Republican politicians are the least fiscally responsible people on the planet. They don't care about debt and deficits. They care about tax cuts for rich people, and raiding the Treasury to enrich their friends.
Weirdly, though, Brill sniffs at one thing that we know works to keep prices down: single-payer systems that can say no. There's a reason single-payer systems are pretty much universally much cheaper than systems — even the Swiss system — that run things through private insurers. And it's not just the administrative costs.Note that Medicaid, in particular, which is able to say no in ways Medicare can't, is substantially cheaper than both Medicare and, even more so, private insurance.So why does Obamacare run through the private sector? Raw political necessity: this was the only way that it could get past the insurance industry's power. OK, that was how it had to be.But you should really be outraged at the efforts of some states to ensure that the Medicaid expansion is done not via direct government insurance but run through the insurance industry. What you need to understand is that this is a double giveaway, both to the insurers and to the health care industry, because private insurers don't have the government's bargaining power. It is, bluntly, purely a matter of corporate welfare for the medical-industrial complex.