I think I’m finally starting to understand where trump support comes from. I mean, it’s still total bs, and the things he says he’s going to do are either things he can’t do or things that will make everyone worse off. But at least he talks about making things better and getting people more money. The alternative (establishment dems) literally don’t do that at all. It’s “were going to open up the mines and get you all lots of money” vs “you’re all going to have to move and spend the rest of your life on a computer.” Which is why it really has to be bernie, not even warren really promises stuff.
I mean it’s worse than that really. If they have to spend 80% of premiums on care, then they can make $100 profit on a $400 insulin shot, but if the insulin shot costs $800 then they can suddenly make $200!
Sure - there are ways to game the system, and there’s lots of room for action on prescription drug pricing. Again, I don’t believe that the ACA fixed everything.
But here’s why I’m getting so frustrated in this thread: The ACA made real and substantial improvements to this country’s healthcare system. I get the feeling that, rather than defending those improvements and wanting to campaign on maintaining those improvements, some of the people in this thread would rather say, “The ACA was a steaming shitpile that didn’t accomplish anything and doesn’t deserve to be defended. If we can’t get a public option or single payer, there’s no point in working for improvement.”
That seems like a terrible way to campaign, particularly since there’s a 0% chance that a Democratic president could pass anything like the ACA in 2020, let alone something more progressive. And it’s likely to be very wrong - The real choice is between a Democrat who will at least keep the ACA in place and possibly build on it vs. a Trump term that’s likely to feature:
more work requirements
an expansion of short-term insurance policies that don’t meet the requirements of the ACA
further cutbacks in spending
Like, there was an earlier comment about rising insurer profit margins. I look at something like this and I see how harmful it can be to have someone like Trump in office:
Look at that individual market - that’s the one that was viewed as most in need of reform. Steady decreases from 2010 through 2015. Then a crazy spike:
By 2017, the individual market generally had begun to stabilize. However, going into 2018, insurers raised benchmark premiums by an average of 34% in response to policy changes such as the Trump Administration’s decision to cease cost-sharing subsidy payments and uncertainty over whether the ACA as a whole would remain law or whether the individual mandate would be enforced. These premium hikes, along with slow claims growth, made 2018 the most profitable year for individual market insurers since the ACA went into effect.
I think it’s both inaccurate and bad strategy to simply dismiss the changes made by the ACA.
Sure, each of those things in a vacuum are small improvements, but all of the “small accomplishments” of the Obama admin still moved the country in a positive direction.
Repealing DADT, his evolution on gay marriage and putting the deciding justices for Obergefell on SCOTUS were bfds to gay people. Trump is booting trans people out of the military via tweet.
The DOJ was taking positive steps to reduce the use of civil asset forfeiture and impose consent decrees on some of the most abusive police departments in the country. Good old Beauregard rolled those things back.
Obama lifted some sanctions and travel restrictions on Cuba and worked out the Iran deal. Trump rolled it all back.
Oh, and let’s not forget that he got us out of a horrible recession in a manner that was pretty good relative to the likely outcomes possible @ the time of the crisis.
Sure, these are individually marginal changes, but (a) they collectively add up to real significant progress for millions of people and (b) they’d be looked at much differently now if Trump hadn’t spent his entire presidency going after everything Obama did like a heat seeking missile.
[And, sure, I put some blame on Obama for building things that could be taken down so easily, but I also recognize that there is a fundamental asymmetry between a brick layer and a wrecking ball - the wrecking ball will always win, no matter how much we yell at the brick layer to go faster]
The whole system needs to be nuked, period. Of course it’s an improvement over bankruptcy or death but when you’re making $50k and shipping off $8k a year to health insurance companies you aren’t super excited about not dying, you’re still pissed off and susceptible to voting for Donald Trump because while he may be an asshole at least he fights.
The core need for Democrats is a flame throwing DGAF burn it all down and salt the soil of the GOP politician. Period.
The tiniest possible improvements to stave off structural change has been around a long time. Probably since before Otto von Bismarck pioneered the modern social welfare state.
And does the architect of the ACA want further concessions? He sure doesn’t seem to. Eh, maybe he does. It’s just a lower priority than keeping power out of the hands of a non-party member.