Here's what Barack Obama had to say about the Affordable Care Act, aka "Obamacare," after some of its key provisions went into affect:

Because of this law, nearly 8 million seniors have saved almost $10 billion on their medicine because we’ve closed a gaping hole in Medicare’s prescription drug plan. We’re closing the donut hole. And because of this law, a whole lot of families won’t be driven into bankruptcy by a serious illness, because the Affordable Care Act prevents your insurer from placing dollar limits on the coverage they provide.... But today should remind us that the goal we set for ourselves—that no American should go without the health care that they need; that no family should be bankrupt because somebody in that family gets sick, because no parent should have to be worried about whether they can afford treatment because they’re worried that they don’t want to have to burden their children; the idea that everybody in this country can get decent health care—that goal is achievable.

And here's what you'll read on the front page of the NYT today:

Here is the surest way to enjoy the peace of mind that comes with having health insurance: Don’t get sick.

The number of uninsured Americans has fallen by an estimated 15 million since 2013, thanks largely to the Affordable Care Act. But a new survey, the first detailed study of Americans struggling with medical bills, shows that insurance often fails as a safety net. Health plans often require hundreds or thousands of dollars in out-of-pocket payments—sums that can create a cascade of financial troubles for the many households living paycheck to paycheck.... Among those who reported having problems paying their bills despite having insurance, 63 percent said they used up all or most of their savings; 42 percent took on an extra job or more work hours; 14 percent moved or took in roommates; and 11 percent turned to charity....

Ten years ago, David Dranove, a professor of health management at Northwestern’s Kellogg School of Management, conducted research on people experiencing medical bankruptcies. The study he co-authored found that bankruptcy was largely a problem of the uninsured. “But with more people buying less generous health insurance, I think the old evidence might no longer be relevant,” he said.

You remember "don't get sick," right? That was supposed to the the GOP health care plan...

But "don't get sick," as it turns out, is the GOP's health care plan and the Democratic health care plan. Even under Obamacare, millions of Americans still don't have health insurance (the plan was never designed to cover everyone), Americans are still at risk of losing their health insurance (particularly in red states), and American families still have to worry about going bankrupt if somebody gets sick (and Americans with health insurance are still being bankrupted by medical bills).

So what Justin Beiber said in way, way back in 2011—before any of the provisions of the Affordable Care Act took affect—remains sadly true. This is from the chapter about Obamacare in my most recent collection of essays, American Savage:

Justin Beiber said it best in a 2011 interview with Rolling Stone. Asked if he thought about becoming an American citizen, the Canadian-born pop star flatly refused, citing Canada's system of socialized medicine as the chief reason. (A recent poll by the Association for Canadian Studies found that 94 percent of the Canadian citizens surveyed said their universal health care system was a source of collective pride.)

"You guys are evil," Beiber said. "Canada is the best country in the world. We go to the doctor and we don't need to worry about paying him, but here, your whole life, you're broke because of medical bills. My bodyguard's baby was premature, and now he has to pay for it. In Canada, if your baby is premature, he stays in the hospital as long as he needs to, and then you go home."

But now that Barack Obama has been reelected, now that Obamacare is safe for at least the next four years, it's time for liberals and progressives to come out of defensive crouches and admit that Obamacare—as good as it is, as much of an improvement as it is—is till kinda evil. It's the lesser evil, sure. But it's still evil.

And some of us saw this coming (also from American Savage):

Obamacare is still health insurance. It's not single-payer, it's not socialized medicine. People can still lose their health insurance, or risk going without it, or wind up bankrupted even if they have health insurance, or wind up dead if they don't. Fewer American children will die of toothaches, it's true, but American children—unlike, say, Canadian children or German children—will still die of toothaches.

I don't think this guy is going to get the nomination, but... he's absolutely right about what we need to do:

What should the US be doing to improve this abysmal situation?

President Obama's Affordable Care Act is a start. It prevents insurance companies from denying patients coverage for pre-existing conditions, allows people up to age 26 to stay on their parents' insurance, sets minimum standards for what insurance must cover and helps lower-income Americans afford health insurance. When the marketplace exchanges open for enrollment on Tuesday, many Americans will find the premiums will be lower than the ones they're paying now. Others will find the coverage is much more comprehensive than their current plans.

Most importantly, another 20 million Americans will receive health insurance. This is a modest step forward. But if we are serious about providing quality care for all, much more needs to be done.

The only long-term solution to America's healthcare crisis is a single-payer national healthcare program.

UPDATE: The nation's biggest assholes, aka "Congressional Republicans," are determined to bring evil back up to its pre-Obamacare levels...

Congressional Republicans on Wednesday are set to make good on a central campaign pledge from the 2014 midterms, delivering a bill repealing the health care reform law they loathe to President Obama’s desk, forcing a certain veto.