I think part of the big problem with this debate is that people without insurance (and thus, those most liable to benefit from the ACA) are getting labelled as 'lazy assholes.' While there are plenty of lazy assholes out there in the world, some of them eke by on their limited amounts of money and others are trust fund douchebags, the fact is not having insurance doesn't make you one. Not all jobs have insurance policies for their employees. Are the waiters of the country just supposed to just go out and brave the unsubsidised health care market?
But to me, "lazy assholes" isn't measured by "having insurance" or "not having insurance". Prior to ACA, whether someone was insured or not fell into (basically) two buckets: 1) didn't have a job (or access to healthcare insurance) and couldn't afford it on their own; 2) had a job (or access to healthcare insurance) and through conscious choice opted not to participate. Neither of those are "lazy assholes" by definition. A good portion of number 1 SHOULD be subsidized, and all of number 2 SHOULD be able to opt out (with the caveat that they accept the consequences of that opting out). I didn't coin the term, and wouldn't use it outside of this specific conversation, but my underlying premise is that people participate at the level they can in order to sow the benefits that they need. If the "can" is zero, then so be it. I'm fine with that. But I was on another board, and there was a guy who was taking unemployment, and would presumably be able to avail himself of the subsidized healthcare. He had a job opportunity and decided that, and I am not making this up or exaggerating, because he would have to shave his beard, he was going to stay on the dole. C'mon man. Now, whether this is one person or a 1,000,000, I don't know, but it's an example of where I am headed with this.
And remember, this is only one aspect of the problem. The big problem for me is in the reduction of costs; not as measured by what the insured pays, but by what the actual services costs. That Obama cut a deal before the ACA was ever passed that essentially guaranteed profit levels for the pharmaceuticals told me all I needed to know about the sincerity of government to work on driving out costs.
I think the only way to cover all 3 of Stadler's requirements for health care reform are to just... well, jettison the free market solution completely or at least regulate it to such a degree that it's not really free anymore. I have no problem with that solution at all considering how shitty the free market has handled health care in this country, but I know others might not be so quick to agree.
Except, no. Part of the free market's inability to actually be successful here is based on the highly regulated nature of the healthcare industry even before the ACA came into play. Just the simple fact that it was regulated on a State basis rather than a Federal one was a HUGE barrier to allowing the free market to work effectively. The aforementioned disconnect between the regulations and the intent (i.e. the intent was to promote wellness but the regulatory framework promoted waiting, a reactionary response). If there was a specific issue that needed addressing (dropping coverages, for example) then address that, I have no beef, but no system - capitalism, communism, socialism - is going to work when it is implemented half-assed.