Again, I’m not saying ACA should be repealed. I’m saying why the current congress won’t be able to fix it.

AKA, they’ve glue their nuts to the third rail.

We as a people want Caesar’s Bacchanal Buffet, but we want to pay the Port O’ Call price.

So your statement [quote]In order to make make the math work, we need a good mechanism to ration care, administratively or market wise. That’s the way it is with everything.[/quote] is correct.

And that is what will make people scream bloody murder.

If we don’t do that, and we keep the stuff people want, guaranteed coverage, no gouging sickies, your ‘kid’ can ride your plan until they’re 26, its costs $$$$. Oh wait people don’t like it costing $$$$.

Anecdotally, I know people in Canada that were very happy with their health care, the they weren’t. The reason is simple, they hit one of the gaps.

For years I’ve been saying we ration healthcare, we’ve just been choosing to let for profit insurance do it under the guise of low cost insurance.

Again, we need to focus on the cost bending part of the equation. Government entering as an insurance provider is one way to do and leverage medicare and VA buying to drive costs down.

Changing laws to prevent Epi-pen gouging is another. Changing others to prevent Shrkeli is more.

Simplifying the administrative burden is a third.

And making people pay, is the forth.

And finally, change the law so the the providers need to publish a cash up front price and frankly, that price needs to be lower than insurance provided rate (which conflicts with laws on Medicare and other things). What we have today is backwards. You want outpatient surgery? The hospital charges are $30,000. It’s $20,000 if you pay cash up front. And if you have insurance, the insurance will pay $15,000 and you have $1500 co-pay… Broken.