Reid says Obamacare just a step toward eventual single-payer system

[TheKentuckian]

45. Being better than what we had is arguable but this isn't anything like your example of an NHS

even actual single payer isn't a NHS and the Wealthcare and Profit Protection Act will have to sensibly evolve quite a bit with from design to even transform the current system to a utility type arrangement much less actual single payer and certainly a complete revisiting of the current paradigm to move to a NHS, in fact I see zero tracks laid in that direction which would largely mean not only an end to the cartel but to the for profit delivery system.

I think it is beyond optimistic to expect natural progression even to the utility model, even that would be no less than twenty years out because it will take about that long for the adjustments passed to be fully implemented, observed, and tinkered with at all.

The current reform is to extend the viability of the insurance cartel not to end it. It is the cartel that desperately needs mandated customers with substantial subsidies to exist. Reverse incentives and the rate of growth inflation dictate that no matter how much people want to be covered that the cartel was within sight of pricing its self out existence. Folks and companies just simply cannot afford the ever increasing costs and would be forced out of the market, this would shrink pools and make those that still could afford to hang on to plans less likely to be able to do so. Eventually there would be cascade failure. No profits to be mined out of rapidly shrinking pools and no consumer benefit as cost shares would ever be on the rise.


Supporters of the kind of theories you forward are often locked into an unsustainable calculation which is that left as is that most folks would be able to keep paying the extortion forever but they can't and were already reaching the threshold of systemic collapse.
We are still heading toward choking off the rest of the functional economy at 16%+ of GDP, the hope is that brakes enough to reduce the rate of growth are there and if not that the impacts of cost sharing, self denial of care, squeezing of benefits, wellness programs, subsidies hiding cost, and other machinations slow growth of costs enough to stabilize the for profit system enough to keep the extraction going for the foreseeable
In the end when the collapse does come that a broke and desperately indebted government will be too hogtied to do anything but abandon the public to a true wild west not only in the healthcare arena but overall.
By feeding the cartel and making their well being an essential government responsibility (too big to fail), we will be forced to "drown the pig" as the sector out black holes the real deals, which appear to have periods of calm.

I once upon a time believed what you described as the intent but we aren't on that trajectory yet. Closer, okay but at a stiff price, increasing the longevity of the cartel and forcing the biggest structural showdowns into a most likely lower resource (and horrible distribution) period. This I think has been a pretty huge lift for leaving fully the existing structure and profit centers in place.
We also are left with little to negotiate with for future "rounds" so we need a whole new SOP politician wise, no "careful consultations with the stakeholders", no collaborations between aides and lobbies to draft marks, no CEO's testifying but rather a "telling them how it is going to be" of a nature I can't say I'm familiar with.

Steps where made that does not automatically follow that those steps changed the trajectory to the degree required to reach escape as laid out.