If ACA mandates are upheld, we won't get Medicare-for-All and better health care for a generation.

[jeff47]

128. Math. It's your friend.

See...insurance companies make money two ways. One is by having people pay. The other is by not paying for their health care.

The ACA indeed creates a mandate. But it also puts in a whole lot of regulation on the paying for health care part. See, back in the day, insurance companies would charge a ton of money, spend 60% of it on health care. that's called the medical loss ratio. Of the remaining 40%, half was overhead and half was sweet, sweet profit. Those evil, vile, disgusting exchanges created by the ACA require a medical loss ratio of 85%. So now they have to take their overhead and profit from the remaining 15%, instead of 40%. 15% < 40%. They either have to massively cut overhead somehow, or they have lower profits. Meaning they have less lobbying cash because of the ACA, which means less influence.

Now, what you propose is to return to the system that allowed a 60% medical loss ratio, and then magically that will mean insurance companies have less money and thus influence despite having much, much, much, much more profit.

Not only that, but you want to return to a system that allowed insurance companies to dump expensive patients, and thus make even more money.

You make money with insurance not by covering everyone. You make money by covering the people who won't need you to pay. The ACA makes them cover everyone. The old system let them only cover people who are unlikely to need expensive care.

What will they buy with those dollars to function longer?

That is an extremely dumb question.

You want Congress to create a single-payer system. Insurance companies don't. Insurance companies give a lot of donations to Congresspeople and help them via SuperPACs. You complain on a message board. Which do you think will yield results? Your complaints, or their ability to get people elected to Congress who will block any attempt to pass single-payer. You know, what they already fucking do. And the reason the ACA has no public option or single-payer.

I know you have a hatred of mandated private insurance. But your hatred can't change math.