Obamacare Shows How Americans Are Becoming Jerks

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1. Americans (many) have always been jerks (or at least had selfish motivations)

The biggest flaw in the ACA is that it assumed everyone would suddenly start to cooperate

* insurance CEOs would be happy with more customers and not want to keep increasing profit/policy

* insurance CEOs would treat the MLR as intended rather than as "a reduction of medical costs means a reduction in profit while increase in medical costs (and premiums) is the only way to increase profit on ACA policies"

* corporate CEOs would not cut hours to 29/week or drop insurance when it's in their financial interest

* healthy people without insurance would choose a more expensive policy over the tax

* republicans who were against the ACA when it passed would cooperate in it's implementation

* medical providers and pharma would reduce costs of services and drugs

* doctors and hospital would take lower reimbursement rates rather than focus on non-ACA patients

* people who's insurance got worse would not raise a big stink

* unions would be ok paying $63/policy (like all other policies) for the next 3 years to make sure insurance companies stay in the exchanges

In the first 2, the CEOs may be legally obligated to do what's in the best interest of their shareholders and are in a bind if they want to cooperate with the ACA.

You just can't get 300 million people to work together when many of them will need to go against their own self-interest. Single-payer is the only way to accomplish the objectives of the ACA.