It works pretty well when it's allowed to.

As some of you have seen on the main board, I'm a cord cutter. Started with Sling, then PlayStationVue, and now DirecTV Now. I was an early adopter of DT Now, and it was painful at times. They had a lot of tech issues (and still have some from time to time), but the intro $35 deal (now $60, but I'm grandfathered at $35 indefinitely) for 120 channels or so was too good to pass up, so I stuck with it.

I got an e-mail from them today thanking me. And giving me free HBO for a year.

My guess is it's a way to try to avoid churn from the upcoming YouTube and Hulu services, along with competition from the others that already exist. Competition is a wonderful thing when it's allowed to happen.

But enough about health care.

Medicaid, and welfare.

Competition in and of itself isn't what brings about lower prices on products and services. Those products and services must be available on a (mostly) free market. (For example, "cable" providers.) Healthcare is no longer anything of the sort. Even those advocating for competition are largely missing what a free market solution would entail. Increasing competition among insurance providers would do little to nothing to bring down healthcare costs. It's the entire notion of healthcare insurance that needs to be addressed. It's become something unlike any other insurance.

For example, auto insurance. Do you use it for oil changes? Door dings? Car washes? Waxes? To fill up your gas? No, you pay cash for all of those. The only thing you use it for is something that's unlikely to happen.

For home insurance, do you use it for lawn mowing? Hedge trimming? Replacing the roof (when not caused by a storm, accident, etc.)? No, you pay cash for all of those. The only thing you use it for is something that's unlikely to happen.

People view healthcare insurance differently, though. They view it as how to obtain healthcare. And a lot of people want (1) no part in discussing the economics of one procedure versus another, (2) the best care available, and (3) that such care be available to all. Insurance is just a means to this end.

The end, then, is not about freeing up the market from the many restrictions (that chemo has discussed many times), which would enable competition and bring about lower prices. That is simply not the end.

The end is healthcare for all--regardless of cost. It's all very quaint to throw a term like "affordable" onto a mandate that increases prices for everyone across the board. But it sure doesn't make it so. Nevertheless, the one thing that really stuck from the ACA is that no one can be denied health insurance based on current health. In other words, there can be only one risk pool, and everyone is in it. In other words, it ain't insurance. There is no such thing as insurance without a risk pool.

You smoke? You pay higher life insurance premiums. Have a history of reckless driving? You pay higher auto insurance premiums. Live in a place prone to earthquakes? You pay higher property insurance premiums. That's how insurance works. But not with healthcare insurance. Not anymore.

And whether you, I, or any other individual doesn't like it is largely irrelevant. It's what the people want. People have willed it--just like SS, Medicare, Medicaid, and welfare--into an entitlement. And once something is an entitlement, the people never, ever, ever change their minds about it.

To test this, just suggest that a tiny, tiny fraction of one's SS should be self-directed, and you will not get any reasoned analysis as to why it shouldn't be (I could offer such analysis myself). You will get shouting, insults, ad hominem attacks, straw men arguments, etc. It's a third rail. It's untouchable. It's an entitlement.

Like it or not, now so is healthcare. And entitlements are necessarily expensive--because there is only one risk pool. And the only way for there to be only one risk pool is to mandate it. And the only way for that to happen in a free country is for the people themselves to demand it.

Again, setting aside all other aspects of the ACA, the one thing people are largely behind is that no one be denied insurance. That's the very definition of an entitlement.