The simplest reason for that is that with the structure of our congress and the party discipline that both major parties maintain means that you're not voting for a person. You're voting for which party you prefer. They vote in enough lockstep that they can say whatever stupid or brilliant things they want. They can be angels or devils. As long as the parties vote together on bills, the individual doesn't matter. Most people would rather have a moron or serial killer who will reliably vote with the party that shares their preferences than a pure-of-heart genius who will reliably vote with a party that doesn't share thier policy preferences.

The problem is that the program has increased by a third in membership the span of six years (almost 48 million in 2009 to 65 million last year) while the economic base that pays for Medicaid still grows slower than the rate of growth in the program (and of health care cost as a whole).

That 1/3 increase in enrollment is not a problem so much as it's how the law was designed. More support for lower income people by expanding Medicaid and Medicaid receipts to support them. That initial growth is accounted for in the law's budgeting. As for the rate of growth, I'm wondering what data you have on that. In aggregate, the growth rate in per-capita healcare spending has declined over the past few years, averaging about 1.3% in real terms per year. Not great, but also not something that looks to be outstripping our ability to pay for it. That includes Medicare spending, so it's possible that the Medicaid data is drastically different and being averaged out, but I don't have a clean dataset in easy reach. Based on private market trends, I'd be surprised if Medicaid turned out to be growing at a uniquely high per-capita rate.

Only if you count Medicaid as part of that.

This one gets me every time. Of course you count Medicaid as part of that! A huge part of the law was getting more lower income people healthcare by providing it through Medicaid.

If they had implemented a 100% coverage single payer system, I bet there would be people who say that it didn't expand access to healthcare "unless you count that government plan." It's one thing if we accidentally made everybody too poor to afford anything but public assistance, but the Medicaid expansion was completely intentional. It was the answer to the question, "How you going to get health insurance to lower income people?"

While I don't have a lot of experience with the program, it does appear to be going downhill to me, especially with below market rates for most medical care.

I don't really know how to respond to feelings of vague unease with the quality of the program. Are you really asserting, as you imply below, that Medicaid is no better than just showing up at an emergency room? I don't think there's a lot of data to support that. The mainstream consensus is quite the opposite.

What amazes me is that the program is working more or less as designed, costs are running lower than expected, the economy has failed to collapse as predicted, and people are still saying everything was perfectly fine when stumbling into an emergency room to be stabilized and sent home was "healthcare." The idea that there have been no objectively measurable improvements to the situation baffles me.

I'll bite.

It is unconstitutional in several ways...

I'll leave that one to the Supreme Court. So far, it hasn't really taken much of a thrashing.

...and these choices were made so to pass costs on to individuals, businesses, and the states

I'm not sure I understand this. Is there some entity that could bear costs that doesn't fall under one of the categories you listed above? I mean, ultimately individuals and businesses bear all of the costs of everything that costs anything.

It made Medicare even more unhealthy by dumping more people on it.

I think you mean Medicaid. And I'm not sure why you'd say that expanding Medicaid makes it unhealthier. The program is simply becoming larger and covering more people.

And there's still no move towards long term affordable health care or universal coverage, the two alleged goals of Obamacare.

There's a very good argument to be made that offering standardized, easily evaluated insurance products on an open exchange is an important step in keeping costs in check. Any system that moved us a step away from our unholy employer-based system would do that. Enabling consumers to choose from more than one option in something that resembles a market is a major step in the right direction, even if we didn't also kill off the employer-based option in the process.

As for it not moving toward universal coverage, I don't know how a multiple percentage point drop in the uninsurance rate isn't a move "towards" universal coverage. If the criticism is that the end result will not be universal coverage, that's true. But at a glance, it looks like results in that direction a pretty positive.

Even stranger, let's say we the Iranians totally capitulate and give us unconditional surrender. What do we get? Their word that they'll behave and regular inspections of the weapons program. But if we make a deal before they capitulate completely, we'll get their word that they behave and regular inspections of the weapons program. So if we beat the shit out of them, inspections will work and we don't have to trust them. If we negotiate, inspections don't work and it's all just Obama trusting them like an idiot.

I'm not a nuclear weapons expert, but it seems to me that this all simply hinges on the definition of "inspections" and whether inspections are enough to keep tabs on the weapons program. My instinct says that any country as large as Iran can probably build a bomb somewhere without inspectors knowing it, but I'll assume for the sake of argument that inspections are good enough to put a stop to it. If that's the case, does anybody have a good argument that the inspections we'd get under this deal are somehow inadequate and the inspections we'd get under their hypothetical "Ronald Reagan dumps his 3 foot long dick on the table and the Iranians quake in fear and agree to everything" deal would do the trick?

The mere presence of Iran at the bargaining table suggests that sanctions were working. Ratchet up the sanctions.

To achieve what, exactly? Play out the scenario for us.

Right. Israel would surely just figure that the Palestinians built the nuke themselves fair and square and leave it at that.

Agreed. Even if they had passed no law at all, "You can keep your doctor," is total bullshit. Our insurance system was and is in a constant state of churn. My wife had to change doctors three times in five years even before the ACA. Even if the ACA had been perfect and had zero impact on the status quo, people would have lost their doctors. That promise was obvious bullshit at the time.

All we had to do, was simply not lift the sanctions.

Wait, what? You mean that there was no way they'd finish their weapon under sanctions? It had ground to a total halt?

This statement gets thrown around a lot when discussing college, but I just don't see how it holds up. It is very rare for an undergraduate to do any significant research, so most of the learning comes from assignments and probably a little group work.

I'd argue that a big part of it is being given assignments that stretch you more than you've been stretched. You don't have to do original research to be geniuinely challenged and grow from the experience. You just have to be given an assignment that requires you to dig for answers and fail. You have to exhaust most of your options when trying to figure something out. It's something we should probably be doing much more to kids well before they get to college, but college seems to be where we start doing it, so that's where the value is.

Since this is slashdot, there will be a million posts by clever college students who are doing really well in their classes and see them all as a waste of time. "Nothing at a university can challenge me! I'm the hottest shit that ever was shat!" All I can say is that they either didn't choose programs that were challenging enough for their level of talent or they're unusually talented people--the most brilliant of the most brilliant--and the world was not really designed for them. Or they're badly overestimating their level of talent, but that almost never happens.

What I want to know is why anybody would expect online education to replace traditional education any more than the printing press and wide availability of books made traditional education obsolete. Widely available course materials are great and we're a richer world now that we have them, but the fact that universities survived the democratization of books should tell us that real schools still add some value above and beyond the raw information.

You're going to have to come with an explanation for why this historical percentage holds true in the US but not in any other country. My theory is that it's what we generally prefer and when we adjust our tax policies, we do so within that narrow range. There's no magic economic force that reduces the government's take below 20% no matter what we do. We just choose not to raise taxes that high (and when I say, "We choose not to," I really mean, "We elect officials with enough variety in their preferences that they don't all agree to raise taxes that high"). A couple of other points:

1) The difference between 16.9% and 19.2% of GDP is massive. At our current level of GDP, it's well over $300B. The idea that changing tax rates so that the receipts bounce around in that range has no real effect is just silly.
2) I'm happy to give the Republican congress the credit for the things they were involved in, but let's not rewrite history. The deficit trajectory reversed direction before 1995. The 1993 budget was passed with no Republican support and over screams that it would destroy the economy. To my knowledge, there was nothing particularly special about the 1995 budget in terms of deficit reduction.

Once you've rammed through those gates, it's not unreasonable to weigh the possibility that you're doing something like this. If you don't want your intentions to be misunderstood, not ramming the gates is a good place to start.

If you're guarding an NSA facility, your job is to risk your life for the people and secrets inside that facility, not people trying to force their way in. If you try to strong arm your way into an NSA facility, you're probably up to no good. At best you're an unstable person trying to make a political statement and you don't mind putting others in danger to do so. At worst, you're carrying an assault team or a car bomb and things will get infinitely worse if your vehicle is allowed to hit one of those buildings.

The "Let's just see how this plays out" response is the response you get before you try to breach the outer perimter. That's your not-getting-shot-at freebee. Once you've used up that freebee, you don't get the benefit of the doubt anymore. It's kind of like breaking into somebody's house at night while their family is sleeping. You get the benefit of the doubt if you stay outside the front door. Once you climb in the window, you've burned through all of your goodwill and nobody really owes you any deference.

Overly broad non-competes are almost universally unenforceable. The lawyers writing this non-sense know this.

So why, in a world with a professional class of licensed legal experts who write contracts, are lawyers allowed to put obviously illegal and unenforceable stuff into contracts and pay no personal or professional penalty for it? A pilot who regularly disobeyed FAA regulations or a doctor who consistently gave bad medical advice would be penalized, but attornies can write contracts that don't mean anything and the only thing that happens is a judge draws a line through their nonsense and gives them credit for whatever they got right. WTF? With a system like that, *I* could write contracts and take fees from clients.

You really think Amazon wants to take the PR hit by suing a contractor who worked in their warehouse for 10 dollars an hour?

Yeah, I've heard that stuff a lot from employers trying to get ridiculous bullshit into contracts with me. "It says we can burn your home to the ground and sow your fields with salt for no reason, but we'd never actually do it. What? Remove the clause? Well... no."