issue everyone a card. show the card to the medical clinic or doctor. everything else layered on top of that is just another reason to hate democrats, no matter how much ‘better’ it works
My response to this idea of extreme simplification is “This sounds great — how do we do this? More importantly, how do we get to 218-51-1-5?”
Yeah, that is a bit flippant, but there is a great question of how do the politics work to get a massive change as El Dorado proposes through the veto-strewn minefield of the US government.
If there is text for El Dorado’s bill available this morning, there is likely a 1 in the White House willing to sign a law. There are not 218 votes in the House nor 50 + a cooperative VP in the Senate to get a bill to the White House. There is definitely not 5 on the Supreme Court willing to uphold the law as constitutional. This equation gets worse in a few weeks.
So in the short run, technocratic tinkering is what becomes plausible and available to improve a non-ideal system.
Will it be perfect? FUCK NO.
Will technocratic tinkering that modestly eliminates frictions borne by the individual modestly improve coverage and the lived experience of the law? I think it would.
Is this emotionally satisfying? FUCK NO!
Is this the realm of the current possible? Yeah…
The challenge and disconnect is time frames. Technocratic tinkering is what can be done now. It is what can be done in 2023 and 2024. It is most of what might be done in 2029.
Complete restructuring of the US healthcare system is a generational or more political and constitutional project. It pays off, if it ever does pay-off, in decades. And striving towards an ideal future is a damn good thing, but it is in conflict with people who are operating on shorter time horizons and thus more constrained possibility spaces.