Also, if I remember correctly, the ACA is similar to but not identical to a GOP plan from the 90's and the state plan adopted when Mitt Romney was governor of Massachusetts in the way you describe - continuing to use existing insurance companies.
https://www.publicintegrity.org/2015/02/16/16766/elimination...
Lieberman is certainly worth of endless condementation, but trying to pretend Obama didn't do everything he could to kill single-payer and a public option in order to implement Romneycare is just wrong.
The political situation and polarization of the country certainly got a lot worse when the ACA was passed and that is arguably the biggest political problem the U.S. has had since, affecting basically every policy decision the U.S. makes.
To bring it back to jobs without purpose, not wanting to quickly rearrange an entire sector of the economy is a completely cogent reason to oppose a change you would otherwise vote for if it were applied differently.
Now it seems rare, the Maginsky Act sanctions and the Iraq War powers are the only consensus votes that come to mind.
[1] https://www.congress.gov/bill/115th-congress/house-bill/676
My personal take is that a bunch of these pointless jobs would get shoved into government sector.
So I would gladly layoff most healthcare administrators and have them figure out what to do, by themselves. It's their fault and their fault only if they can't. “That’s what freedom is all about: taking your own risks.”[1]
Fuck them, this is America, you 'own' your career. I mean, this is the universe I'm currently working in, why shouldn't they be subjected to the same thing? Especially when they chose to work in a parasitic system? If my skills lag behind, I'm unhirable in my industry. Coupled with my increasing age, IT'S ALL MY FAULT AND MY FAULT ONLY if I get fired/laid off and end up with no healthcare.
[1] https://www.nytimes.com/2011/09/16/opinion/krugman-free-to-d...
A significant reduction in overhead would free significant funds into the hands of the consumers, who would employ them to improve their lives, generating economic growth and demand in other economic areas that would pick up the slack. Granted, it's not comfortable for the workers made redundant, hence the tendency to band together as a special interest group and put political pressure to keep things inefficient (that's all assuming single payer is indeed an efficiency improvement, an entirely separate discussion).
If the facts on the ground were that it was actually possible to get single payer passed, I think those questions would have been easily answerable. It just wasn't tactically necessary to answer them in the context of what was achievable because of one horrendous (sorry Lieberman, but you really blew it) person.
The statement was clearly entirely political, of course.
"What will happen to them" doesn't have to mean preserving a broken system, it just has to mean caring humanely for those affected.
Also according to that article, former coal miners are more open to retraining where other industries have jobs readily available and/or where coal has no credible chance of comeback in that area.
None of that contradicts my suggestion as applied to the health insurance industry, which isn't really part of any cultural identity, and which would clearly not be about to rebound quickly in a single-payer world.
Retraining could even be pretty quick if they retrained to other forms of insurance, especially life insurance (which still cares about individual health) but there are many other kinds too.
I mean, sure, it's easy to setup negative incentives if you setup a welfare system and you aren't paying attention, but that's really a different sort of issue... and one that can be solved by looking at those negative incentives. (the earned income tax credit is a good place to start if you want to look at real-world attempts to amelerate the negative incentives that come with "you lose all benefits if you earn more than X dollars" style need-based plans. I'm just bringing it up because it's a real-world attempt to solve that problem and because there is real-world research on it.)
An imaginary way to deal with those negative incentives is Milton Friedman's "negative income tax" or even the 'basic income' people are on about.
But point being, the negative incentives are a thing that you have to watch for with welfare programs... but they don't negate the good done by, you know, allowing poor children to access medical care, food and education.
The discussion here was between welfare and bullshit jobs, not welfare or starving.
The pointless job sucks out many hours of productive hobbies and caretaking, space to think, innovate and organise.
This might be the desired effect - one of the means to control the population.
I tend to be more optimistic and think that the problems arise by our current model of unemployment rather than the idleness by itself, but I can't pretend I know the answer.
"Everybody who supports single-payer health care says, ‘Look at all this money we would be saving from insurance and paperwork.’ That represents one million, two million, three million jobs [filled by] people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?"
So it seems that Obama didn't pursue a single-payer system because keeping 2-3 million "bullshit" jobs was more important than efficiency in the health care system, or at least it was part of his reasoning.