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[SalmonGod]

EDIT: @SalmonGod: As I understand it the ACA is less bureaucracy and expense for the government than if they provided and payed for all the care directly.

So when you responded to the article that began this discussion

cheaper for whom?

What you really should have said was "I believe this article is flat out wrong, and the opposite is true in reality."

To which we would respond "Can you counter this research with any valid supporting information of your own?"

[Frumple]

Competition in health care lowers prices, eh?

... how's that been working for us, over here in the US where we've been mostly trying that for the last ever?

I mean, other than horrifically :V

Ah. Wait, wait. You said good for prices. Well, that's kinda' been true. Just not for the consumer, ha.

[Bauglir]

Ah, okay, so. Urist, the ACA is the opposite of what you understand it to be. Sorry. It adds additional layers of bureaucracy by making health insurance mandatory and maintaining the private system. It in no way provides universal healthcare, because there was no way to make that politically acceptable (if you believe the Dems) or because the medical industries in general pony up way too much dosh for campaigns (if you don't). Competition in the industry is hypothetical.

The efficient option would be to scrap the entire insurance system and the infrastructure that goes with it and instead implement universal healthcare, which would ideally mean that you walk into a hospital, get treatment, end of story. That may not be the exact model they used. But the point of the article is that free riders and everything else that could go with it are apparently significantly less of a cost than the overhead we employ to keep those costs down.

That is, the article is very much for universal healthcare, which is antithetical to the bureaucracy that the ACA propped up.

[mainiac]

Anyways, I REALLY don't know. What reasons? Somehow avoiding free riders? Not making the government the sole payer for care? Like, don't take this as snark, I just really don't see the problems.

Considering that free riders have resulted in the collapse of half a dozen state insurance market reforms they are a crucial issue.

The core 3 things that the ACA does:
Universal affordability (at least until the Supreme Court gave a middle finger to the medicaid expansion)
Avoid a free rider death spiral
Affordability (so the mandate doesn't lead to bankruptcies)

I would have loved if Congress had just expanded Medicare to cover all Americans.  It would have been a vastly preferable outcome and very simple.  However it wasn't going to fucking happen.  The ACA was a big fucking deal.  Sure it had compromises and imperfections but it was what they could get.  A lot of politicians considered it so important that they committed political suicide just to get it passed.

Of course people will cynically disagree with anything congresspeople say.  We are simultaneously shouted at that the law goes too far and not far enough, generally by media fingers who dont know the first goddamn thing about healthcare costs.  C'est la vie.

[FearfulJesuit]

President suggests mandatory voting.

I'm not entirely sure I agree with it, but it would definitely change the political map. Huge numbers of otherwise gerrymandered House districts might flip, and the GOP would very suddenly find itself up a creek without a paddle. That might be a good thing in the long run.

[Reelya]

cheaper for whom?

Total cost of ownership. Most countries spend less on health than USA and get more coverage for it.

For example, Australia spends about $5000 per capita per year on health coverage. And you can just go to hospital and get treated, no expectation to pay or questions about insurance. The US goverment spends about $5000 per person already, over $1.5 trillion per year spent on both federal and state level, yet they turn you away for not being "insured". You're hit twice - once by taxes and again by private companies, and get less coverage than many places where you pay that only once.

You pay the same health taxes we do, yet most people who pay the tax in America can't go to hospital without paying again. We in Australia just pay the tax once at about what you guys are taxed, but our taxes at least cover ourselves when we get sick and not just other people.

[Morrigi]

President suggests mandatory voting.

I'm not entirely sure I agree with it, but it would definitely change the political map. Huge numbers of otherwise gerrymandered House districts might flip, and the GOP would very suddenly find itself up a creek without a paddle. That might be a good thing in the long run.

It's a terrible idea, and violates the concept of American freedom. Voting is a right, and rights are not mandatory for the individual to exercise, only mandatory for the government to protect. Also, all this would probably do is increase the number of people writing in "Mickey Mouse", "Adolf Hitler", and other ridiculous shit because they don't want to vote.

[nenjin]

Also seems like, when you double or triple the amount of votes coming in, it's an easier situation in which to falsify votes. If everyone is on a sheet somewhere that says that they to vote, rather than registered voter lists, what is to stop a less scrupulous polling place to just vote in their stead?

I'm not wholly opposed to the idea, but...I'm torn. On one side, yay for suggesting a dramatic change to the way we do business. On the other....seems kind of like Obama is just shooting wild ideas from the hip, as 2nd-term president with no fucks given.

[Sheb]

Yeah, because everyone know Austria and Belgium's government are just elected by fake voters frauding...

[GreatJustice]

Competition in health care lowers prices, eh?

... how's that been working for us, over here in the US where we've been mostly trying that for the last ever?

I mean, other than horrifically :V

Ah. Wait, wait. You said good for prices. Well, that's kinda' been true. Just not for the consumer, ha.

The US hasn't had competition in health care for about fifty years. Doctor licensure is very strictly limited, there are less hospitals in the US now than there were fifty (or, indeed, a hundred) years ago, states basically require that all insurance plans cover such a wide variety of procedures that paying for "insurance" is basically just pre-emptively paying for regular medical care (except the costs aren't passed onto the consumer unless you don't have insurance, so there's no incentive to cut costs), and the FDA basically regulates the pharmaceutical industry in such a way as to ensure it operates like a cartel and to prevent any competition arising.

The only thing "free market" about American healthcare is that it nominally isn't operated directly by the government but by a network of politically connected corporations. Even that ignores those exemplars of American-style universal healthcare, the Indian Health Service and the Veterans Administration, as well as indirect government interventions such as Medicare and Medicaid.

[Angle]

Hmm, mandatory voting. I kinda like it. though I'm not convinced it'll really change anything. In my experience, most people who don't vote are pretty ignorant.

[nenjin]

Yeah, because everyone know Austria and Belgium's government are just elected by fake voters frauding...

Did I mention either of those countries? Are either of those countries America with our brand of partisan politics, or even a fraction of our population, or our rickety ass system of voter registration? Did I even mention the voters frauding?

[Angle]

Is voter fraus seriously a problem? I thought we had a bigger issue with voter suppression.

[nenjin]

Is voter fraus seriously a problem? I thought we had a bigger issue with voter suppression.

Right wing Republicans and the Tea Party like to claim fraud, committed by voters, is a real issue. (Believed by the left to be a smoke screen for arguments that increase voter suppression/disenfranchisement.)  It's essentially been proven to not be, something on the order of 1 to 3 percent iirc.

Fraud committed by polling places and political organizations has also never been definitely proven but it got a lot of attention in the Bush/Gore election.

To be clear, I'm not saying "Mandatory voting will make it easier for voters to commit fraud." My worry is that "Mandatory voting will make it easier for political organizations to commit fraud, and/or harder to prove that they did so." Voter apathy in America is a big thing and I can imagine many not voting because of it, consequences be damned, yet their votes still getting cast anyways by someone since legally it's supposed to be.

I mean, my old polling place still had 5 elderly women handing out paper and marking your vote by hand on a piece of paper. Now quadruple their workload and double the # of polling places. Seems like a place ripe for manipulation and abuse. Not by the voter, but by the vote takers.

[Bauglir]

1 to 3 percent iirc.

That would be a huge problem, given the margins of so many of our elections. Fortunately, it's not so much 1 to 3 percent as it is 1 to 3 dozen. Incidents. 31, to be exact. Over the course of a billion ballots. The whole thing is a fucking joke, yeah.