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[sebastian_dangerfield]

Originally Posted by taxwonk

I agree with you that ACA may have provided an improvement for people who are hit with catastrophic health issues in some cases. But the vast majority of people don't get those sort of catastrophic illnesses and if they do, they die long before they get any benefits because they can't afford to pay for care to keep them alive until they meet a $5000 deductible.

So you get people who are forced to choose between losing their job or spending all day in a clinic if they get pancreatitis or have an arrhythmia. The clinic is packed with people who are suffering from everything between diabetes, heart disease, and allergies and morphine withdrawal. So everybody gets a minimal look-see and a scrip for extra-strength Tylenol, a set of x-rays, and an order to make another appointment, which they may or may not get because the clinic hits capacity for the day by 8:00 so the appointment gets canceled.

If I have $30/week in income after rent, day care, almost enough food, and utilities, how am I going to pull together the $125 a real doctor will require to see me, let alone pay for the $175 prescription? I'm dead long before I ever make the $5000 deductible.

I agree you can't make the perfect the enemy of the better. But if poor people still can't see a doctor, can't get basic wellness care or care for a chronic disease, and can't pay for the drugs they need to manage disease, where is this "better" of which you speak?

The ACA was at best a thing that might work while acting as a door opener to single payer, at worst a thing the failure of which would create a situation where single payer became a politically possible solution. The former didn't happen and the latter is now impossible, as it required a single-payer-friendly political climate.