieu. > [@](#): > > By comparison, I’ll note that the heavy lift with Social Security was getting it passed in the first place. It’s been expanded and improved a number of times since, and none of those instances were the big political deal that getting it established in the first place was. Figure out how to make ACA popular and then there might be a comparison. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [June 27, 2015, 1:34pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3583 "2015-06-27T13:34:43Z")
> [@adaher](#): > > We can’t afford Medicare for all. It’s a matter of adjusting tax rates, that’s all, to broaden the extent of a program that is much more efficient than any private system. You would have us go back to the bloated bureaucracy and incredible overheads of Big Insurance instead - \*that \*is what we can’t afford. > [@](#): > > Then you have to convince all the Blue Dogs to commit political suicide again. They’re mostly gone already. > [@](#): > > Figure out how to make ACA popular and then there might be a comparison. That is not a hypothetical. Support is already a majority, and still growing. All the way past the graveyard, friend. Of course, there is no Republican plan to provide a “comparison” to, is there? And there will never be one in this generation, either, will there? And you’ll never face up to that reality, will you? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 27, 2015, 2:29pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3584 "2015-06-27T14:29:32Z")
> [@ElvisL1ves](#): > > It’s a matter of adjusting tax rates, that’s all, to broaden the extent of a program that is much more efficient than any private system. You would have us go back to the bloated bureaucracy and incredible overheads of Big Insurance instead - \*that \*is what we can’t afford. Vermont found that in order to do single payer it would cause a huge increase in taxes. And Vermont has a better than average per capita income. > [@](#): > > They’re mostly gone already. I mean the new ones you’ll inevitably need to have a Senate majority again. > [@](#): > > That is not a hypothetical. Support is already a majority, and still growing. All the way past the graveyard, friend. Support is not, nor has it ever been, a majority, even by your own weird arguments of what constitutes “support”. When someone says “opposed” because it doesn’t go far enough, that is not “support”, although it’s not the same type of opposition as conservative opposition. If the Republicans repeal ACA, single payer becomes more likely, not less. And I’m sure a lot of single payer advocates would shed no tears in getting to that outcome. There were many single payer advocates that tried to kill ACA before it got passed most notably the writers at FireDogLake. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [June 27, 2015, 2:54pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3585 "2015-06-27T14:54:53Z")
> [@adaher](#): > > Vermont found that in order to do single payer it would cause a huge increase in taxes. And Vermont has a better than average per capita income. So? We were discussing Medicare. > [@](#): > > I mean the new ones you’ll inevitably need to have a Senate majority again. Of course. 😉 > [@](#): > > your own weird arguments…When someone says “opposed” because it doesn’t go far enough, that is not “support” Just gonna leave that one there for all to admire. [Meanwhile](http://www.ledger-enquirer.com/2015/06/26/3787820/john-a-tures-slow-change-in-aca.html) … > [@](#): > > For the first time since they’ve polled people on the Affordable Care Act, more Americans like Obamacare than dislike it, according to a CBS/New York Times poll. And an overwhelming majority of citizens like the tax subsidies. Most feel the law works, but could be improved with changes. The change they want is different from what opponents are talking about, however. > > Instead of double-digit leads for those who disapprove the Affordable Care Act, supporters now hold a three-point lead over opponents, 47 percent to 44 percent. An even greater majority, 70 percent, “think the Supreme Court should rule to continue the government financial assistance that helps low and moderate income people buy health insurance.” > > Contrast that with the 21-point advantage opponents had on the ACA in March of 2010, or the 31 point lead opponents had back in 2013. Do ya like apples? > [@](#): > > If the Republicans repeal ACA, single payer becomes more likely, not less. Oh, is \*that \*their alternative replacement plan! Wow! Finally! :rolleyes: ---
**Author:** ![RTFirefly](https://avatars.discourse-cdn.com/v4/letter/r/c77e96/32.png) [@RTFirefly](https://boards.straightdope.com/u/RTFirefly)\ **Post date:** [June 27, 2015, 5:40pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3586 "2015-06-27T17:40:38Z")
> [@adaher](#): > > If the Republicans repeal ACA, single payer becomes more likely, not less. Not sure what you base that on. Going from a program that’s 80% of what UHC advocates want, to one that’s 100%, is a damned sight more likely than going from 0% to 100% after having gone from 80% to 0%. > [@](#): > > And I’m sure a lot of single payer advocates would shed no tears in getting to that outcome. There were many single payer advocates that tried to kill ACA before it got passed most notably the writers at FireDogLake. FDL is generally considered by the denizens of the lefty blogosphere to have gone off the deep end. (This has been the consensus for years, btw.) Didn’t know any non-lefties were paying enough attention to FDL to take them seriously anymore. The point is that any group that’s ‘most notably’ the writers at FDL is probably not a very big group. And in this case, it’s one that I would condemn with great fury: being OK with seeing millions of people once again deprived of reliable health insurance in the _hope_ that we ultimately attain the goal of single-payer strikes me as both cruel and immoral in ways that would have very adverse effects on the life of millions. People’s lives aren’t pawns in a goddamned game. Treating them as such is the work of the devil. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [June 27, 2015, 6:09pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3587 "2015-06-27T18:09:23Z")
Smacks of Leninism, theorizing that provoking brutal oppression is a net positive because it inspires more revolutionary fervor among the victims. The Devil is not a Communist, we may be assured, because the atheistic requirements of dialectical materialism were problematic. > [@](#): > > …When someone says “opposed” because it doesn’t go far enough, that is not “support” … Concur with friend **Elvish**. When Bender on _Futurama_ says “I’m boned”, he means he is screwed, fucked, has taken a Boehner up his Nixon. He is not suggesting that his skeletal structure has been neatly incised. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 28, 2015, 3:30am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3588 "2015-06-28T03:30:17Z")
It’s more that it’s easier to go from “broken” to single payer than “works pretty well” to single payer. Countries simply do not change the basic nature of their UHC programs once enacted. ACA is going to be tinkered with, but we’re not going to go to the trouble of getting everyone private health insurance just to take it away. There’s also the problem of unions and their gold plated plans. They ain’t giving those up, and they have power within the party. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [June 28, 2015, 11:19am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3589 "2015-06-28T11:19:48Z")
> [@adaher](#): > > ACA is going to be tinkered with, but we’re not going to go to the trouble of getting everyone private health insurance just to take it away. There’s your problem right there, you think single payer equals taking away private insurance. All we have to do is offer a public option with lower premiums and better benefits and the private plans will wither as people voluntarily switch over. No taking away required. Private plans cannot compete when there is an alternative with no profit motive, lower overhead and increased bargaining power. Good riddance to bloodsucking parasites. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 28, 2015, 11:56am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3590 "2015-06-28T11:56:10Z")
I’ll be happy to support a public option that has to be funded entirely through premiums and will be allowed to fail should it run out of money. As for increased bargaining power, it can’t get that until it gets enough customers. The problem with your assumptions about a public option is that it has to win the competition in order to gain most of the advantages you ascribe to it. While it’s competing, it’s under the same constraints as the private companies, except for the profit motive. Which gives them a 3% advantage, which would be dissipated if they decided to pay their people a little more than the private companies. There’s also the problem of fraud and waste. Medicare has low overhead because there is little incentive or effort to make sure payments are proper. A public company that has to compete with Aetna, Cigna, and Blue Cross will have to avoid such waste to survive. Can it do it? I’m eager to find out, personally. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [June 28, 2015, 1:20pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3591 "2015-06-28T13:20:33Z")
> [@adaher](#): > > we’re not going to go to the trouble of getting everyone private health insurance just to take it away. Does that mean your party is dropping even the “repeal” part of “repeal and replace”? And that you’re going to stop cheerleading for it? ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [June 28, 2015, 1:42pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3592 "2015-06-28T13:42:47Z")
As much as many of us here on the Boards have endorsed **adaher** for the position of Senior Strategist and Decider in Chief for the Republican Party, our efforts have borne no fruit. As regrettable as this may be, it remains the harsh reality. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [June 28, 2015, 1:58pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3593 "2015-06-28T13:58:17Z")
> [@adaher](#): > > There’s also the problem of fraud and waste. Medicare has low overhead because there is little incentive or effort to make sure payments are proper. Is this based in citeable fact, or is this just more conservative “common sense”? ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [June 28, 2015, 2:02pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3594 "2015-06-28T14:02:57Z")
> [@adaher](#): > > …Countries simply do not change the basic nature of their UHC programs once enacted. … One wonders why. Why do they continue to groan under the oppression of socialized medicine? It being so dreadful, and all. They have democratic mechanisms and traditions that they could bring to bear to overthrow the nanny-state and return to the time-honored values of profit and competition. Even with the shining example of America before them, they do not. They witness at first hand the numbing horror of socialized medicine, and do nothing to reverse it! Perhaps, when you have a moment, you will tell us why. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 29, 2015, 2:57am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3595 "2015-06-29T02:57:35Z")
More countries have private health insurance as the basis of their system than socialized medicine. Exactly none of them are considering scrapping it. Switzerland did have a referendum on it and overwhelmingly chose to keep the private insurance system. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [June 29, 2015, 4:58am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3596 "2015-06-29T04:58:42Z")
Those are interesting, albeit unsubstantiated, facts. Which have no direct bearing on the question. I did not ask if any democratic countries had decided not to try it, I asked about the ones who have tried it and hated it so much, they voted it out. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 29, 2015, 5:13am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3597 "2015-06-29T05:13:28Z")
The opposite is also true. Countries with multi-payer UHC also do not vote theirs out. Which says that once UHC is in effect, voters tend to go ultraconservative on the issue of any major changes. The same will be true of ACA if it succeeds. ---
**Author:** ![Gyrate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gyrate/32/3588_2.png) [@Gyrate](https://boards.straightdope.com/u/Gyrate)\ **Post date:** [June 29, 2015, 10:46am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3598 "2015-06-29T10:46:38Z")
> [@Fear\_Itself](#): > > There’s your problem right there, you think single payer equals taking away private insurance. All we have to do is offer a public option with lower premiums and better benefits and the private plans will wither as people voluntarily switch over. No taking away required. Private plans cannot compete when there is an alternative with no profit motive, lower overhead and increased bargaining power. Good riddance to bloodsucking parasites. The UK, which has universal single-provider health care, still has private health insurance companies such as BUPA (which I get through my job) who cover what are basically add-ons to the current system - private facilities, shortened waiting times, coverage of non-urgent but medically-justifiable conditions, regular thorough health checks, that sort of thing. BUPA do quite well out of it, it doesn’t conflict with the basic care level the NHS provides, and users get added value. Win-win all around. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [June 29, 2015, 1:28pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3599 "2015-06-29T13:28:35Z")
> [@adaher](#): > > Countries with multi-payer UHC also do not vote theirs out. Which says that once UHC is in effect, voters tend to go ultraconservative on the issue of any major changes. Is that because people are naturally ultraconservative, or because they like having UHC? > [@](#): > > The same will be true of ACA if it succeeds. What would it take for you to drop the “if”? ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [July 1, 2015, 3:59am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3600 "2015-07-01T03:59:41Z")
I think the real question now is to what extent do you guys think that ACA repeal will be a centerpiece component of the 2016 GOP nominee? I mean, with this last SCOTUS case basically laughed out of court, the law will continue unimpeded throughout the rest of Obama’s term. By the time he leaves office, we’re gonna be looking at ~30 million people owing their health coverage _directly_ to Obamacare; that’s nearly a tenth of the US population. Any Pub candidate who runs on ACA repeal is effectively going to be running on snatching health insurance from 30 million people. I just don’t see how that’s tenable. ---
**Author:** ![Robert163](https://avatars.discourse-cdn.com/v4/letter/r/4af34b/32.png) [@Robert163](https://boards.straightdope.com/u/Robert163)\ **Post date:** [July 1, 2015, 4:03am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/3601 "2015-07-01T04:03:58Z")
> [@2ManyTacos](#): > > I think the real question now is to what extent do you guys think that ACA repeal will be a centerpiece component of the 2016 GOP nominee? > > I mean, with this last SCOTUS case basically laughed out of court, the law will continue unimpeded throughout the rest of Obama’s term. By the time he leaves office, we’re gonna be looking at ~30 million people owing their health coverage _directly_ to Obamacare; that’s nearly a tenth of the US population. Any Pub candidate who runs on ACA repeal is effectively going to be running on snatching health insurance from 30 million people. > > I just don’t see how that’s tenable. Look, this is not a biased question, I am a far left liberal, but as it stands, the ACA has many problems, primarily that for may people insurance is now more expensive and has less coverage before. Perhaps that is because the state I live in, Georgia, is an “anti-obamacare” state. But, I saw a recent thread that asked what people were paying for coverage under ACA and most people said they had very large payments. So, how will democrats keep support for ACA if it is so expensive? [Previous page](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561.md?page=179) [Next page](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561.md?page=181)