Important thread which helps explain why many POC are NOT thrilled with the prospect of M4All. Strongly recommended...I knew most of this stuff but not all of it.
The larger point is that making ANY major change to our healthcare system has significant effects on EVERY other aspect of society, often in ways many people don’t ever think about...and not always for the better.
The very issues which makes our healthcare system such a mess also make it incredibly difficult to change...and I don’t just mean politically or economically. It’s like a 4-D game of Jenga.
One thing I rarely see discussed re. other nations with universal coverage is to look at how they deal with racial inequality in healthcare...or “medical racism” as she puts it. What’s their racial history and makeup? How does that play into their healthcare systems?
Ten years ago I didn’t understand why most of the ACA’s major provisions took four years to kick in. Now I understand. Some was for CBO scoring purposes I’m sure, but a lot of it was because it required a long list of back-end changes most people know nothing about.
I’m not just talking about the HealthCareGov tech disaster at launch or how Insurance companies had to retool their actuarial projections; I mean EVERYTHING. Making another complete overhaul like that would cause at least as much disruption, some good, some bad.
It would have taken several years for the dust of the overall impact of the ACA to settle even WITHOUT the endless court battles, GOP sabotage, repeal efforts, etc. even without all that, there would be significant problems which need to be addressed.
All of which is why IN THE SHORT TERM, I’m pushing for a robust ACA 2.0 upgrade to repair, protect and significantly strengthen the ACA for a few years (hopefully including a PO) *before* completely replacing it with the Next Big Thing, whatever form that takes.
This is a few years old and isn’t even from my own blog, but it remains one of the articles I’ve written I’m most proud of and still holds up today: cracked.com/blog/a-zero-b.…
