[NoGravitas]

Obamacare complicated health care because it was designed to preserve the existing system of insurance companies, employer-provided insurance, and patchwork regulations. So, of course, it introduced more patchwork regulations, along with subsidies to the existing players.

A single-payer system (Canadian style) would greatly simplify the health care system, largely by cutting out the insurance-company layer for most people. A British NHS-style system would arguably be even simpler, but is even more of a political non-starter in the US.

[jerf]

I think you sort of misunderstood my point. My point was that you'd have an easier time of selling me on it if Obamacare had actually simplified things. Which was one of the promises it made, after all. Explaining why it failed to do so does not contradict my point, it reinforces it.

In terms of Obamacare not simplifying things, my engineering answer is "Then why did we implement it?" If a goal is impossible for some reason, then the correct solution is not to try to obtain it, not to just cruft up the system harder anyhow. How many people can tell the same story of failure in their engineering jobs? Since this is the same set of people who want to bring us nationalized healthcare and want to write all the regulations for it, it does not encourage me to think well of their judgment in doing so.

I am abundantly confident that our current ruling class would find some way to muck it up. Even if we handed them The Pristine National Healthcare System Act of 2018, they'd have regulated it to death in just a handful of years. Our current ruling class doesn't seem to be able to sneeze in anything less than 50 pages of legislation and several hundred pages of accompanying regulations.

[nradov]

That's not how politics works. Everyone has a different opinion and priorities. Obamacare made the overall system better by providing more people with affordable access to healthcare, at the cost of increased complexity in some areas. It was a good trade-off. If everyone had insisted on perfection then nothing would have been changed at all.

[u801e]

The ACA originally was going to have a public health option (but it was removed because a senator at the time threatened to filibuster). Had that been included, I believe it could have led to something very similar to a single-payer system.