>> the risk in the public ACA pool is lower than the employer's pool of employees

as a general rule, the public pool is substandard rating.

That's a weird way of putting it. Young people are getting far less value from their healthcare premiums than the old. That's how the entire system is able to work.

Health insurance, social security, medicare etc. all discriminate against the young in favor of the old. And I'm not passing judgement for or against such a system. That's just how it is.

The ACA is actually a wealth transfer from the young to the old, like social security, because the young pay much more than their portion of healthcare costs, while the old have a ceiling on their healthcare costs.

Whether this is good policy is for the think tanks and politicians, but after the ACA it is not true that health insurance discriminates against older Americans.

Medicare exists only for the elderly.

A reminder that government services suck on purpose. There is no reason for government healthcare to be ineffective other than the malicious intent of those who run our government (D or R).

Yes. Government employees and elected officials have weekly meetings with a standing question: Where are we doing things well? And then they coordinate to fuck it up and make it suck. /s

I have these 2 questions/thoughts:

1) Do you think it's a good idea to have all the branches of the government controlled by 1 party? We actually had this a few decades ago in the Czech republic and we refer to that period as "totalita" or dictatorship. Let's say the wet dream (based on comments like yourself) of all Democrats becomes real and they control everything from communal level to presidency. How is it different than China, USSR or Czechoslovak Socialist Republic?

2) What has changed in the past half a year? If I am not mistaken, Democrats have had control of the presidency and house for over half a year now. I admit HN is my only source of news, but it seems like there are still ICE camps. There is still half-built wall between US and Mexico. The US still drones countries on the other side of the world. From the statistics people are still living paycheck to paycheck and can't afford healthcare (I understand the plague has its fair share here too). The US still helps Israel, which is IMO a rogue state at this point, as per the Pegasus scandal.

1b) We don’t really need 1 party. More than 2 parties would be great as well. But really we just need the Republican party to not be obstructionist nor actively harmful to democracy.

2) Democrats have the presidency, which, while having greatly expanded powers over the last 50ish years, is still a relatively weak executive. The Democrats have a narrow majority in the House and Senate; due to parliamentary rules, the narrow majority that they have does not allow them to pass or amend laws as freely as you may think. The Supreme Court, while notionally non-partisan, is filled with a majority of conservative Justices which can dissuade or reverse policy made by more liberal branches of the government (federally, or at state levels).

2b) 6 months is not a long time for governments the size of the US. Barrack Obama likened it to a large ocean-liner: there’s a lot of built up momentum, so it takes a long time to stop it or change direction.

Would you mind elaborating on that? From my own perspective the federal government’s ability to help fund and drive the vaccine development and then to purchase in quantities to get the entire population vaccinated is actually proof of how powerful a single payer system could be. I’m curious as to what I might be missing.

1. Fund and drive vaccine development

2. Purchase large quantities

Neither of those is what I want from my insurance company. How much are those two things costing me? If my taxes just went up $100/year for the next 3 years to pay for that vaccine, that maybe wasn't ideal. If my taxes went up $10 total, that was an awesome deal. If I have no idea how much that vaccine cost me, and nobody else seems to have a way to figure it out, that's really bad. One of my biggest complaints about health insurance in general is the lack of transparency. If government control reduces transparency, that would be bad.

Are governments or private companies more transparent?