this post was submitted on 17 May 2024
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[–] gAlienLifeform@lemmy.world 3 points 6 months ago

Thank you for the sincere and thought out reply, that was honestly really refreshing.

I'm really, truly, glad for your people and that they're doing better and doing more good in the world, and very much believe that's exactly what healthcare can and should do for people and society. However, I know one person who spent years dealing with medical debt because their insurance basically did a bait and switch (hospital was in network but the doctor wasn't), probably a dozen who spent years at jobs they hated because they needed the insurance, and one person who worked in healthcare and basically had to switch jobs and move to a different specialty because having to fight insurance companies for her patients and losing those fights was destroying her mental health.

Also - and this feels kinda petty and I'm sorry if it comes off as disrespecting your story but I've just gotta say - I'm pretty certain dental coverage isn't mandated for employers under the ACA, or for adults on state Medicaid plans. So, though the ACA certainly may have helped or played a role in the people you know getting dental care (like, some states do provide dental, and there's probably matching money or a grant or some other mechanism somewhere in the ACA to support that), it didn't do it alone, and there's all too many people who don't get that treatment because they have a lousy employer plan and/or live in a red state.

And my problem with the ACA is that it really serves to lock a lot of these problems in and just completely neutralize any political will to change them. Beyond shoveling money at health insurance companies, it's made them a central player in healthcare policy, both through their lobbying work and through the kinds of influence they're more able to exercise over healthcare providers (e.g. what health insurance will and won't cover determines what departments get what kind of staffing, let alone the impact it has on what individual providers can and can't do). The deeper these things set in to our various bureaucratic and political systems the harder it becomes to even imagine another way to do things because the administrative and intellectual resources to do all the nifty gritty detail work of healthcare are owned outright or deeply intertwined with this inefficient and unjust market system.

Also, there's a deeper historical conversation to be had about how the politics of 2008-10 played out, and how bank bailouts and the ACA both gave Tea Party assholes material to work with, but frankly I don't have the mental energy to disentangle that from the fact that straight up racism and lies did a lot to propel them. Like, to discuss that 2 year period properly really would take a whole book, but the harm that was done to this country by the 2010 election and the census and gerrymanderings that came after it is really hard to overstate, and I really think that the mishandling of policy and messaging around the foreclosure crisis and healthcare reform by Democratic lawmakers really set the stage for that disaster.

That all being said,

If we survive November, we’ll meet back up and hassle the newly-electeds together

Hear hear, that's something I'll look forward to while holding my nose and filling out my ballot. Good luck to you and your people, whatever may come.