[marricks]

> ACA was the most radical package that could have passed, and it still cost Democrats the Congress.

People aren’t excited by half measures that let health insurance companies generate tons of money and CONTINUOUSLY raise premiums. People still go bankrupt receiving cancer care here.

The person who gets free healthcare and cuts overall costs by destroying health insurance middle man will be massively popular and, once the effects are borne out, win congress in a landslide.

Perhaps Obama couldn't have made it happen, but he didn't try. He could have made a speech about "how we will do because not because it's easy, but because it's possible because every other western nation has this same basic thing." But here we are with a crappy compromise.

[macNchz]

> once the effects are borne out, win congress in a landslide.

There is a deep, foundational information problem that would need to be overcome for this to ever actually happen. Medicare, for example, is viewed incredibly favorably, but tons of people don’t even know it’s a government program! This survey found only 58% of people over 65 recognized that: https://www.nerdwallet.com/article/insurance/medicare/medica...

We are in an information twilight zone where perception of policy outcomes is basically entirely dependent on choice of news sources.

[toast0]

The solution is simple. Expand Medicare. But you need to do it slowly or it will implode.

For ten years, every year, drop the eligibility age by 1 year. Then for the next ten years, every year, drop the eligibility age by 2 years. Maybe keep going at 2 years every year from there, but it should probably be adjusted over time as the effects of rising enrollment show the acheivable enrollment rate.

In the meantime, start covering all kids with Medicaid from birth to X, adding 6 months every year for the first 10 years, then 1 year per year until it overlaps with most people getting enough social security credits to be eligible for Medicare. At that point, you can probably just make Medicaid available for everyone, if you don't have 40 social security credits by age 35, you probably qualify for Medicaid under current rules. Again, it'd be helpful for Congress to supervise and adjust as needed.

[arcticbull]

A lot of Americans don't even realize that Obamacare and the ACA are the same thing -- even in 2017 it was 1/3. I believe the skew is even worse today.

https://www.nytimes.com/2017/02/07/upshot/one-third-dont-kno...

[EgregiousCube]

“It works in Europe” isn’t a very good American political rallying cry though; Americans generally don’t have the opinion that Europe works very well.

[mdhb]

Only because American discourse and thinking is so utterly poisoned by the absolute bullshit that is “American exceptionalism”.

In terms of almost any possible quality of life metric you can think of Europe is ahead of the US.

That combined with just a breathtaking level of ignorance of what Europe is actually like in any meaningful sense. You saw this a lot in this NYC election where they were trying to paint Mamdani as an actual communist because well over half of the country has no idea what “democratic socialism” means let alone communism.

[troupo]

> Perhaps Obama couldn't have made it happen, but he didn't try.

They barely passed ACA after over a year of negotiating with the Republicans and removing lots off provisions from it. How do you expect someone to just come along and pass an even more radical reform?