[4RealFreedom]

American politics are riddled with examples - look at the Patriot Act and the Affordable Care Act. It seems to happen most with sweeping legislation. Of course, large legislation will have additional consequences because the point is it intervenes more. The flipside is that administrations that don't pass laws are referred to in derogatory ways - they are a lame duck. We've basically forced action, any action, no matter the consequences.

[m0llusk]

That misses a lot of context. The Affordable Care Act is considered by many to be an attempt to meet medical care needs with a market solution while most competing ideas go a completely different route such as Single Payer. It isn't just a patch to a system, but an attempt to fit some difficult constraints. Portraying extremely complex systems as simple may be the most common form of the first failing listed here.

[4RealFreedom]

What context was missing? You can argue that the ACA has benefits or the US system is complicated but I did not simplify anything. From the article "Intervention—by people or governments—should only be used when the benefits visibly outweigh the negatives." My argument was 'damned if you do, damned if you don't' and politicians do not worry about the consequences of their actions.

[m0llusk]

You are asking a question yet seem committed to ideas and political views already. here is an attempt to answer:

Through the Industrial Revolution medicine increased in scope and complexity and cost. By the 1970s people expected access to hospital care which was increasingly expensive to provide. Around the world most developed nations came up with some kind of universal insurance or single payer system to handle this. The US went with employer based care which limits who is covered and puts a burden on business.

Ongoing calls for universal basic care threatened market based care in the US, so Mitt Romney came up with a plan to provide universal care through government regulated insurance markets. Obama tried to bring this plan to a Federal level but was stopped by a complex array of social and political forces. As a notable example of what happened, Frank Luntz who often has interesting ideas to contribute to this day insists that the ACA was not an insurance program even though providing health care through private insurance was the central concept.

So now there are people who see the ACA as a compromised attempt to save market based insurance provided medical care and others who see it as some kind of strange intervention amounting to socialized medicine which oddly enough is exactly what it was designed to avoid. Where ACA was adopted it seems to be working reasonably well, and in Massachusetts where the original Romney plan was adopted everyone is insured and gets care through private insurance markets coordinated by the government.

The really big irony here is that by compromising ACA and then not even adopting it in some states it is increasingly likely that some kind of Single Payer system will end up being adopted at a Federal level. In this sense those who attempted political intervention have generated the most harmful possible result. That is the increasingly likely possibility that the existing system of providing health care in the US through insurance markets will be completely swept away instead of being reformed as Mitt Romney and Barack Obama advocated.

[4RealFreedom]

It seems like you're focused on the implementation of the ACA here. I used the ACA as an example of secondary consequences. My question of context was because that's literally what you said. I was wondering how context related to my post which I could have been more clear about. You seem to be saying that context is everything no matter the secondary consequences and go so far as to give more context. Many people characterized the ACA as a Trojan horse at the time. Was that it's purpose? That's maybe a more appropriate question to all this - why doesn't congress add purpose to bills? We need measurable benefits to weigh. By sidestepping that part of the process, it's a guessing game - all bills are just a mash of secondary consequences. That's convenient for politicians and political parties but not the people.

[Spooky23]

No, lame duck administrations are when you’re in office with a selected successor.

Both of the laws referenced were very strategic laws that largely accomplished their purpose. The ACA in particular was designed to appeal to republicans first - it was in alignment with old guard GOP values. It patched some of the holes in healthcare (pre existing conditions, etc) and drove the economic activity that will drive future universal healthcare (the consolidation of providers into health networks) when political conditions allow.

Overall US governance is deliberately designed to make doing something impossible. Think of any issue of the day that would benefit from Federal action. In general, nothing at all happens unless it’s some spin on an existing law.

[4RealFreedom]

I agree that I didn't use lame duck in the textbook definition but it does show the derogatory nature of not doing anything. Likewise congress would be called ineffective if they didn't pass laws. We often hear about gridlock when there's a balance of power with the 2 party system. I think saying 'deliberately designed to make doing something impossible' is an overstatement. Compromise is required. I see more and more that neither party wants to compromise, though. From my perspective, it's hard to talk about any Federal action that would be of benefit. Granted I'm jaded from seeing and being part of second order consequences. What kind of Federal action did you have in mind?

Edit I didn't address one of your points. You said the laws largely accomplished their purpose. What did you see as their purpose?

[Spooky23]

The Senate is a brake on change. In the most egregious example, the House passed anti-lynching legislation for 50 years, which never made it out of Senate committee.

Patriot act was ultimately designed to avoid the types of failures to coordinate that stopped the authorities from preventing 9/11 attacks. It was very successful at that aim, but created a bunch of other problems in the process. My statement isn’t an endorsement of it.

ACA reduced the number of uninsured individuals by 50%, eliminated a few key policy holes (ie pre-existing conditions) and slowed cost growth.

[4RealFreedom]

How successful was the Patriot Act? Without measurable benefits we can't really say. For the ACA, the numbers I'm seeing are much less than 50%. From the Kaiser Family Foundation "While uninsured rates decreased across all income groups from 2013 to 2016, they declined most sharply for poor and near-poor people, dropping by 9.7 percentage points and 11.4 percentage points, respectively." From that same source "In 2017, the uninsured rate reversed course and, for the first time since the passage of the ACA, rose significantly to 10.2%." You bring to the table an important point, though. We need measurable benefits. The fact that there's even guessing at the purpose of bills shows the flaw. We should require goals with every bill. Without that we just have bickering on specifics which, by design, have never been communicated. Politicians use this lack of information to their advantage.

Edit - source - https://www.kff.org/report-section/the-uninsured-and-the-aca...