Obamacare and the long term fight for a sane Healthcare System

At this point my thoughts on the subject largely echo atrios'. As usual I think he said this really well:

As I've written plenty of times, I remain somewhat optimistic that Obamacare will be a modest improvement over the current system, though I do think there are some worries about how it will evolve long term. On one hand I support decoupling insurance from employment, but on the other hand if the decoupling happens without genuinely affordable substitutes being available then we aren't improving things. This stuff should be easy, not complicated, but DC is allergic to doing anything to help people without adding a Rube Goldberg layer on top of it, and funneling money to the Rube Goldberg machine operators in the process.

At the time of passage I was extremely torn on how I would have voted if I was in congress. In the end I figured I would have voted for it, because crappy private insurance is better than no insurance and there are a lot of people with no insurance. With that said, I have huge concerns of how it will evolve going forward having permanently cemented the private insurance industry's role in this process when they serve no beneficial purpose for anyone and should not exist.

I think the new exchanges system will work very well in states with good democratic governors (especially ones that want to run for president), and be anything from workable to inconvenient to a disaster everywhere else.

Looking into the future I think the next logical step is organizing around a medicare buy-in option to be added to all exchanges while trying to pass single payer systems on a state level. The system won't improve to the degree it needs to until we've added a medicare element, and let's go for the real deal, not some watered down public option. Until the private insurance industry is removed from the equation, there is only so much we can do to improve the system. That's obviously a long term goal (and one we've just made more difficult for ourselves), but the most important aspect of a campaign is picking the right target. Our main target needs to be putting the private insurance companies out of business, and we can move out on the hospitals and pharmaceutical companies from there.