[iamnothere]

One could argue that we are currently stuck on a local maxima, and that the broader political system is designed such that any significant improvement will first require massively disruptive changes that will indeed lead to deaths. In this sort of situation, the end result of a change will save many more lives over the long term, but it will require short term sacrifices. Not just sacrifices of money; unfortunately, some people won't make it through the process.

Opposition from incumbents ensures that any change will be a difficult process, and a "new normal" will not come easily. Any long-term planning efforts will be sabotaged and subverted toward capture of profits. The best we can hope for is a series of smaller disruptive shifts (each followed by a resettling) that eventually improves the situation.

Something needs to happen. Increasingly it looks like dissatisfaction with the current system will boil over and force a major shift, but other events (wars, for instance) could pop up and distract the public for a time.

[Gibbon1]

Before the ACA San Francisco implemented Healthy SF which eventually came to cover every family making up to 500% of poverty levels. It was just slowly phased in over about 5 years.

Key thing I've noted about was it was designed to get people covered and to stay that way. That's the opposite of neoliberal ACA which is designed to be annoying and has traps designed to rat fuck people.

[iamnothere]

The media likes to associate the ACA with Obama, who was at least nominally on the left. This conveniently covered up the fact that the ACA was based on Romneycare, a vehicle from the neoliberal "center" designed to prevent truly disruptive reform.

The ACA was a stalling tactic, and it has been rather successful in that role. People are starting to see through the ruse though.

[Gibbon1]

> designed to prevent truly disruptive reform.

That's been my opinion, more or less the ACA was just to set the take by the Insurance/Health care parasites to 17% GDP no more no less.

Healthy SF was really about access and outcomes.

[notjesse]

That's a great way of looking at it! I've never thought of it like that.