Paul it will happen someday and that why we needed Obamacare, it was the first step. It what what we could do at the time.

Remember it was said in the early 2000s that health care reform couldn't happen either.

Yeah, it'll happen. These things are just slow. It's hard work to have to constantly drag half the nation, kicking and screaming, into a better world.

This is what they should have passed in the fucking first place. That would have been a lot simpler and cheaper to build and maintain than the current jacked-together framework of compromises.

It would certainly not have spelled the end of insurance companies. They would have survived just fine.

It basically resembles the Swiss model. The private insurance companies generally do well upselling
services and benefits....kind of like adding nuts and cherries on top of your ice cream.

@4

Who's doing this hard work? Politicians? Pfft. The media? Pfft. Celebrities? Pfft. Bloggers? Pfft. Who do you have in mind?

@9
Of course not, I don't want to be near a Republican, let alone touch one, and forget this dragging stuff! No thank you, I like my bubble.

@7: who = the Center for Medicare and Medicaid. It's the Federal agency with the power to make administrative law in interpretation of acts of Congress, i.e. the Affordable Care Act. Slowly but surely they have their sights on single payer, but the final form it will probably take is the Feds paying insurance companies on your behalf; these companies will then "own" you (so to speak.) The insurers will get paid a set fee per head by the Feds, then it's up to the insurers to ensure you stay healthy. Otherwise, they'd go broke paying your claims because they couldn't drop you. This will inevitabily lead to the consolidation of insurers and providers, in other words: HMOs for everyone.

It's already in the ACA. As long as Congress remains gridlocked CMS will make it regulatory law, it's just that this process takes time. Eventually CMS will rein in the commercial healthcare insurance market, making it essentially a captive industry serving the federal government (with plenty of incentives for certain people to make a lot of money at the Fed's expense...)

I voted for Bernie for mayor of Burlington and later for Vermont senator. I'd vote for him in a second if he would just run for President. Imagine a President who doesn't owe any allegiance to some outdated, out-of-touch political party machine. Goosebumps.

I'm a freaking Democrat from Seattle and I send Senator Sanders money each election cycle.

He's one of the few politicians that doesn't reek from the stench of evil.

@11
you're too kind. great answer, informative. from Urgatha's statement @4 I thought the hard work might be up to me and maybe other losers that chat on this blog. Whew, we're in the clear. Other people are doing the hard work. good to know.

so, should we gossip about famous actors then? and on which talkshows they'll be appearing?

Obamacare is a mess in the long run, but it will be very hard to go back to denying coverage for preexisting conditions, and insuring young people is a good thing as well. So, I suppose there is nowhere to go but up. For the majority, who share the values nominally espoused by the Democrats, given how corrupt or ineffective the elected representatives have been, going back would unsustainabley delegitimatize the whole political system. I think things are going to get shittier, but based on the opinion of people whose analytical skills I trust more than my own, I'm more optimistic that the public won't accept full-on fascism.

@16: no, Obamacare is a mess in the short run. In the long run it will work, but the next three or four years will be a shakeout period. Odds are after that there will be a few giant HMOs, but they won't be the same as the HMOs of the past or present. They will employ scads of smaller companies offering customized benefits for select populations: young families; retirees; the chronically ill. They will pay closer attention to getting you to take responsibility for managing your own health, and consumers who do will save money unlike in the current system. Obamacare was focused on getting more people coverage, not saving anyone money. That's a point that much of the media has forgotten lately.

In the long run, it will save money provided you act as an active partner in taking care of yourself. That's how the CMS regulations are being structured.

And to add: you'll be able to switch your HMO just about the same way you do your phone company: you can do it, but it will be a pain in the ass.

@7,

Everyone who realizes that change--although painful--is necessary, and that it frees us from the shackles of past injustice and inequality.

Bernie's bill would not set up a "national" single-payer program, Paul. It would set up 50-plus* state single-payer systems, with higher administrative costs, far weaker monopsony bargaining power, and considerably greater complexity (especially for people moving from one state to another, whether for work, school, family, or just for treatment). But it's designed to appeal to the Republican fetish for states' rights and the quaint, fanciful notion that states are laboratories of democracy rather than corporate pawns in an interstate race to the bottom. Big Pharma, Big Device, and Big Specialist will salivate over state-by-state because they'll be negotiating prices with a large number of uncoordinated buyers, only a handful of which have large enough populations to have much market power. It will be like in Switzerland, where they have canton-by-canton bargaining and where pharmaceutical prices are even higher than here.

HR 676, "Expanded and Improved Medicare for All," is the national single-payer bill. It's the plan that the Congressional Progressive Caucus used to pretend to support before they stabbed their constituents in the back and voted for Obama's and Max Baucus's backroom deal with Big Health. HR 676 is the silver bullet for America's healthcare problems -- it's the only solution that would actually provide comprehensive, zero-out-of-pocket coverage to every American from cradle to grave and actually save a lot of money doing it.

State-by-state single-payer is a vast improvement over Obamacare, but it's still a fairly distant second-best. On the other hand, if we're definitely planning on dissolving the union and breaking up into independent sovereign state or smaller unions or federations -- I'd be reasonably happy joining Canada, once they give Harper and the Conservatives the boot and their extraction industries stop poisoning the world -- well, then, state-by-state is the way to go.

*Don't forget DC and the territories.

Only idiots believe healthcare in the US pre-Obamacare was worth a warm bucket of spit.

Post? Well that remains to be seen but yeah I gotta agree some sort of base level public coverage cradle to grave will come to pass. The numbers don't work for it to go any other way.

@17 I don't agree. Have you imagined your life as a 30 yo worker on a bronze plan? Have you really? Fewer people will die, but the level debt being incurred for the those on the low end will continue to rise and wreck havoc. The short run is only interesting because it acts as one more smoke screen for Washington to keep fucking people over, like the recent bipartisan budget "achievement" wherein Patty Murray sold out her fig leaf constituents, the veterans.

Will they continue to pay for it with the mandatory 3.8% NIIT?

24 cont'd

Oops. Noope.

...include a new health care income tax, an employer payroll tax, a surcharge on high income individuals, and a tax on securities transactions.

Wow...EXPOSED!

Wasn't this the game plan all along...find a way to tax everyone across the board, especially the already overtaxed middle classes.

@26 Holy shit, they want to pay for public services with taxes! Call Fox News, you've got a breaking story!

@2- " It what what we could do at the time."

Bullshit. It was what over-compromising right out of the gate got us. It wasn't the best possible result, it's the shit we got because the Democrats were to cowardly (or fundamentally conservative) to reach for better.