Republicans had almost eight years to propose an alternative and failed to even try to do so
There is no viable alternative in this legal and cultural system.
americans are reluctant to pay for 'others' if they feel others dont 'deserve' it,,,
There's more to it than that.
More such as in order to pass some kind of single payer/NIH system, like in the UK, it would require all people to pay into it. ALL. That includes poor people.
No more earned income "credits." No more tax refunds.
Otherwise (or in addition to) it would require huge cuts to other things. Like social security, military spending, education, veterans, agriculture.
Medicare right now has some 45 million beneficiaries, and there are approximately 70 million medicaid beneficiaries.
More than 25% of the entire budget is spent on medicare/medicaid, more is spent on healthcare than anything else, even the military if you compare it honestly rather than cherry pick.
Budgets that deficit spend, budgets that require the U.S. to go into $20 trillion worth of debt.
Do you know many democrats that would propose a bill from either approach?
Increase taxes significantly/reduce income exemptions, or cut the budget of the military, social security, other entitlements, education? All of which already spend significantly less than medicare/medicaid?
For the first few years Obama kept falsely bragging about how he didn't raise any taxes.
Obama pushing the ACA kept touting how it would be budget neutral, how it would "only" cost something like 750 billion dollars, how the fines would offset the costs, how the competition in the marketplace would drive costs down.
Without those lies, without the false numbers he used that proved to be complete BS, he would never have passed the ACA.
Politicians don't want to be seen as raising taxes.
Politicians don't want to be seen as cutting benefits.
One or both would have to happen in extremely significant ways for any kind of effective universal healthcare system to be enacted.
Not to mention it's not "just" Americans reluctance to pay for another persons benefit.
You also have basic capitalistic psychology driving citizens.
Things like "super size for only $1 more!"
How is everything run? "Half off sale! BOGO! Use your savers club card! We honor competitor coupons. Free medium coffee with every $10 gas purchase. Rollback prices. Going out of business sale! White sale this weekend."
Why do you think it's called "Black Friday?" And do you automatically associate "deals" with Black Friday?
People want their moneys worth and then some. They want to get more than they're paying for.
They want the perceived value they are receiving to outweigh the perceived value of what they're paying.
Force them to pay for something, they will want to get their moneys worth. Basic moral hazard of insurance.
Healthcare, and especially insurance, only work if you consume less than you pay for, the aggregate consuming less than it pays for.
You make them pay $1, they want $1.25 in value.
That = overuse. That will always drive up costs.
There's also the fundamental idea that one is not entitled to the efforts of another. Private property rights.
Healthcare is doctors. Healthcare is a product of another's efforts.
Professional healthcare is not seen as a right, it is ultimately a luxury. It's not a natural resource.
Other than that you can say this:
reluctant to pay for 'others' if they feel others dont 'deserve' it,,,
is a basic tenet of "democracy."
"I want control and a say over who gets and does what."
You can either have democracy, or you can have universal healthcare.
The two are not compatible. One or the other will fail over time if you try to have both.
Keep private insurance and reform Medicaid, Medicare and (especially) VA benefits
None of those systems work.
Social Security is barely keeping afloat because it receives more in taxes than it pays out, its future unfunded liabilities as the population ages are a huge problem.
Medicare and medicaid pay out more in benefits than they take in through taxes.
Part of social security money is being used to subsidize medicare and medicaid, not to mention debt.
Rob peter to pay paul and kick the can down the road, don't worry about unfunded liabilities now, just cut benefits later.
"Later" is now for the VA, and it's giving all sorts of horrible service, but commensurate with its budget.
In this country, hospitals don't turn people away (regardless of income or status). It's called the Hippocratic Oath
It has nothing to do with the Hippocratic Oath.
Hospitals used to turn away people without insurance all the time.
They were run like any other business.
"We have the right to refuse service to anyone. If you can't pay, don't come here, go to that government subsidized place with the bad doctors."
Then in the 80's the government intervened and passed a law requiring all hospitals to treat patients no matter what their insurance status.
At the very least "stabilize" them before allowing a transfer.
I think it was part of a social commentary plot line in the 70's movie Mother, Jugs, and Speed.
Other than that, doctors turn away patients all the time. Many to most will only accept a certain number of medicaid/medicare patients, and only certain insurance carriers.
Why, did the liberals threaten people with jail?
The law had to be written a certain way, in order to garner votes, where the full power of the IRS could not be used against people for not paying their tax fine for not carrying health insurance.
The IRS was limited to keeping any tax refund money if you didn't pay the tax fine for not carrying insurance.
No politician wants their opposition to run ads like "Senator Davies supports your grandma being thrown in jail after making the choice of either eating dogfood or paying for health insurance. Vote for Jim D'Bag."
illegals here get into the system? Whose paying for them? ... They don't. It's a propaganda myth that they do.
Not really a myth.
Illegals have anchor babies.
Anchor babies are eligible for benefits, which also benefit family.
Housing, WIC, medicaid, food stamps.
Illegals can go to school, subsidized by government.
Illegals can walk into any emergency room and get treated.
Not to mention identity theft, forged documents, overstaying expired green cards past the mandatory minimum 5 years, allow for them to "get into the system."
It's not "a propaganda myth that they do," at best it's just the cost/severity/problem is overstated, made to look worse than it is because the principle is "bad."