Yeah, when you already have a plan that heavily involves private corporations in the health care system the way pre/post ACA works, it's much harder to make it even more conservative without just basically destroying people's lives even more than they already are. The only way to actually fix it at this point would be more left-wing proposals, which obviously isn't coming from Republicans (well, or Democrats either). And I guess that's the weird silver lining of the ACA, since corporations actually want it to exist (at least, until you try to fix more of the aspects that affect everyday people), then that makes it somewhat politically untouchable (though that's kind of a sad indictment of our political environment!)
on another note, this is how far to the right the US has swung:
building upon an existing overly complex and expensive private insurance model with an even more politically unpopular and complex system of subsidies, multiple federal/state programs, tax credits, deductibles, networks, that might maybe cover everyone eventually, at some unknown point in the future = sober, rational, pragmatic.
building upon existing public programs that have existed for years and are already politically popular, and routinely cited as cheaper, and would guarantee coverage of practically everyone and also be much simpler to administer and participate in = radical leftist garbage that shouldn't be taken seriously and
will never ever ever happen (c) the progressive party
And that's not even getting to the idea that universal benefits tend to be more politically resilient due to their universal nature (*everyone* buys into it, so there's less chance of resentment), and just on a pure messaging level, it's a much easier sell. At least, to those who haven't already bought into the "even though I ran on hope and change and the Fierce Urgency of Now, I will immediately settle for less before even starting the fight, and never fight for anything bolder, the Tepid Complacency of Eh, Maybe Later" mindset. Or the "I must negotiate with giant corporations first and foremost while ignoring any kind of grassroots movement or popular struggle" mindset.
Xe4 said:
Switzerland's model is certainly going to be the easiest to implement, and is really only a (unobstructed) law or two from being a reality. I'm more of a fan of Germany's system because I think the Swiss model still takes up too much GDP, but I'm honestly fine with either. I'd be fine with single payer too, but there's no way to achieve that without fucking over a lot of people who work in the health industry. If it is something that happens, it won't be anytime soon.
I'll use your post as a jumping off point (don't know your history on other issues, so this statement may not necessarily apply to you in particular), but I do find it interesting that when it comes to things like health care, there's often a lot of concern from liberals for the jobs of those who work at health insurance companies (isn't that part of the rationale from Cory Booker types as well when they justify their votes?), but if it's a factory in the Rust Belt, or coal companies in WV/KY, you tend to hear a lot of "find a new job/go back to school/those jobs are never coming back/move to a new city" type of talk. Sure, they might support some funding for job-retraining and speak of vague notions of "investment", and they aren't intentionally trying to adopt conservative "bootstrap" framing (even though that's still basically what it is), but I do think it's interesting that certain types of workers get "tough love", whereas other types of workers get more leeway.
