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Mannahnin wrote:
If every state required people to sign up the way Massachusetts does, and the way all the states do for car insurance, sure, we could do it state by state. But if they don't, then people living in a no-mandate state while they're healthy and getting sick/old after moving to a mandate state sabotage the funding for the system.

Even then there are issues due to variance in coverage and, more importantly, mean and median population age.

Weird fact: Utah has the lowest media population age by a fairly wide margin at 28. The highest is Maine at 42.


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CptJake wrote:Remember, the Constitution was intended to LIMIT the power of the Federal Gov't. If you buy off on "it is commerce therefore they can force you and control you", you will have a very hard time defining anything in your personal life they cannot control and anything they cannot force you to buy or do under the same argument.

I'm not sure why the federal government having the power to compel purchase is especially different from state governments possessing the same power. I guess you could make the argument that you could always move, but you can do that with respect to the US as well; plenty of people seem to think its actually a very good option. The major distinction is likely that state policy is thought to be easier to influence than national policy, but I'm not necessarily sure that's true, or even good if it is.

Regardless, the government can regulate or compel pretty much whatever it wants to, the only real barrier there is willingness, same as always.

CptJake wrote:
Honestly, that bothers me. A lot. To use a limiting document to grant damned near unlimited control is wrong. I strongly suspect this is NOT what the founders intended.

What they intended is of little concern in my mind. The Founders weren't all knowing god-kings (though some people seem to feel differently), or even unified as a group of flawed, but fairly intelligent people.

There is one thing i did just think of in relation to this issue...

There are in America, certain religions and religious groups who feel that any medicine other than prayer, and God, are not acceptable to be used on them....

This includes health insurance, because hey... God works on prayers, not AFLAC. So, in essence, forcing someone to buy something that goes against their religion is actually an infringement of their individual 1st Amendment right, regardless of whether it is considered "Commerce" or not..

Regardless of how you feel about religions or even certain religions, you have to be extremely wary of a Government who will impinge upon the rights of its citizens, even if they veil it behind a figurative smoke screen

Ensis Ferrae wrote:There is one thing i did just think of in relation to this issue...

There are in America, certain religions and religious groups who feel that any medicine other than prayer, and God, are not acceptable to be used on them....

This includes health insurance, because hey... God works on prayers, not AFLAC. So, in essence, forcing someone to buy something that goes against their religion is actually an infringement of their individual 1st Amendment right, regardless of whether it is considered "Commerce" or not..

Regardless of how you feel about religions or even certain religions, you have to be extremely wary of a Government who will impinge upon the rights of its citizens, even if they veil it behind a figurative smoke screen

I might point out that argument has failed in court repeatedly in cases where the family's religion conflicted with giving their children proper medical treatment and they died, leading to said parents arrest.

CptJake wrote:Remember, the Constitution was intended to LIMIT the power of the Federal Gov't. If you buy off on "it is commerce therefore they can force you and control you", you will have a very hard time defining anything in your personal life they cannot control and anything they cannot force you to buy or do under the same argument.

Honestly, that bothers me. A lot. To use a limiting document to grant damned near unlimited control is wrong. I strongly suspect this is NOT what the founders intended.

I might point out two things: First, The government has 'forced' people to buy insurance for various things for a long time. It's usually a licensing requirement. Second, The Founding Fathers deliberately worded it the way they did realizing they could not see all possible situations where Congress would need to regulate Commerce. It was deliberately written as broad (unlike several other sections) as possible to try and cover a very wide range of possibilities, because they were all more then aware of the rapidly changing nature of commerce. It's one of the few areas that the Founding Fathers gave the Federal Government wide discretionary power, because the regulation of Commerce was seen as a key role the Fed had to play.

CptJake wrote:

Melissia wrote:

And again, using force to make people buy something is wrong in my opinion.

Right, so why do you support the uninsured's right to force me to pay for THEIR health care?

Can you point to where I state my support for that?

This entire thread, really.

BaronIveagh wrote:I might point out that argument has failed in court repeatedly in cases where the family's religion conflicted with giving their children proper medical treatment and they died, leading to said parents arrest.

Hopefully setting precedent for later on when people start dying of pertussis because of all the gaks out there that think vaccines cause autism.

Monster Rain wrote:

BaronIveagh wrote:I might point out that argument has failed in court repeatedly in cases where the family's religion conflicted with giving their children proper medical treatment and they died, leading to said parents arrest.

Hopefully setting precedent for later on when people start dying of pertussis because of all the gaks out there that think vaccines cause autism.

Given that we don't know what actually causes autism to show up in children, what evidence is there to suggest that a given vaccine might not actually be the cause?? (obviously, that vaccine would only cause autism in those whose genetics mesh wrong with said vaccine..we all know that vaccines by and large do far more good than bad)


I mean, the same could be said of SIDS or ALS, or any number of diseases that we don't know what the cause of them is. I should point out that I am in favor of just about all vaccines out there (can't really think of one that is all that controversial, even that cervical cancer one for girls.. hopefully when that comes up for my daughter, my wife and I will have been good enough parents that she wont be a tramp)

Ensis Ferrae wrote:what evidence is there to suggest that a given vaccine might not actually be the cause??

The complete and utter, 100% lack of evidence that it does.

I mean you could argue that nitrogen in the air is what really causes alcoholism, but you'd still have no leg to stand on because you have no proof whatsoever.

Also? We know, generally speaking, what causes autism. The problem is that it is not one specific thing, no silver bullet, but a wide collection of things (vaccines have been proven by clinical studies to not be amongst them). We have an entire field of study dedicated to understanding abnormalities in physiological development, called Teratology.

Ensis Ferrae wrote:

Monster Rain wrote:

BaronIveagh wrote:I might point out that argument has failed in court repeatedly in cases where the family's religion conflicted with giving their children proper medical treatment and they died, leading to said parents arrest.

Hopefully setting precedent for later on when people start dying of pertussis because of all the gaks out there that think vaccines cause autism.

Given that we don't know what actually causes autism to show up in children, what evidence is there to suggest that a given vaccine might not actually be the cause?? (obviously, that vaccine would only cause autism in those whose genetics mesh wrong with said vaccine..we all know that vaccines by and large do far more good than bad)


I mean, the same could be said of SIDS or ALS, or any number of diseases that we don't know what the cause of them is. I should point out that I am in favor of just about all vaccines out there (can't really think of one that is all that controversial, even that cervical cancer one for girls.. hopefully when that comes up for my daughter, my wife and I will have been good enough parents that she wont be a tramp)

Because nowadays drugs go through such incredibly strict testing before they are deemed appropriate for human consumption that if Aspirin were to be discovered today it wouldn't pass these tests.

Ensis Ferrae wrote:
This includes health insurance, because hey... God works on prayers, not AFLAC. So, in essence, forcing someone to buy something that goes against their religion is actually an infringement of their individual 1st Amendment right, regardless of whether it is considered "Commerce" or not..

Most of the people in those groups, while certainly devout, aren't stupid. They won't refuse or fail to seek medical treatment in the case of severe injury, and I imagine most of them carry some level of insurance even they don't make use of it as freely as other might.

Ensis Ferrae wrote:Given that we don't know what actually causes autism to show up in children, what evidence is there to suggest that a given vaccine might not actually be the cause??

http://www.miottawa.org/healthcomm/health/pdf/2007_Nature_DeStefano_Vaccines_and_Autism.pdf
http://www.cdc.gov/vaccinesafety/Concerns/Autism/Index.html

Oh, and the jerkoff who started the entire idea of a link with his study in the Lancet?

http://www.cnn.com/2011/HEALTH/01/05/autism.vaccines/index.html

"Elaborate fraud" is a key phrase here.

This is my favorite part:

Wakefield has been unable to reproduce his results in the face of criticism, and other researchers have been unable to match them. Most of his co-authors withdrew their names from the study in 2004 after learning he had had been paid by a law firm that intended to sue vaccine manufacturers -- a serious conflict of interest he failed to disclose. After years on controversy, the Lancet, the prestigious journal that originally published the research, retracted Wakefield's paper last February.

The series of articles launched Wednesday are investigative journalism, not results of a clinical study. The writer, Brian Deer, said Wakefield "chiseled" the data before him, "falsifying medical histories of children and essentially concocting a picture, which was the picture he was contracted to find by lawyers hoping to sue vaccine manufacturers and to create a vaccine scare."

dogma wrote:Most of the people in those groups, while certainly devout, aren't stupid. They won't refuse or fail to seek medical treatment in the case of severe injury, and I imagine most of them carry some level of insurance even they don't make use of it as freely as other might.

Or, as I imagine they think of it, "God helps those that help themselves". I know there was a old joke that was repurposed right around when Hurricane Katrina hit, of people evacuating.

As the last bus is going, they ask the Joneses are you sure you won't go? And, of course, they reply "We'lll be safe, God will save us".

The storm gets worse, and the Joneses go to the second flood, as the first is totally flooded. A rowboat goes by, and the occupants yell into the windows to come with us, to safety. The Joneses reply that "We'll be OK, God will save us."

Finally, as the whole house is flooded, they go onto the roof. A Coast Guard chopper swoops down, and throws them a rope. They turn away from it, insisting that they will be fine - God will save us.

Right after the chopper leaves, the entire house is covered, and they slip off the roof into the water. Shortly thereafter, they drown. As they go to the Pearly Gates of Heaven, they come across St. Peter, shaking his head. They ask, we lived as devout Christians, why did not God save us? St. Peter replies, "He tried 3 times!"

Melissia wrote:

CptJake wrote:

Melissia wrote:

And again, using force to make people buy something is wrong in my opinion.

Right, so why do you support the uninsured's right to force me to pay for THEIR health care?

Can you point to where I state my support for that?

This entire thread, really.

I guess reading comprehension isn't your strong suit. No problem. To each his/her own.

Can we drop the hostility? Be nice, folks.

CptJake wrote:

Melissia wrote:

CptJake wrote:And again, using force to make people buy something is wrong in my opinion.

Right, so why do you support the uninsured's right to force me to pay for THEIR health care?

Can you point to where I state my support for that?

What's your alternate plan, Jake?

As a society, we choose to provide emergency care to people who can't pay, rather than let them suffer or die. To do that, the rest of us all wind up paying for that care.

The individual mandate is a way of addressing that fact and attempting to fund it in a more intelligent way, requiring people who CAN afford the care they will inevitably use to pay ahead of time the way most of us do, and the taxpayers to pay ahead of time for the poor and indigent so that money can be invested and more efficiently used, rather than paying after the fact (like now). Again, if people have coverage studies show that most of them will see a doctor and get preventive and other cheaper care, rather than waiting until they are desperate and using emergency rooms, clogging the system and racking up comparatively enormous charges which still get dumped off on those of us who pay takes and pay for our own insurance.

Again, we're paying for it either way, unless you can get society as a whole to agree NOT to provide emergency care to people who can't afford it. Is this what you'd like to see happen? Do you believe it's more ethically acceptable to let folks die in the ER waiting room or parking lot rather than to care for them? Because if not, we've got to pay for it somehow, and the individual mandate is the smarter and more cost-effective way.

Of course, we could also have a genuinely government-provided single payer healthcare system, like most first-world countries (say, like our neighbors Canada) do. But the "Obamacare" plan is a compromise solution designed by Republicans to give business to private sector insurance companies, rather than having the government actually take over healthcare.

I wonder how much it costs to drag dead folks from the waiting rooms to the funeral homes. I mean, someone would have to do it. And in this hypothetical future, since people wouldn't pay for the uninsured, their deaths wouldn't be a crime, would the police still handle the processing of the body? Would relatives have to do it? Or would it be the janitors?

Poor janitors.

Funeral Homes will do it, assuming you have end-of-life insurance coverage.

Oh wait.

Easy E wrote:Funeral Homes will do it, assuming you have end-of-life insurance coverage.

Oh wait.

How did this become a discussion of vaccination? Mosts vaccinations are not really necessary any longer with how improved public health is, it is trading temporary immunity for life long immunity.

Anyway, I think this topic really highlights the difference between right and left thinking. The left wants goverment to protect the "common man", like a benevolent version of Orsen Well's Big Brother.

Right thinkers want the "common man" to chose for himself, like the rugged pioneers of early America. They also want him to suffer the consequences of his poor decisions.

So who is right? Big government that protects or small government that allows choice? Both sound like opinions to me.

Bastion of Mediocrity wrote:How did this become a discussion of vaccination? Mosts vaccinations are not really necessary any longer

After the hubub that stupid, vapid woman caused about it, a small minority of parents chose not to vaccinate their children.

Coincidentally, that same population were also found to have sicker children because of an outbreak of the viruses the vaccines were preventing being caught by them.

Okay, so it's not coincidental.

Bastion of Mediocrity wrote:How did this become a discussion of vaccination? Mosts vaccinations are not really necessary any longer with how improved public health is, it is trading temporary immunity for life long immunity.

Anyway, I think this topic really highlights the difference between right and left thinking. The left wants goverment to protect the "common man", like a benevolent version of Orsen Well's Big Brother.

Right thinkers want the "common man" to chose for himself, like the rugged pioneers of early America. They also want him to suffer the consequences of his poor decisions.

So who is right? Big government that protects or small government that allows choice? Both sound like opinions to me.

You mean George Orwell. Orson Welles is Citizen Kane.

This sums up the rather sad situation extremely well.

How did this become a discussion of vaccination? Mosts vaccinations are not really necessary any longer with how improved public health is, it is trading temporary immunity for life long immunity.

I'm confused. For disease like small pox, that don't mutate much, vaccination is permanent immunity. For diseases that mutate regularly, like the common cold, it doesn't matter if your vaccinated or not. No immunity will be permanent. Vaccines use the bodies natural immune system and give it a hi jump kick in fighting infection there's no 'trade' involved.

Besides, the mentality that 'its not necessary' is how we ended up with drug resistant strains of TB.

Bastion of Mediocrity wrote:How did this become a discussion of vaccination? Mosts vaccinations are not really necessary any longer with how improved public health is, it is trading temporary immunity for life long immunity.
.

Thats one of the most interesting yet dangerous opinions ever put forth on Dakka. You sir win an award.




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What's your alternate plan, Jake?

The Swiss Plan?
Hey if its good enough for de Swiss Miss its good enough for me.

Thet is quite possibly the most awesome image macro I hAve seen this month. Mind you this month just began but still.

@ A Town Called Malice: thanks that was an oops

@Frazzled, while I love the pic, I did say "most" not "all". I think that you insinuated "rabies" with the picture, but that dog lacks the symptoms. I'd be more worried about Lymes personally.

@LordofHats: many vaccines use antigens of dangerous vectors of disease, but many also use attenuated viruses (which means functional "since viruses are not considered to be alive" but weakened). All immunity is based on the bodies own immune system, but if you would like to see that most vaccines do not provide life-long immunity you should take either a pathology course or a pediatrics course. Or look up the zoster virus (chicken pox).

Sorry, did not mean to continue altering this thread to a vaccination one. I was enjoying reading the conflicting views on Obamacare.


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@LordofHats: I am interested in the idea of drug-resistant TB, living in the capitol of TB in the states (Los Angeles) I am curious if you have a link. Thanks

Mannahnin wrote:What's your alternate plan, Jake?

As a society, we choose to provide emergency care to people who can't pay, rather than let them suffer or die. To do that, the rest of us all wind up paying for that care.

So, what is my alternate plan? First I want to see exactly what you consider the problem(s) to be. Without scoping and defining the problem it is hard for me to come up with a plan. Is the problem 'Health Service is Too Expensive"? That is a pretty all-encompassing statement. What is "too expensive" and why is it considered such? If "too expensive' is the problem set, I disagree the Fed Gov't is the answer.

What specific problem/issue was the ACA supposed to address? I'm not being a smart ass here. My perception is that the Democratic Party has held the idea of 'Universal Healthcare As A Right' as part of their platform for decades and that the ACA was an attempt to get that started. Since I do not believe 'Universal Healthcare' IS a 'right' I have issues with it, especially as the provided solution limits individual choices and freedoms and grants the Federal gov't more expansive powers.

We have already seen insurance premiums go up. The latest CBO projections indicate they believe penalty payments from individuals and companies will be higher than the earlier projections showed (because it is cheaper to pay the penalty than to comply with the law, that should say something),
companies, especially small businesses, currently view the restrictions and requirements of the ACA as reasons to not expand/hire new employees, and the cost to the country is higher than initially projected.

First let me lay out some assumptions, you can agree or disagree with them as you want, once I have a defined problem I'm most likely going to base any plan on these assumptions.

1. As it stands, if you purchase insurance, either on your own or through your employer, YOU are freely entering a transaction in which YOU perceive the cost you pay is worth the benefits you gain from having paid that cost. As such, it really does NOT matter who else benefits or does not benefit from that transaction. If YOU are not happy with it, no one currently forces you into the transaction.

2. Health care is not a right. It is a commodity/service someone provides. The more money you are willing to pay (or the more debt you are willing to incur) does indeed help to define the level and types of care you have access to, even in places with Gov't Provided Healthcare. As a society we collectively believe ourselves rich enough to provide some level of basic care to those who need it and cannot provide for it on their own. There are programs in place for that (Medicaid for example). People who pay state and federal taxes are already putting into those programs. Frankly if someone is not covered by one of those programs and chooses not to purchase insurance, they are accepting risk. That should be allowed. There should also not be freedom from consequences. Using tax payer dollars to mitigate the consequences from bad choices encourages those bad choices. Remember too there are many private organizations which help those in need of help, some quite extensive (Shriner's kids hospitals for example).

3. The gov't systems are not and will never be the most efficient way to solve a problem (though often we accept the inefficiencies to ensure the problem is solved), and the inefficiencies cost everyone who pays taxes. The multiple thousands of pages of tax code at the federal level are a fantastic example of inefficiency. A couple thousand pages of bill that (I paraphrase) 'must be passed so we can see what is in it' is another great example.

4. No one is currently denied basic emergency services, regardless of their (in)ability to pay. People don't generally die in the ER because treatment was refused. Yes, I know someone will point out some case where it has happened, those are very isolated and not indicative of a systemic/policy level problem. gak happens, no system is ever perfect.

5. The Federal Gov't has constitutionally limited powers. Every power we grant the gov't takes some freedom away from the governed. We pay (taxes and acceptance of limits on our freedoms) for the benefits we receive from the Federal Gov't, and those benefits do exist. Freedom is not inherently easy or comfortable and there is freedom to fail as well as to succeed.



So based on those and freely admitting I am not anything like an expert on health service and that the problem set has not really been defined I submit the following improvements to the 'as is'. I am sure they are filled with holes and inaccuracies:

1. Allow insurance providers to sell policies across state lines. Allow for 'bare minimum' policies. Encourage employers to allow new employees to bring their current policies if they choose to do so (perhaps paying the employee a portion of what the employer would have contributed to the employer sponsored policy and allowing the employee to buy their own with pre-tax dollars).

2. Implement some type of tort reform. A lot of hospitals do a lot of tests and treatments not because they are medically required but because the hospital administration is scared of lawsuits. Personal example. My son crashed a car and went to the ER under his own power just to get 'checked out'. He was shaken up but not really hurt. No ambulance ride, no traumatic blood gushing injuries. They gave him an MRI 'just to be sure'. Several thousand dollars worth of 'being sure' because the hospital was scared if they didn't perform it they may be sued.

3. Crack down HARD on lazy, incompetent or corrupt Fed employees and on private companies that commit fraud against existing programs. As a tiny example, all those 'Scooter Store' and 'Testing Supply' commercials you see where the company files your Medicare/Medicaid paperwork for you. In many cases they are forcing us, the tax payer, to fund a service that is not actually needed because they know how to fill out paperwork to make it appear as if the service or product is needed. In other cases certain Fed employees either through laziness, incompetence or corruption approve these types of paperwork and worse, again costing tax payers. Frankly the fact that a whole class of businesses exists to take advantage of Federal programs is a great example as to why Fed porgrams are rarely a good answer.

4. Quit duplication of effort/benefits at taxpayer expense. The whole mandated birth control coverage is a decent example of this. There are already plenty of clinics and organizations (many of which are in part already funded through tax dollars) giving access to cheap and in many cases free birth control. Why should the Federal Gov't mandate redundant coverage and the funding there of? It just doesn't come across as a non-resourced requirement. Allocating more resources is wasteful. DON'T get hung up on my example, the fact is there are redundant programs, anothe hallmark of gov't efficiency.

5. Force individuals to be responsible for their actions. If I lead a lifestyle which includes high risk activities I should expect insurance companies to charge me higher premiums or even deny coverage for injuries or illnesses related to those high risk activities. If I choose as an individual to skip coverage and still engage in those activities I should reasonably expect to only receive rudimentary emergency care until I can show I have a mechanism to pay for more (to include ability to secure credit if that is what is needed). If that means a person doesn't get expensive fancy care, so be it. Freedom of choice is not freedom from consequences.

I have the ultimate solution to the US health care crisis. I've mixed up a large batch of cherry flavor aid and every politician, trial lawyer, lobbyist, insurance CEO and judge in the US needs to drink some.


Now.

CptJake wrote:...the fact is there are redundant programs, anothe hallmark of gov't efficiency.

By that definition of inefficiency the fact that there are multiple companies marketing identical drugs shows that the private sector is highly inefficient.

The presence of multiple sources of coverage, and multiple outlets for a medical service, does not indicate that the system is particularly because people don't carry, as per your example, carry birth control coverage and then buy 18 different types of birth control from 18 different places. Similarly, what birth control is purchased is still purchased at the same actual costs, its simply that the insured person isn't paying directly in most cases.

dogma wrote:

CptJake wrote:...the fact is there are redundant programs, anothe hallmark of gov't efficiency.

By that definition of inefficiency the fact that there are multiple companies marketing identical drugs shows that the private sector is highly inefficient.

Mind you, some are not entirely identical. Even the illegal ones have a degree of variation, and for much the same reasons, namely to dodge the law. (at least until they came up with that one that made the actual act of getting high illegal. Why they are not arresting people for running or having sex under that one I don't know.) They just differ in which law they're dodging. I mean, seriously, move a carbon atom but otherwise be exactly the same and they seem to think it's the Harvard Mouse all over again.

Throughout this whole debate I've been left wondering exactly who out there is that bothered at the idea of sending the government the maximum fine of $600, in exchange for knowing that if they get sick they can join a healthcare fund, and be safe in the knowledge that once insured they won't ever be left high and dry because the insurer declared you had a pre-existing condition?

Ensis Ferrae wrote:Given that we don't know what actually causes autism to show up in children, what evidence is there to suggest that a given vaccine might not actually be the cause?? (obviously, that vaccine would only cause autism in those whose genetics mesh wrong with said vaccine..we all know that vaccines by and large do far more good than bad)

We actually have a pretty decent handle on the causes of autism, and the biggest one is the age of the mother and father. Autism rates tie very closely to older mums and dads. Not absolutely, but the relationship is most definitely there.

The problem is people don't like hearing that their decision to wait until they were 38 or whatever played a contributing factor in their child having autism. They'd rather blame vaccinations, and as a result there's a whole mess of lying liars out there willing to play on the emotions of those parents.

I mean, the same could be said of SIDS or ALS, or any number of diseases that we don't know what the cause of them is.

We've got a pretty decent idea with SIDS too, sleeping on their stomach and being exposed to cigarette smoke are the major risk factors.


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Bastion of Mediocrity wrote:How did this become a discussion of vaccination? Mosts vaccinations are not really necessary any longer with how improved public health is, it is trading temporary immunity for life long immunity.

Uh, one of the major drivers in increasing life expectancy has been vaccinations. There is 'improved public health' for polio, it's the vaccine that's solved the problem.

You don't get to just make gak up. Stop it.

Anyway, I think this topic really highlights the difference between right and left thinking. The left wants goverment to protect the "common man", like a benevolent version of Orsen Well's Big Brother.

Right thinkers want the "common man" to chose for himself, like the rugged pioneers of early America. They also want him to suffer the consequences of his poor decisions.

So who is right? Big government that protects or small government that allows choice? Both sound like opinions to me.

Both are absurd, ridiculous bits of nonsense. The real world doesn't find working solutions by shouting one vague slogan, then shouting another and seeing which one people like. It solves problems by studying the system, identifying issues and working to fix those system specific problems.

"Government protects the common man" and "the common man should choose for himself" are political theatre, and great for people who want to pick a side and yell at people who picked the other one, but absolutely, completely fething useless for addressing matters of policy.

If the people you're listening to are talking about things on those vague terms, then you need to find new people to listen to.

Oh, and like A Town Called Malus said, you meant George Orwell. And for the record 1984 is a critical analysis of communism, written by a socialist. The real world is complicated like that.

CptJake wrote:So, what is my alternate plan? First I want to see exactly what you consider the problem(s) to be. Without scoping and defining the problem it is hard for me to come up with a plan. Is the problem 'Health Service is Too Expensive"? That is a pretty all-encompassing statement. What is "too expensive" and why is it considered such?

Because it costs you about 16% of GDP, while plans with superior health outcomes in other countries cost as little as 8%. How do you not know that?

What specific problem/issue was the ACA supposed to address? I'm not being a smart ass here.

Outside of the GFC, the primary cause of bankruptcy in the US was medical costs. This came from people being denied coverage. This is not an obscure thing, and again I really have to wonder you can be honestly asking that question this late into the issue.

And the ACA is designed, among other things, to begin a clawback of spiralling healthcare costs, specifically in pharamceuticals and insurance. The former is achieved through better negotiations with pharmaceutical providers (already begun) and in insurance by reducing the portion taken by insurers (there's now a fixed minimum of total revenue generated by a healthcare fund that must be spent of patient health, not swallowed in advertising and admin).

1. As it stands, if you purchase insurance, either on your own or through your employer, YOU are freely entering a transaction in which YOU perceive the cost you pay is worth the benefits you gain from having paid that cost. As such, it really does NOT matter who else benefits or does not benefit from that transaction. If YOU are not happy with it, no one currently forces you into the transaction.

Your assumption here is let down by the simple fact that healthcare coverage is necessary. As such, a person who can afford it will still take it, even if it's a poor deal. For example, food might have a completely disfunctional system, where your employer pays for you to get into a collective, who hands out food whenever you get really hungry, leaving you with a co-pay. Advertising and promotions for these food providers are astronomical, and so are the court cases they run from constantly denying coverage to paying customers once they become too expensive, if they manage to find a technicality that allows them to deny coverage.

You will still buy into because you need food, even though the system to get food sucks.

2. Health care is not a right. It is a commodity/service someone provides.