, "it will take some time to see our results", "we had some "unexpected setbacks with implementation" and excuses followed by any number of years and decades of goofy tweaks in a "reform" that was never built to deal with the structural failures in both the narrow focus of funding that it is falsely promoted as solving and the broader healthcare system as a whole that is out of hand.
Honestly, when you make free riders the epicenter of our issues you should take a swift kick in the ass and a seat in the corner with a dunce cap on.
The access problem quickly morphed into a participation problem and largely to the exclusion of anything else and completely to the elephants in the room, that not only remain the basis for access to healthcare but entrenched and enriched. The biggest problems like the health insurance cartel, the employer based system, insane pool fragmentation, underfunded and outmatched state regulators, wild inflation, and affordability.
All the dumb as dogshit we did before, we will continue to do and actually attempt to build on that foundation of quicksand with a few pay to play features that make folks in reasonable places take to the streets for being discussed as benefits.
I also think people forget that we've made a devil's bargain and have little else to trade to get further concessions, the only path is to mack them and if that is the intent then why bolster them?
People are all like "we're going to regulate them into a public utility and this legislation allows us to do so" and ignore that there are no teeth, no resources for enforcement, and no restructure of the "regulatory" system and willfully leaves the predators with an anti-trust exemption while keeping as many people as possible OUT of the exchanges (aka the only real point of leverage), minimizing the ability of competition to impact systemic costs as well.
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