Another rambling comment in the form of a post

If you've never read "The Phantom Tollbooth" you're missing out in a serious way.  Near the end of the book, as our hero is nearing his rescue of the two banished princesses Rhyme and Reason, he has do deal with a number of nefarious creatures in the Lands Beyond above Digitopolis.  One of these is the two-headed demon of compromise, which, as you might imagine, never gets anywhere.  I used to wonder why Norton Juster would characterize compromise that way; it is, after all, what our government is set up to do.

The theme I see coming out here is that just about any "pure" implementation would probably be better than what we've got.  The problem isn't public healthcare vs. take care of yourself healthcare, because either system would work great in the social equivalent of the perfect physics world.  Public education might be a good idea for the public if it's implemented correctly, but what we've got is not implemented correctly.  Public healthcare might be good if implemented correctly, but it isn't.  It's people's human pride and selfishness that breaks everything.  In that world, the best we can do is compromise, which, in terms of actual function, is very often the worst of the available options, but the only one that allows for common peace.  Or is supposed to.

Take socialism.  I think this is probably the ideal.  My investment is good for me, true, but in a round-about way that requires me to have faith in you to return the favor at some undetermined future date.  It would just be so simple.  There are numerous examples of the failure of socialism, but none, to my knowledge can be ascribed to a failure in the system itself.  We just don't have that much faith in one another, and the system requires everybody to live solidly by charity.

Then there's the opposite, libertarianism.  It'd also work pretty well.  Everybody takes care of themselves, your problems aren't my problems, and since I'm a nice guy and I like you, I'll pay attention and help you out when you need it.  In our imperfect world, though, it doesn't work because it depends on self-motivation, which is apparently less common than one might hope, and the correct application of agency.  The problem I have with libertarianism, when carried to its logical end, is where it leaves the offspring of the unmotivated.  You would seem to get these cells of parents who don't take care of their children's education, for example.  The failure of the parents limits the children's choices going forward.  The motivated families keep getting smarter and smarter, the unmotivated ones keep not getting smarter, and the gap widens, making it increasingly difficult for a person in unmotivated-land to get in with the better-offs.  To solve this problem, the uppers have to either ignore the disparity, calling it the consequence of agency badly applied (not a solution, and not very charitable, in my view), or help out in some way, effectively ending the libertarian ideal.  I see libertarianism as the default system, from which things like monarchy developed as the uppers realized their power over the lowers and institutionalized the disparity.  In any real world, it just doesn't seem sustainable, unless I misunderstand the concept.  This is a tangent.

So, we're left with the capitalistic republic.  We can't innovate for the sake of innovation very well, so we have to leverage the powerful basic human drives, like selfishness, to drive innovation.  To me, the fact that such astonishing progress is achieved on the back of something like selfishness is both elegant and ironic.  I love it and hate it all at the same time.  And, since we can't agree, (and can't be bothered to discuss things amongst ourselves), we get to elect people to compromise for us.  Again, the solution here is inspiringly elegant.  A system that has done so well at postponing our social collapse, despite our humanity, could only have been divinely inspired, and deserves to be respected and protected.

I think Antares has hit it on the head by recognizing the ACA as possibly the best of the bad solutions, not because it is good in and of itself, but because it is available and is, if nothing else, a chance to look deeply at what we've got and hopefully find a way to fix it.  Following our discussion here, though, I'm not optimistic about that.  Like Antares pointed out, we've already got social medicine, but even though it eats up more of the federal budget than anything except defense (did I get that right?), we can't call it that, and since it's mixed up in this amalgamated behemoth with a few parts capitalism and some healthy doses of anti-capitalistic subsidies and backwards incentives, it doesn't work.  Thank you, compromise.

I guess this isn't a discussion about healthcare anymore.  So, what is the root problem here, and is there a fix for it?

I think I know... :)

No, that is not a sarcastic or malicious smiley face.