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Regardless of the ultimate success (or lack thereof) of the ACA, the fact remains that it was written by staffers and lobbyists, signed into law by politicians who had not read it, and will be enforced by the Internal ******* Revenue Service.
Partisan Democrats have to defend it regardless of the above fact, and partisan Republicans have to attack it knowing they didn't have the guts to present a clear and reasonable alternative at the time.
This could have been done quite differently, there are already effective smaller models that could have been scaled up, but both pig-headed parties were too busy practicing rectal-cranial inversion to work together to do it.
So now both parties have to take their stand, and here comes the ACA.
Enjoy.
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The real irony:
The architecture of the Affordable Care Act is based on
conservative, not liberal, ideas about individual responsibility and the power of market forces.
This fundamental ideological paradox, drowned out by partisan shouting since before the plans passage in 2010, explains why Obamacare has only lukewarm support from many liberals, who wanted a real, not imagined, government takeover of health care. It explains why Republicans have been unable since its passage to come up with anything better. And it explains why the law is nearly identical in design to the legislation Mr. Romney passed in Massachusetts while governor.
The core drivers of the health care act are market principles formulated by conservative economists, designed to correct structural flaws in our health insurance system principles originally embraced by Republicans as a market alternative to the Clinton plan in the early 1990s. The presidents program extends the current health care system mostly employer-based coverage, administered by commercial health insurers, with care delivered by fee-for-service doctors and hospitals by removing the biggest obstacles to that systems functioning like a competitive marketplace.
Chief among these obstacles are market limitations imposed by the problematic nature of health insurance, which requires that younger, healthier people subsidize older, sicker ones. Because such participation is often expensive and always voluntary, millions have simply opted out, a risky bet emboldened by the 24/7 presence of the heavily subsidized emergency room down the street. The health care law forcibly repatriates these gamblers, along with those who cannot afford to participate in a market that ultimately cross-subsidizes their medical misfortunes anyway, when they get sick and show up in that E.R. And it outlaws discrimination against those who want to participate but cannot because of their medical histories. Put aside the considerable legislative detritus of the act, and its aim is clear: to rationalize a dysfunctional health insurance marketplace.