Well, when I said “fix the ACA” I meant also “include cost control mechanisms” which really only work if the patient has some skin in the game. Basically, you want a system where the patient gets paid by choosing less expensive service channels, or avoiding unnecessary service altogether.

The Dutch have this sort of system in place, while Singapore uses a universal care system that looks very much like HSA’s.

And, sorry, every other developed nation is dancing on thin ice because they are struggling to pay for their medical benefits. We here in the US are largely insulated from their political struggles, but the bottom line is that cost controls don’t solve any problems, because you are forcing not just the doctor, nurse, and hospital to freeze costs, but everyone all the way down the supply chain has to freeze costs as well.

And, like any other business, 70% of your health care costs are due to the underlying wages and benefits of the individuals working in health care. I don;;t know who you gig for, but would you gig for them if they told you they were freezing your wages indefinitely, and a 2–8% decrease in wage each year was on the table?

Solutions out there are possible, but with one party saying “change nothing”, and the other wanting to force everyone into a single universal care paradigm, neither party is really being thoughtful right now,