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> ACA was the most radical package that could have passed, and it still cost Democrats the Congress. People aren’t excited by half measures that let health ins

by marricks 11mo ago

> ACA was the most radical package that could have passed, and it still cost Democrats the Congress. People aren’t excited by half measures that let health insurance companies generate tons of money and CONTINUOUSLY raise premiums. People still go bankrupt receiving cancer care here. The person who gets free healthcare and cuts overall costs by destroying health insurance middle man will be massively popular and, once the effects are borne out, win congress in a landslide. Perhaps Obama couldn't have made it happen, but he didn't try. He could have made a speech about "how we will do because not because it's easy, but because it's possible because every other western nation has this same basic thing." But here we are with a crappy compromise.

EgregiousCube 11mo ago
“It works in Europe” isn’t a very good American political rallying cry though; Americans generally don’t have the opinion that Europe works very well.
- mdhb 11mo ago
  Only because American discourse and thinking is so utterly poisoned by the absolute bullshit that is “American exceptionalism”. In terms of almost any possible quality of life metric you can think of Europe is ahead of the US. That combined with just a breathtaking level of ignorance of what Europe is actually like in any meaningful sense. You saw this a lot in this NYC election where they were trying to paint Mamdani as an actual communist because well over half of the country has no idea what “democratic socialism” means let alone communism.
  - olelele 11mo ago
    Except the McMansions and that every family has at least 3 cars…
    - mdhb 11mo ago
      The majority of Americans live pay check to pay check back in the real world. It’s the only country I’ve seen outside of a war zone where people are regularly trying to crowdfund money for basic things like food, education, justice or medical care. The story you’re telling yourself is entirely divorced from reality. I remember the parent of an ex of mine who was from NY tell me how lucky they were to have such incredible insurance and medical coverage when his wife got cancer because he only had to pay the first $100k/yr out of pocket and then the rest was “free”. It was repeatedly stressed to me what a rare thing this was and most people would be in such a worse position. Anyways, long story short… They hit that limit by February and then spent the rest of the year getting denied by their insurance company until the day she died. But at least she was treated at “the best cancer hospital in the world”.
      - defrost 11mo ago
        > But at least she was treated at “the best cancer hospital in the world”. Last time I checked, Australia had better cancer survival rates than the US, higher quality of life, greater expected life span, and a hybrid medicare / private insurance system that covered almost the entire population such that very few faced medical bills outside the reach of their income (or lack thereof). I had a stent inserted to clear a clot that travelled to my heart from a knee injury - free (surgery, two and half days in hospital, follow up recovery and lifestyle advice appoints). The ambulance cost more as I was between St John's Ambulance covers at the time, that was $500 which I was happy to pay (myself, my father, and multiple family members have all worked as volunteer ambulance drivers and paramedics over the years).
        mdhb 11mo ago
        Yes, that was the sad joke unfortunately. The hospital was genuinely world renowned but what good does that do you if you can’t afford to use it. You die… hence the difference in survival rates.
        mlrtime 11mo ago
        "Average Cancer Survival Rates by Country: United States: 68% (overall), UK: 63% (overall), Canada: 67% (overall), Australia: 70% (overall), and France: 65% (overall). " -google You're not wrong, but this thread makes it sound like the US is completely backwards when it's off by 1-2% and higher than other "socialist" countries.
  - throwaway91530 11mo ago
    > In terms of almost any possible quality of life metric you can think of Europe is ahead of the US. Laughable statement, considering Europeans give a leg and a arm to live in America.
    - mdhb 11mo ago
      Real land of the free and home of the brave stuff here with a throwaway account to offer such gripping commentary. Just talk like a normal adult with your normal account and accept that maybe some people think your opinion is bad and you lose an internet point.
      - throwaway665667 11mo ago
        Judging people by the content of their character and their opinions, and not their superficial characteristics is an American value. Is that an alien concept to people who supposedly enjoy such a high quality of life?
        mdhb 11mo ago
        What on earth are you talking about? I’m asking why you’re scared of losing magic internet points and need to hide behind throwaway accounts and you’re here talking about the inner fortitude of the American character. For what it’s worth, not that you asked but this year in particular has really only cemented my view of the general US citizen as a very scared individual who is terrified to stand up for anything. What you’re doing right now is actually great example of that under what could only be described as the lowest stakes scenario possible. You could probably learn something from the “cheese eating surrender monkey” French who you’re all to happy to compare yourselves against but at least they are willing to fight for what they have.
        Hikikomori 11mo ago
        >and not their superficial characteristics is an American value Is this satire? Or do you not believe that racism exist in America?
    - 11mo ago
  - sillyfluke 11mo ago
    Yeah, but this only strengthens the parents point that "It works in europe" is not a good rallying cry in the states. It's also too easy for opponents to counter and point to random europeans who complain about their own system and win cheap debate points on that front. It might be better to just lean into the exceptionalism and say, "We're America, we're richer, we can make a better system." Or something along those lines.
    - mdhb 11mo ago
      Counterpoint: The country really needs to learn how to have a grown up conversation and not allow the dumbest people in the room with the least generous interpretation of everything possible who were never going to vote for you anyways to constantly set the agenda. Sensible voices are a rare thing in this climate and it’s incredibly easy to stand out as one if you stop playing by a set of rules that were intentionally designed to make you fail in the first place. Honestly I think the American exceptionalism shit is a cancer on the society and I find it incredibly hard to distinguish from the "Deutschland über alles" nonsense that the Germans went through. It’s just a fundamentally flawed way of looking at the world. It’s like a story a small child might believe but it really doesn’t stand up to even the most gentle of scrutiny.
      - sillyfluke 11mo ago
        >Honestly I think the American exceptionalism shit is a cancer on the society and I find it incredibly hard to distinguish from the "Deutschland über alles" nonsense that the Germans went through. I think it would be wise for us to remember that it is/was not only Americans that believed in American exceptionalism, but immigrants that were actually trying to come to the States among other possible options who believed in it-- prior to this administration that is. You would have to admit it would be a ridiculous thing for them to do if they couldn't distinguish it from "Deutschland über alles". >>You can go to live in France, but you cannot become a Frenchman. You can go to live in Germany or Turkey or Japan, but you cannot become a German, a Turk, or a Japanese. But anyone, from any corner of the Earth, can come to live in America and become an American. This was the Republican president Ronald Reagan speaking. The world has caught up obviously since then in this regard as well, but prior to this administration it would not be a stretch to say this was true of America more than any other nation.
macNchz 11mo ago
> once the effects are borne out, win congress in a landslide. There is a deep, foundational information problem that would need to be overcome for this to ever actually happen. Medicare, for example, is viewed incredibly favorably, but tons of people don’t even know it’s a government program! This survey found only 58% of people over 65 recognized that: https://www.nerdwallet.com/article/insurance/medicare/medicare-study-2023 https://www.nerdwallet.com/article/insurance/medicare/medica... We are in an information twilight zone where perception of policy outcomes is basically entirely dependent on choice of news sources.
- toast0 11mo ago
  The solution is simple. Expand Medicare. But you need to do it slowly or it will implode. For ten years, every year, drop the eligibility age by 1 year. Then for the next ten years, every year, drop the eligibility age by 2 years. Maybe keep going at 2 years every year from there, but it should probably be adjusted over time as the effects of rising enrollment show the acheivable enrollment rate. In the meantime, start covering all kids with Medicaid from birth to X, adding 6 months every year for the first 10 years, then 1 year per year until it overlaps with most people getting enough social security credits to be eligible for Medicare. At that point, you can probably just make Medicaid available for everyone, if you don't have 40 social security credits by age 35, you probably qualify for Medicaid under current rules. Again, it'd be helpful for Congress to supervise and adjust as needed.
- arcticbull 11mo ago
  A lot of Americans don't even realize that Obamacare and the ACA are the same thing -- even in 2017 it was 1/3. I believe the skew is even worse today. https://www.nytimes.com/2017/02/07/upshot/one-third-dont-know-obamacare-and-affordable-care-act-are-the-same.html https://www.nytimes.com/2017/02/07/upshot/one-third-dont-kno...
troupo 11mo ago
> Perhaps Obama couldn't have made it happen, but he didn't try. They barely passed ACA after over a year of negotiating with the Republicans and removing lots off provisions from it. How do you expect someone to just come along and pass an even more radical reform?

EgregiousCube 11mo ago

“It works in Europe” isn’t a very good American political rallying cry though; Americans generally don’t have the opinion that Europe works very well.

mdhb 11mo ago
Only because American discourse and thinking is so utterly poisoned by the absolute bullshit that is “American exceptionalism”. In terms of almost any possible quality of life metric you can think of Europe is ahead of the US. That combined with just a breathtaking level of ignorance of what Europe is actually like in any meaningful sense. You saw this a lot in this NYC election where they were trying to paint Mamdani as an actual communist because well over half of the country has no idea what “democratic socialism” means let alone communism.
- olelele 11mo ago
  Except the McMansions and that every family has at least 3 cars…
  - mdhb 11mo ago
    The majority of Americans live pay check to pay check back in the real world. It’s the only country I’ve seen outside of a war zone where people are regularly trying to crowdfund money for basic things like food, education, justice or medical care. The story you’re telling yourself is entirely divorced from reality. I remember the parent of an ex of mine who was from NY tell me how lucky they were to have such incredible insurance and medical coverage when his wife got cancer because he only had to pay the first $100k/yr out of pocket and then the rest was “free”. It was repeatedly stressed to me what a rare thing this was and most people would be in such a worse position. Anyways, long story short… They hit that limit by February and then spent the rest of the year getting denied by their insurance company until the day she died. But at least she was treated at “the best cancer hospital in the world”.
    - defrost 11mo ago
      > But at least she was treated at “the best cancer hospital in the world”. Last time I checked, Australia had better cancer survival rates than the US, higher quality of life, greater expected life span, and a hybrid medicare / private insurance system that covered almost the entire population such that very few faced medical bills outside the reach of their income (or lack thereof). I had a stent inserted to clear a clot that travelled to my heart from a knee injury - free (surgery, two and half days in hospital, follow up recovery and lifestyle advice appoints). The ambulance cost more as I was between St John's Ambulance covers at the time, that was $500 which I was happy to pay (myself, my father, and multiple family members have all worked as volunteer ambulance drivers and paramedics over the years).
      - mdhb 11mo ago
        Yes, that was the sad joke unfortunately. The hospital was genuinely world renowned but what good does that do you if you can’t afford to use it. You die… hence the difference in survival rates.
      - mlrtime 11mo ago
        "Average Cancer Survival Rates by Country: United States: 68% (overall), UK: 63% (overall), Canada: 67% (overall), Australia: 70% (overall), and France: 65% (overall). " -google You're not wrong, but this thread makes it sound like the US is completely backwards when it's off by 1-2% and higher than other "socialist" countries.
- throwaway91530 11mo ago
  > In terms of almost any possible quality of life metric you can think of Europe is ahead of the US. Laughable statement, considering Europeans give a leg and a arm to live in America.
  - mdhb 11mo ago
    Real land of the free and home of the brave stuff here with a throwaway account to offer such gripping commentary. Just talk like a normal adult with your normal account and accept that maybe some people think your opinion is bad and you lose an internet point.
    - throwaway665667 11mo ago
      Judging people by the content of their character and their opinions, and not their superficial characteristics is an American value. Is that an alien concept to people who supposedly enjoy such a high quality of life?
      - mdhb 11mo ago
        What on earth are you talking about? I’m asking why you’re scared of losing magic internet points and need to hide behind throwaway accounts and you’re here talking about the inner fortitude of the American character. For what it’s worth, not that you asked but this year in particular has really only cemented my view of the general US citizen as a very scared individual who is terrified to stand up for anything. What you’re doing right now is actually great example of that under what could only be described as the lowest stakes scenario possible. You could probably learn something from the “cheese eating surrender monkey” French who you’re all to happy to compare yourselves against but at least they are willing to fight for what they have.
      - Hikikomori 11mo ago
        >and not their superficial characteristics is an American value Is this satire? Or do you not believe that racism exist in America?
  - 11mo ago
- sillyfluke 11mo ago
  Yeah, but this only strengthens the parents point that "It works in europe" is not a good rallying cry in the states. It's also too easy for opponents to counter and point to random europeans who complain about their own system and win cheap debate points on that front. It might be better to just lean into the exceptionalism and say, "We're America, we're richer, we can make a better system." Or something along those lines.
  - mdhb 11mo ago
    Counterpoint: The country really needs to learn how to have a grown up conversation and not allow the dumbest people in the room with the least generous interpretation of everything possible who were never going to vote for you anyways to constantly set the agenda. Sensible voices are a rare thing in this climate and it’s incredibly easy to stand out as one if you stop playing by a set of rules that were intentionally designed to make you fail in the first place. Honestly I think the American exceptionalism shit is a cancer on the society and I find it incredibly hard to distinguish from the "Deutschland über alles" nonsense that the Germans went through. It’s just a fundamentally flawed way of looking at the world. It’s like a story a small child might believe but it really doesn’t stand up to even the most gentle of scrutiny.
    - sillyfluke 11mo ago
      >Honestly I think the American exceptionalism shit is a cancer on the society and I find it incredibly hard to distinguish from the "Deutschland über alles" nonsense that the Germans went through. I think it would be wise for us to remember that it is/was not only Americans that believed in American exceptionalism, but immigrants that were actually trying to come to the States among other possible options who believed in it-- prior to this administration that is. You would have to admit it would be a ridiculous thing for them to do if they couldn't distinguish it from "Deutschland über alles". >>You can go to live in France, but you cannot become a Frenchman. You can go to live in Germany or Turkey or Japan, but you cannot become a German, a Turk, or a Japanese. But anyone, from any corner of the Earth, can come to live in America and become an American. This was the Republican president Ronald Reagan speaking. The world has caught up obviously since then in this regard as well, but prior to this administration it would not be a stretch to say this was true of America more than any other nation.

macNchz 11mo ago

> once the effects are borne out, win congress in a landslide. There is a deep, foundational information problem that would need to be overcome for this to ever actually happen. Medicare, for example, is viewed incredibly favorably, but tons of people don’t even know it’s a government program! This survey found only 58% of people over 65 recognized that: https://www.nerdwallet.com/article/insurance/medicare/medicare-study-2023 https://www.nerdwallet.com/article/insurance/medicare/medica... We are in an information twilight zone where perception of policy outcomes is basically entirely dependent on choice of news sources.

toast0 11mo ago
The solution is simple. Expand Medicare. But you need to do it slowly or it will implode. For ten years, every year, drop the eligibility age by 1 year. Then for the next ten years, every year, drop the eligibility age by 2 years. Maybe keep going at 2 years every year from there, but it should probably be adjusted over time as the effects of rising enrollment show the acheivable enrollment rate. In the meantime, start covering all kids with Medicaid from birth to X, adding 6 months every year for the first 10 years, then 1 year per year until it overlaps with most people getting enough social security credits to be eligible for Medicare. At that point, you can probably just make Medicaid available for everyone, if you don't have 40 social security credits by age 35, you probably qualify for Medicaid under current rules. Again, it'd be helpful for Congress to supervise and adjust as needed.
arcticbull 11mo ago
A lot of Americans don't even realize that Obamacare and the ACA are the same thing -- even in 2017 it was 1/3. I believe the skew is even worse today. https://www.nytimes.com/2017/02/07/upshot/one-third-dont-know-obamacare-and-affordable-care-act-are-the-same.html https://www.nytimes.com/2017/02/07/upshot/one-third-dont-kno...

troupo 11mo ago

> Perhaps Obama couldn't have made it happen, but he didn't try. They barely passed ACA after over a year of negotiating with the Republicans and removing lots off provisions from it. How do you expect someone to just come along and pass an even more radical reform?