Single payer would come out of tax revenue, and the amount you pay for your healthcare would effectively rise with your income. Despite the fact that behaviors that increase ones burden on the healthcare system are less common in high earners. I used to support single-payer, but after looking into it, I've become a big aca fan.
The ACA prevents insurers from dropping you when you're sick and allows sick people to get health insurance. That's a huge relief for a lot of people, especially in the post-bush economy when jobs (and the insurance they provide) are easily lost. But how do you keep people from just paying out of pocket until they get sick, then signing up? Individual mandate solves that nicely. You can choose not to contribute to the insurance pool, but it'll cost you an additional tax.
The Medicaid expansion provides low income women with the means to properly plan their reproduction. Previously it only kicked in once the woman became pregnant. This seeks to address the 5fold higher rate of unplanned pregnancies amongst low income women. Currently, ~50% of newborns are covered under Medicaid, an entirely unsustainable number.
The mandatory coverage of birth control and the equal cost of insurance for men and women support some ideas I believe in. First, men and women are equally complicit in the conception of a child. Second, unplanned pregnancies are a society's burden, not just a family burden. Just as I support everyone chipping in to educate your brat so that I don't have to deal with as many tards like r00t, I support everyone chipping in to keep children who won't be properly raised from being conceived. The people who would take birth control if its given to them but can't be burdened to buy it are the last people we want having children.
The employer mandate and the medical device tax should be removed from the law, the companies responsible for the website should be held financially liable and possibly criminally charged, and more efforts should be made to strengthen insurers bargaining power with hospitals, pharma companies, and medical device companies, as is seen in single-payer systems. But its a good start.
If Republicans want to prove its a bad system, they should work with democrats to make it as good as possible, rather than try to undermine it. Otherwise, they'll never be able to convincingly argue that its hopeless.
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