<p>The time for alternative proposals was back in 2009, but unfortunately, opponents put all their energy into killing ACA, not improving it or proposing something better. We were never going to have single-payer, and the public option was quickly killed by the insurance industry. So the individual mandate is what we’re left with. I think we could have done a lot better, but it was the only proposal ever put on the table.</p>
<p>BTW, having health insurance, forced or not, is highly correlated with getting health care, and in a more timely manner and at less cost.</p>
<p>For those who think that universal coverage is a dark socialist nightmare, here’s an account of health care in France and The Netherlands. Better care, quicker care, lower cost. I don’t understand why anyone objects to this.</p>
<p>Population Neatherlands: 16 Million
Population France : 64 million
Population USA : 320 Million</p>
<p>The population of the Neatherlands is not only stable, it has virtually no illegal immigration issues and is boringly homogenous. I wonder in how many languages the Neatherlands are required to provide their healthcare. 'Press 1 for Dutch, press 2 for XYZ". France is also a homogeneous society when compared to the US. Somethings are just not scalable. </p>
<p>Also, a very different approach to basic healthcare. When my sisters kiddle had a bike accident while in France they stopped in at the local doc. Doc took one look at the knee, cleaned it and stitched it up. No long intake forms asking about previous health issues, whether kiddle had had chicken pox or whether either parent had a family history of heart disease. Simply - when was your last tetanus and then a few stitches. Part of the US problem is our lawsuit happy population and the subsequent layers of CYA added to even the simplest transactions.</p>
<p>“The population of the Neatherlands is not only stable, it has virtually no illegal immigration issues and is boringly homogenous. I wonder in how many languages the Neatherlands are required to provide their healthcare. 'Press 1 for Dutch, press 2 for XYZ”. France is also a homogeneous society when compared to the US. Somethings are just not scalable."</p>
<p>I don’t understand this line of argument. It is like if someone said we couldn’t have a public school system because we are so much larger and so much more diverse and have illegal immigrants which X, Y. Z country don’t have.</p>
<p>dietz199, I have to agree with emilybee. Your argument doesn’t make sense. I hope you’re not trying to blame our health care problems on illegal immigrants or the diversity of our citizens.</p>
<p>"Part of the US problem is our lawsuit happy population and the subsequent layers of CYA added to even the simplest transactions. "</p>
<p>This.</p>
<p>And, yes, Aqua, illegal immigrants are a huge part of our healthcare problems. Unfortunately, this will not be addressed by ACA as they are exempt.</p>
<p>The Netherlands and France are both part of the Schengen visa area, and are both in the European Union. This means visitors and long term residents from many other countries where different languages are spoken may be present there, even if the citizens are linguistically homogeneous. (Lack of illegal immigration may be at least partially due to having very lenient rules on legal immigration from neighbor countries. Perhaps the US should consider that.)</p>
<p>In addition, France is not linguistically homogeneous, with indigenous minority languages like Proven</p>
<p>Oh good grief…I wasn’t blaming anyone. My point was that the US has a very different social issues and a much much much much much larger population than the countries which circus ponied about as examples of stellar systems. So, sometimes one size does not fit all.</p>
<p>dietz, one size doesn’t NEED to fit all. Various nations have taken myriad approaches, all the way from true socialized medicine to single-payer to public-private partnerships to individual mandate. And every single one of them works better than our system.</p>
<p>It doesn’t matter if all the countries added together equal or exceed the US population. Each country individually has a much smaller population (Japan as the second in line has roughly 35% the population of the US). Each system which gets pulled up as a shining example works for a much much much smaller number of people. </p>
<p>I don’t have the solution, but it is intrinsically um - canard (good SAT word)- to to look at country X with a population very different in size and behavior and believe that same system can be blindly scaled to 3-10 times X and still function.</p>
<p>Hey Germany has no speed limits on the autobahn…let’s try that and see how it works on our older broken and curvy roads, with our preponderance of large SUV’s. Remember their autobahns were built post WWII, with mandatory long straight portions which can function as airplane landing stripes and most cars are much smaller and handle better at high speeds. Old run down junkers aren’t on the road because they can not pass safety tests and thus are not relicensed (T</p>
<p>"Hey Germany has no speed limits on the autobahn…let’s try that and see how it works on our older broken and curvy roads, with our preponderance for large SUV’s. Remember their autobahns were built post WWII, with mandatory long straight portions which can function as airplane landing stripes and most cars are much smaller and handle better at high speeds. "</p>
<p>Actually, a great deal of our interstate highway system was built to be perfectly fine for speeds exceeding 100 miles or more. </p>
<p>There is no reason we cannot have a health care system like any other country because of the size of our population.</p>
<p>^^We can have a different system than the current one, one which functions better. But to make it ‘like any other country’ is a simplistic approach. But, maybe that is all we are capable of.</p>
<p>State based and implemented. That way whatever gets implemented, if good will serve as an example, if not so good it will serve as a warning.</p>
<p>Inter state agreement to honor origin states contract for a defined period of time in case a citizens moves. Similar to residency requirements for instate tuition.</p>
<p>This could also serve as a mechanism to attract businesses. Bring in your jobs and we will give you support to the tune of $$$ per employee for X amount of time. Or it could server as a moral statement of the states values…we cover everyone for everything all the time.</p>