Giantaxe

I am reasonably certain of that too, because few western countries started from the confusion of existing systems that the US did: employer provided insurance, private insurance, Medicaid and Medicare.The approach of the ACA was what was politically possible given those parameters. Nevertheless, having a mandate in combination with covering those with pre-existing conditions is a sound principle that should be built on.

dc koop

Well don't worry all you ACA members out there, Donald is going to replace it with something "wonderful"

zzrmark

Gulags?

morpeth

The mandate though doesn't seem ti take into account that simply many people cannot afford insurance even under Obamacare.

I agree ACA at the time certainly better than before, and the Republicans have consistently been unable to propose an alternative.

Meanwhile the real problem, outrageous medical costs and low wages, continue. There are solutions but neither party has the willpower to undertake solutions. For example, why is there a cap on wages that sre subject to social security and medicare taxes ? Why not remove the cap and lower age for medicare and up income level one qualifies for Medicaid ? Why not finally address outrageous costs by doctors and hospitals ?

Giantaxe

The Medicare income threshold was increased as part of the ACA and that is one of the things Republicans frequently have tried to repeal and which presumably will go under Trump.The ACA also increased the income level for Medicaid (and made all people below that level eligible, not just those with families of minor age children as had been the case in most states). A Supreme Court decision allowed states to opt out of that extension, which many Republican-controlled states did.

johnwoo

How many people in the UK do you think would choose the previous US system
of Heath care, and how many would like to scrap the NHS?
Do you think the NHS would survive if people could opt out?
The flaws in the ACA are a consequence of Republican determination to make it so. Nobody seems sufficiently envious of any form of American health care to want to copy it.
As a retired couple on medicare, we are paying $800+ a month on supplemental insurance.

scrubbedexpat099

People can opt out of the NHS.

I would imagine most people want excellent care immediately available at no cost to them. I doubt the mechanics of how that was done would be of prime concern.

tom169

Opt out? By just not using it and exclusively using private healthcare?

A regular PAYE employee in the UK will keep paying for it via taxation regardless of using it. There is no way to opt out of the financial burden.

scrubbedexpat099

Nothing to do with PAYE.

dc koop

The Republicans had the opportunity to work with the Obama administration in developing the ACA as a really workable healthcare plan for those who needed such a plan but it was bad enough having a black man as President let alone helping someone like him to bring about something that could have been as big and beneficial to millions of Americans since Lyndon Johnson's Medicare program. That wasn't in the cards. Obama was to be a one term President and that's all there was to it.

It makes me laugh when I see these pathetic Republicans now scrambling to find a solution to the prospect of some 20 million Americans who are about to have the rug pulled from under their feet. They haven't got anything to replace it.... never will.... clueless twats

morpeth

No disagreement but there shouldn't be any threshold , and Medicaid/Obamacare as constructed put many in a trap that they don't qualify or cant afford premiums.

morpeth

Surely the Obama administration itself made some errors in the design of the ACA, but overall quite agree on this one the Republicans have proven that driven by politics and ideology they failed and continue to fail to address the problem of health care in America. Neither party seems to have the political courage to address the out of control costs of the health sector- but at least Obama did provide coverage to millions.

I do not know whether his race had anything to do with opposition to the ACA or how one would determine that on the basis of publicly-available information.

Whatever the objections might be to the single-payer system at least Sanders had the vision to offer a comprehensive solution.

tom169

I know. So how does someone opt out of paying for the NHS if they're in work and being taxed?

scrubbedexpat099

Irrelevant if they are working.

Giantaxe

The only way to "opt out" financially is not to pay any general taxation, including income tax. The NHS used to be funded solely from National Insurance, but that's long not been the case.