Knowing what you know now, would you have voted for ObamaCare....

[windjammer]

Of course. It is working!

[Frodo]

I definitely would still have voted for it, and in the future -once we get back our majorities in Congress- we should federalize Medicaid and have one single national health insurance market, instead of leaving it to the states so they can do their mischief at the expense of the most vulnerable.  

[Antonio the Sixth]

It's not even feasible here in the Netherlands.

Wait, don't the Netherlands already have a public health service?

[Intell]

No, full on for public option.

This position makes no sense. The question is: did you want something that's imperfect that saved and helped many lives, or nothing and therefore those lives weren't saved or helped?

So you're both saying you would rather have let people die, let families go bankrupt, because you wanted something more ideologically pure? Rather than accept the imperfect, and try to build progress from there? Either you didn't think it through, or you're more wedded to ideological purity than actually helping and serving others.

The democrats didn't need to pass a half-assed law on healthcare reform, and they could've gone full on  public option, which the american public strongly support, or in idea strongly support. They could've supported the public option, if the progressive/left-wing of the democratic party, led an revolt against Obamacare.

The health insurance hasn't worked for a lot of people, and has caused an anti-public healthcare sentiment to grow.

I very much oppose it's repeal though.

[DavidB.]

It's not even feasible here in the Netherlands.

Wait, don't the Netherlands already have a public health service?

We have a system that's obviously more "public"/regulated and better functioning than the U.S. system, but it's not a single payer system like the NHS: people are insured through private insurance companies (which has become an oligopoly). Being insured is mandatory. The system is functioning pretty well, but co-payments have gone through the roof (as have healthcare costs in general, to be fair) due to the fact that we have an aging population and I would probably support switching to a single-payer system, but only the SP and the PvdD want to do so.

[Since I'm the mad scientist proclaimed by myself]

No, full on for public option.

This position makes no sense. The question is: did you want something that's imperfect that saved and helped many lives, or nothing and therefore those lives weren't saved or helped?

So you're both saying you would rather have let people die, let families go bankrupt, because you wanted something more ideologically pure? Rather than accept the imperfect, and try to build progress from there? Either you didn't think it through, or you're more wedded to ideological purity than actually helping and serving others.

The democrats didn't need to pass a half-assed law on healthcare reform, and they could've gone full on  public option, which the american public strongly support, or in idea strongly support. They could've supported the public option, if the progressive/left-wing of the democratic party, led an revolt against Obamacare.

The health insurance hasn't worked for a lot of people, and has caused an anti-public healthcare sentiment to grow.

I very much oppose it's repeal though.

It would have failed and split the left in two in the process.

[Blue3]

No, full on for public option.

This position makes no sense. The question is: did you want something that's imperfect that saved and helped many lives, or nothing and therefore those lives weren't saved or helped?

So you're both saying you would rather have let people die, let families go bankrupt, because you wanted something more ideologically pure? Rather than accept the imperfect, and try to build progress from there? Either you didn't think it through, or you're more wedded to ideological purity than actually helping and serving others.

The democrats didn't need to pass a half-assed law on healthcare reform, and they could've gone full on  public option, which the american public strongly support, or in idea strongly support. They could've supported the public option, if the progressive/left-wing of the democratic party, led an revolt against Obamacare.

The health insurance hasn't worked for a lot of people, and has caused an anti-public healthcare sentiment to grow.

I very much oppose it's repeal though.

Joe Lieberman killed the public option because he denied them 60 votes, (and I think a couple other Democrats too but not sure). Nelson and Landrieu were originally going to vote against it, until they said they would vote for it if their states got some pork spending.

So if you demanded a public option as a necessity, it wouldn't have passed, and people whose lives were saved would have died.

[Antonio the Sixth]

It's not even feasible here in the Netherlands.

Wait, don't the Netherlands already have a public health service?

We have a system that's obviously more "public"/regulated and better functioning than the U.S. system, but it's not a single payer system like the NHS: people are insured through private insurance companies (which has become an oligopoly). Being insured is mandatory. The system is functioning pretty well, but co-payments have gone through the roof (as have healthcare costs in general, to be fair) due to the fact that we have an aging population and I would probably support switching to a single-payer system, but only the SP and the PvdD want to do so.

You mean PvdA, or does the animal rights crowd have a particular reason to want single-payer?

[DavidB.]

It's not even feasible here in the Netherlands.

Wait, don't the Netherlands already have a public health service?

We have a system that's obviously more "public"/regulated and better functioning than the U.S. system, but it's not a single payer system like the NHS: people are insured through private insurance companies (which has become an oligopoly). Being insured is mandatory. The system is functioning pretty well, but co-payments have gone through the roof (as have healthcare costs in general, to be fair) due to the fact that we have an aging population and I would probably support switching to a single-payer system, but only the SP and the PvdD want to do so.

You mean PvdA, or does the animal rights crowd have a particular reason to want single-payer?

No, I mean PvdD, who are significantly to the left of the PvdA (not a high bar these days, but still). Their economic program isn't that different from that of the SP. (Oh, and I forgot that 50Plus want it too.)

[Antonio the Sixth]

Haha, Netherlands never ceases to amaze.

[🦀🎂🦀🎂]

I assume deworming, neutering etc. will all be covered under the pvdd's plans?

Also, kind of surprised that GL under its LEFT TURN doesn't support single payer.

[Mr. Smith]

Not in 2009/2010 with a midterm under way. More stimulus would be priority.

But in 2012 if the same things happened, yes.

[Antonio the Sixth]

Agree with Antonio and Blue3 here. The ACA is very imperfect but it has saved lives.

It's counter-intuitive, but evidence in favor of this is surprisingly thin.

One of the strange features of the debate over repeal and replace is that whether Americans have been getting healthier since the Affordable Care Act was implemented is virtually ignored by both sides. We talk about rates of coverage, cost growth, access to care, and maybe quality of care, but we don't talk about premature death, age-adjusted mortality, rates of chronic disease, and self-assessed well-being.

The truth is that the ACA has not had a clear positive effect on measures of population health. More Americans are killing themselves, more Americans are dying or being hospitalized on account of drug overdoses, more Americans are obese, more Americans are diabetics, more Americans are binge drinking, and mortality rates across almost all causes of death are beginning to creep up.

Looking at the trend since ACA's passage is an incredibly misleading approach. Plenty of other things have changed to affect health indicators over that time period, so you can't connect any change causally to the ACA. What you need to compare it to is the counterfactual of an America where ACA was never passed (which we obviously can't see, but which we might be able to estimate).

[Santander]

Agree with Antonio and Blue3 here. The ACA is very imperfect but it has saved lives.

It's counter-intuitive, but evidence in favor of this is surprisingly thin.

One of the strange features of the debate over repeal and replace is that whether Americans have been getting healthier since the Affordable Care Act was implemented is virtually ignored by both sides. We talk about rates of coverage, cost growth, access to care, and maybe quality of care, but we don't talk about premature death, age-adjusted mortality, rates of chronic disease, and self-assessed well-being.

The truth is that the ACA has not had a clear positive effect on measures of population health. More Americans are killing themselves, more Americans are dying or being hospitalized on account of drug overdoses, more Americans are obese, more Americans are diabetics, more Americans are binge drinking, and mortality rates across almost all causes of death are beginning to creep up.

Looking at the trend since ACA's passage is an incredibly misleading approach. Plenty of other things have changed to affect health indicators over that time period, so you can't connect any change causally to the ACA. What you need to compare it to is the counterfactual of an America where ACA was never passed (which we obviously can't see, but which we might be able to estimate).

If the trends were positive, you would not hesitate to attribute it to Obamacare.

[Filuwaúrdjan]

On the issue of downballot losses note that the Republicans are a hair away from having a Constitution-amending majority amongst the State Legislatures. Not a joke, although I wish otherwise.

[White Trash]

Would only vote for it if a public option or single-payer was off the table.

[Antonio the Sixth]

The main concern here are the persistent downballot losses from 2010 through 2016 rather than any particular presidential election, which is inherently less predictable.

There's an argument to be made that the ACA made 2014 significantly worse for Democrats, but that's about the only year for which I can see such argument. For 2010, do you really think Democrats would have been in a better position if the bill had failed? I could only see it hurting them further. In 2012, the bill was actually fairly popular and Romney's attacks on it seemed to backfire for obvious reasons. In 2016, it was barely mentioned as an issue, and I doubt any of Feingold, McGinty, Kander or House members lost because of it.

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Fair enough. Well, that's a shame.

[TheDeadFlagBlues]

Agree with Antonio and Blue3 here. The ACA is very imperfect but it has saved lives.

It's counter-intuitive, but evidence in favor of this is surprisingly thin.

One of the strange features of the debate over repeal and replace is that whether Americans have been getting healthier since the Affordable Care Act was implemented is virtually ignored by both sides. We talk about rates of coverage, cost growth, access to care, and maybe quality of care, but we don't talk about premature death, age-adjusted mortality, rates of chronic disease, and self-assessed well-being.

The truth is that the ACA has not had a clear positive effect on measures of population health. More Americans are killing themselves, more Americans are dying or being hospitalized on account of drug overdoses, more Americans are obese, more Americans are diabetics, more Americans are binge drinking, and mortality rates across almost all causes of death are beginning to creep up.

^^^

I'd argue that co-payments play a role in this but it's worth noting that the role that insurance plays in treatment outcomes was studied in a policy experiment in Oregon and researchers found that there was no effect on physical health, though Medicaid coverage dramatically improved mental health outcomes of participants, which is a strong argument for the ACA being important, of course.

More and more, it's clear to me that health outcomes are the product of something broader than the efficacy of the healthcare system. There have been a number of studies relating to drug addiction that indicate that the propensity for drug dependence is affected by internal beliefs about external success/meaning. It's not hard to see how this could translate to other areas of life; everyone knows that junk food, smoking and opiates are bad and that physical activity is good but only certain people act on this knowledge. I don't think it's necessary to "nudge" people towards good behavior (they know what that is), you have to give them the sense that their lives matter and this is more simple than it seems: give them economic security by redistributing wealth/income, which in turn gives them power.

[Torie]

It all depends on how I perceived what the alternative was to voting Obamacare down. Would there by enough votes to enact something else that would work better?  You know, like my plan? Or were the votes just not there to do something sensible. Obamacare was better than the then status quo, that left millions with no insurance and no adequate medical care.

It is the same issue when it comes to firing somebody. If you do, can you expect to find somebody better? Sometimes given the constraints, there is no better option, so one has to suck it up, and live with something that basically sucks. Who knew?

Gosh, I sound like a left winger these days or something

[Blue3]

Like I said on page 1:


It has saved lives.

It has saved families from bankruptcies.


I probably could be in either of those 2 categories.

[RaphaelDLG]

I would have probably voted for it, but then offered to go campaign for Joe Lieberman's primary opponent, and bitched endlessly about the filibuster.

[SWE]

I would have probably voted for it, but then offered to go campaign for Joe Lieberman's primary opponent, and bitched endlessly about the filibuster.

You'd have had a tough time finding someone to primary an independent.

[Blue3]

That was when he was a Democrat, I think?

[Antonio the Sixth]

That was when he was a Democrat, I think?

Nope. Besides, he retired the next time his seat was up.

[Oldiesfreak1854]

No, support repeal, but only with a replacement.