In 2009 when the Affordable Care Act was being crafted together a calculation was made not to challenge the entrenched power of the big stakeholders in the American Health Care system no doubt to avoid provoking their opposition to the reforms in health care that would have probably prevented its passage. This Faustian bargain prevented any constraints being imposed on the revenue streams going to those powerful stakeholders like hospitals and Big Pharma. So Democrats in the Congress Like Senator Max Baucus essentially let the stakeholders lobbyists like Liz Fowler wrote protections for the inflated revenue streams for the powerful stakehilders into the A.C.A. Cost containment went by the wayside. Now we've got a reformed health care system that expands access to segments of the population that were being left out, but we still have a for profit healthcare system with its attendant very high costs.
No one I know framed these problems with how the A.C.A. was crafted together largely by lobbyists to protect entrenched interests revenue streams better than Bill Moyers did back in the Fall of 2009.
So now we're saddled with this expensive for profit Rube Goldberg machine of a health care system instead of the single payer system many of us on the Left were clamoring for.
The power of the entrenched interests has only grown since the Moyer piece described it in 2009. We now have a congress with Republican majorities in both houses looking for ways to dismember the A.C.A. as much as they can, threatening the reforms that are so desperately needed by millions of Americans. Its a predicament that's likely to get a lot worse the more Republicans meddle with the A.C.A.