Well the progressives including President Obama pushed for single payer (or a public option) which would eliminate abuse on the billing side, at least to the insured.
If the democrats were serious, they could have deployed the "nuclear option" on this (suspend Senate rules). But of course there was more than one person's objection going on.
Ipso facto there weren't enough votes to suspend the 60-vote in the health care case.
But that's not always the case - Neil Gorsuch was confirmed by a vote to suspend the 60 vote rule. So the rule is available for things that a strong party consensus.
It was dropped because it was politically impossible and it wasn't worth burning political capital on it. Even just the public option wasn't able to gain traction; single payer was never going to happen in 2009.
I would just note that "...it was politically impossible" and "the Democrats were never serious in saying they wanted it" are two ways to frame the same reality. Both are true. Take your pick.
I'm not saying any democrats at the time were willing to go all in on it, but the two statements would only be two ways to frame the same reality if democrats had the ability to make unilateral decisions in the senate. They never did.
The nuclear option - changing the rules to allow majority votes to override a filibuster - has existed in potentia for a long time. The republicans have used it lately for things they consider crucial to their agenda. If the democrats wanted single payer and considered it crucial to their agenda, they could have done that. Of course neither of those "ifs" are true and we can use the lack of action to judge this.
> If the democrats wanted single payer and considered it crucial to their agenda, they could have done that.
And then watched it get blown away by next congress as soon as the GOP gained 51 seats to do whatever they want. Blowing away the fillibuster is an awful, terrible, no good idea and there is almost no legislative agenda which would validate it.
And to be clear, the GOP senators were and still are slimey bastards for basically everything they did leading up to Gorsuch. It should have never been done. They will almost certainly regret it as soon as they lose the senate.
As I recall, the rough idea was to adopt a Republican plan (RomneyCare) in order to achieve bipartisan support (and "stake holder" support). And then it became the evil spawn of the Democrats...
And that is counting Lieberman as a D; a person who backed McCain for president and who later personally killed the public option.
I do think we will get to the public option at some point. It just makes too much sense not to and would strengthen the healthcare as a whole while allowing people more choice.
Public option is unlikely to happen in the near future. Too many people start frothing at the mouth and yelling "socialism!" every time it is proposed.
Well, if it works anything like IHS[1], then the system would run out of money before the end of the fiscal year and then you end up paying for it anyway or not getting the treatment. I find people who say "but it will be different for us" to need some proof from the US and not other countries.
> which would eliminate abuse on the billing side, at least to the insured
How does single payer fix that? If the hospital gives you a bill and won't negotiate down, how does the government "fix" this? Which is kind of what my question is: were specifics given in the ACA on how that problem will be fixed?
Well since single payer typically refers to the government being the single payer, the bill goes to the government because you the insured are not the payer of the bill.
See: Japan where the government decides the price of procedures.
On national health insurance (monthly cost depends on your salary but for an average person it is a few hundred bucks per month) the hospital pays 70% and patient pays 30%.
It means basic visits to the doctor or dentist are very cheap here. Like $20 for consultation + medicine. ER+X-rays and MRI (appendicitis, sigh) was a little bit over $100.