[orthodoc]

The reality is that the US has to move to universal coverage. The ACA is a step in that direction, but only a first baby step. It still leaves things in the hands of private insurers, because Americans refuse to contemplate anything else. BUT it takes a few steps to rein in the insurance companies' worst excesses.

I wish we (the US) would take a careful look at how universal health care has worked out in different countries and then modify things to avoid the worst pitfalls. Canada had a great program for a couple of decades, then threw it all away in 1981 with the Canada Health Act. Other countries have developed programs where public and private insurances work side by side. Everyone wins. Canada is coming to that belatedly.

Reining in the insurance companies from a few of their worst sins (unilateral breach of contract, cherry-picking, anti-trust violations) is a start. The ACA will evolve over the next several years. We have to move to a preventive emphasis or our bad habits will bankrupt us. Yes, it means someone telling us what's good for us. But given the 'free' market and the power of multinational corps to manipulate us, we haven't done well. We've let Agribusiness and Fast Food tell us what to eat and how to live. We didn't rebel against that. Maybe we should have enough independence of mind to consider other information, even if it comes from government sources. Chances are, if the information helps us live longer, it isn't a conspiracy against us.