Dialogue

There's conversation taking place in comment threads, and perhaps even in real life. There are those who believe we need to stay the course with PPACA, that Democrats, and liberals, own the program and need to stand behind it. There are others who believe that the recent implementation problems offer an opportunity to improve the system.  Here's a stylized version of that debate, inspired by the chat accompanying this VS episode.

 

Stay the Course: The PPACA may not be the best thing evah but, yes, it can get you insurance and it will probably save money for many people, and also save some people's lives

 

Fix  it Now: I end up explaining that the PPACA is like Ryan's plan for Medicare, except that it carves out a tiny population of sympathetic folks who can stand in as marketing tools for all the other people who are getting screwed.

 

Stay the Course: Tiny?! It helps millions! Millions of poor people!

 

Fix  it Now: No it's not! 5 percent! And they're hostages to be ransomed off to insurance companies.

 

Stay the Course: There's good stuff in there. Negotiated prices on physicians visits and prescription drugs. A huge boon for young couples having children.

 

Fix  it Now: It's a bad deal. Too much more power given to these monopolies. A bronze plan with 6000 dollar deductibles is no boon.

 

Stay the Course: It's better than nothing. it's still the law, and still an improvement. We have to fix the damn law, but that is going to take time.

 

Fix  it Now: What?  We need to stop defending this dog and ruining our credibility.

 

Stay the Course: Whose credibility?

 

Fix  it Now: Liberals. If we don't we'll own this steaming pile. We need an atmosphere of constructive criticism and policy alternatives.

 

Stay the Course: And a pony! What color are the unicorns in your world?

 

Fix  it Now: They're fuschia. Yours are Bluegrass green. You're touting the "success" of 5000 pre-enrollees in Kentucky. And that's your BEST example. It's ridiculous.

 

Stay the Course: It always was gonna start slow. And, anyway, we can't get anything through the House.

 

Fix  it Now: But we take advantage of this clusterfuck to trade the individual mandate delay for something actually good.

 

Stay the Course: Where will the votes come from?

 

Fix  it Now: There are 7 members now scared of the mandate. Call Boehner's bluff. Go all bipartisan on him.

 

Stay the Course: You'd still have to get it through the House.

 

Fix  it Now: Yeah, but they claim to hate the mandate, that it destroys choice. So give it to them, in exchange for scrapping the antitrust protection. Or SOMETHING that introduces competition takes monopoly power away from the carriers.

 

Stay the Course: I know! Make the GOP to put up their own plan

 

Fix  it Now: They tried to shut down the government over the  mandate. So give them the mandate. And get something for it

 

Stay the Course: But there is no GOP plan! They're cheating! They're not offering anything. Make them commit to something.

 

Fix  it Now: They’ve got nothing that adds up. And now they've staked themselves to the mandate. We can use that. If Obama wants to.  But he wants HHS to have the final say. We need to douse the mandate suspension with  bipartisan fairy dust.

 

Stay the Course: No, we need to buckle down and get through this.  It's the camel's nose under the tent. They hate it because they know that if we can keep the ACA afloat through the rest of the term, they'll never be able to reverse it. And THEN we can fix it.

 

Fix  it Now: I think I’ve seen that movie before.