avatar
Dan Munro @dan-munro.com

No - we don't have UHC - and the ACA is just another tier of commercial coverage - not UHC. HC benefits through unions is better than many individual employers - but we still need employers (incl uinons) out of the HC biz. Until that happens - we're just tweaking cost & coverage. hc4.us/esi20

aug 28, 2025, 7:20 pm • 1 0

Replies

avatar
Teeklin @teeklin.bsky.social

The ACA was literally designed and written as universal healthcare. From the ground up, that's what it was intended for and written to be. The fact that red states literally refuse to cover people out of spite creating gaps in coverage that fuck over millions doesn't change that.

aug 28, 2025, 7:28 pm • 0 0 • view
avatar
Dan Munro @dan-munro.com

Nope. ACA was meant to ADD a commercial coverage option for those who didn't have ESI. It was NEVER intended to REPLACE ESI - and w/ ESI - we'll never have true UHC. What we have is tiered coverage to support tiered pricing. That's never going to be UHC - and the ACA is just another commercial tier.

aug 28, 2025, 7:42 pm • 0 0 • view
avatar
Teeklin @teeklin.bsky.social

Again, the fact that employers are involved in coverage doesn't have any bearing on whether a system is or is not UHC. The ACA had requirements for everyone to be covered and anyone not getting it under employers would have the market and subsidies down to the point of Medicaid. That's UHC.

aug 28, 2025, 7:58 pm • 0 0 • view
avatar
Dan Munro @dan-munro.com

Footnote: Here's the quote from noted healthcare economist Uwe Reinhardt (RIP).

image
aug 28, 2025, 7:52 pm • 0 0 • view
avatar
Teeklin @teeklin.bsky.social

Yes, the ACA is shitty. But it's still a universal healthcare plan. That's why it's important to actually phrase things properly and address the actual issue: single payer We don't need UHC, we have it already and see its flaws. We need single payer AKA Medicare for All to untie from employers.

aug 28, 2025, 7:59 pm • 0 0 • view
avatar
Dan Munro @dan-munro.com

Just not true. ACA is NOT a UHC plan and we absolutely don't NEED single payer. Granted, single-payer works. BUT as a delivery mechansim for single-pricing so does multi-payer [see Germany]. Ultimately, no one really cares how many payers there are. What's CRITICAL is UHC. hc4.us/oneprice

aug 28, 2025, 8:14 pm • 0 0 • view
avatar
Teeklin @teeklin.bsky.social

Can you point out who, under the original ACA with its mandates and expansions in place, would not have had healthcare coverage in the US? As it was written and before they spent nearly two decades gutting it of course, as now it's garbage without any real merits outside of a few provisions.

aug 28, 2025, 8:21 pm • 0 0 • view
avatar
Dan Munro @dan-munro.com

ACA just another commercial tier. Even w/ all those who are uninsured added (somehow) to ACA coverage it would not be the same as true UHC - which is the delivery mechanism for SINGLE pricing. Tiered coverage is the delivery mechanism for tiered (and uncapped) pricing. THAT'S the systemic flaw.

aug 28, 2025, 9:13 pm • 0 0 • view
avatar
Dan Munro @dan-munro.com

My surgery shouldn't be 2.5X the cost (Nat'l avg) my neighbors - simply b/c we're in different coverage tiers. That's the insanity - and ACA doesn't fix that. It just extends coverage into the systemic flaw of tiered pricing.

aug 28, 2025, 9:16 pm • 0 0 • view