if you think court actions striking down the ACA will lead to Single Payer in the short term...

[CreekDog]

Think about who comprised the 60th votes to pass it in the Senate:

Lieberman, Ben Nelson, Blanche Lincoln.

They're all gone now, and there is no 60th vote for ACA now anyway. And back then, if you recall, keeping Lieberman in the fold requiring ditching plans to expand Medicare as quasi-public option for older, but not retirement age folks. Keeping Blanche Lincoln in the fold required getting rid of the public option altogether. And keeping Ben Nelson, well he wasn't very bright, so i'm not sure knowing that is very instructive.

So if you think that if ACA is somehow overturned (or if you're arguing that --I have my doubts that everyone who says this actually believes it... ) we'll get Single Payer to replace it, if I thought you were right, I'd support that too. But I don't because it will not. Even with a 50 vote threshold in the Senate, you don't have the votes (or Bernie Sanders would have supported it and opposed ACA --he didn't, remember?). Even with a 218 vote threshold in the House, you don't have the votes --well that's obvious isn't it.

And true, lightning could strike and miracles do happen. But if that's the basis for thinking we'll get single payer immediately after a court action against ACA, then it's not based on sound reasoning.

Instead of hoping or typing hopes that the law will be fatally struck down, thinking this is the way to single payer, the more solid reasoning is that the reforms in ACA, many of the good ones, are steps towards single payer or public system principles.

Before ACA, you had unlimited profits, with ACA you have limited profits, the latter being closer to single payer than without ACA.

Before ACA, insurers could refuse to cover specific ailments or conditions, with ACA, they can't, the latter being closer to single payer than without ACA.

Before ACA, insurers could charge people more based on their gender or preexisting condition, with ACA they can't, the latter being closer to single payer than without ACA.

Before ACA, insurers could flat out refuse to sell coverage to people, with ACA, they must provide coverage, the latter being closer to single payer than without ACA.

For skeptics, a working ACA demonstrates the advantages of single payer to skeptics better than a non-working ACA does.

[Spazito]

1. Exactly!

If ACA is gutted, there will be NO replacement at all. It will go back to the repubs healthcare plan of 'die faster'. With ACA, single payer could realistically come about incrementally, without it, single payer will remain a pipe dream, imo.

[pa28]

2. Republicans won't have it and neither will the administration.

Single payer is not going to happen on this watch.

[roseBudd]

3. I too am a pragmatic realist

We are a country where the majority of Americans have insurance through their employer.

Changing that will never be easy, and abrupt will never cut it.

[CreekDog]

4. ACA needs to be a bridge to a better ACA or to a better system

giving up on it or wishing for its demise when there is nothing to fill the gap between it and what is to replace it will end up harming people who fall into that gap.

and if it does fall apart, it will be harder to convince people that the reforms, the government reforms and regulation of the health care system were good things worth trying again and on a larger scale, than if the system succeeds, at least partially.

[librechik]

5. yes. And Fuck those conservative turds. May they drown in the blood & pus

they seem to enjoy so much. Let them drown in the disease and pain of others until they beg for single payer to save their own miserable asses.

I look forward to the day that demographics finally overwhelm those ancient ghouls and force some common sense into government. Dumb, huh? but it's all I've got. Pretty sure it won't happen in my lifetime.

[IronLionZion]

6. Thank you

Too many DUers completely ignore the patient protection part of the PPACA.



And I'm very suspicious of those who spend too much time attacking the PPACA rather than doing something constructive to support single payer. Makes me wonder what their real agenda is.

[jwirr]

7. I think it could lead us one step closer. I see the next step as getting the states that are not in

yet to have enough trouble that they finally opt in. That brings us closer to having all the people insured and ready to move another step. The people of those states without expanded Medicaid are beginning to fight back. That is the next step.