Both the left and the right have been vocal about the failures of the Affordable Care Act, or “Obamacare” as it is often derisively called.

But both sides miss the successes. We still have a less than perfect system. And while there is no doubt some were negatively impacted, many more were positively impacted. There are far more Americans with health insurance than before the law was implemented. We’ve got protections in place that prevent devastating policy rescission and denial for pre-existing conditions. And people are protected from financial ruin to a much larger degree than they were before.

There is no doubt we need to continue to make progress on our health care system. Costs are still too high. Too many people still cannot afford adequate coverage. Our system is still a patchwork of wide ranging policies that have very different costs and coverage. And far too many Americans are afraid to go to a doctor because they cannot afford the expense. Having citizens interested in controlling costs and thinking through whether they really need to go to the doctor is a good thing. But having to decide between going to the doctor or putting food on the table should never be something faced by citizens of a wealthy advanced civilization.

I’m not sure where I stand on single payer systems.

I know people in the UK and Canada that while they don’t face the kinds of dramatic financial future altering problems that we have in our country, are very frustrated by the wait times to get in to see some doctors or have procedures. Make no mistake. These aren’t life threatening problems. These are problems of convenience. And given a choice between saving more lives and being personally inconvenienced, the only right decision is to save more lives. But is that really a necessary trade off?

I also look at our current insurance situation and shake my head in disbelief. I have a son that recently went on his own policy through his work. So I’ve got a very good comparison between two very different policies. Both of us have Blue Cross Blue Shield PPOs, but we have wildly different costs for the policy, wildly different cost sharing (out of pocket, deductible, co-pays), and even different levels of discounts for the exact same procedures. My son has a very good policy, while my policy is more aimed at preventing financial devastation for serious medical problems. Why is it necessary to have such wildly different policy coverages?

The debates about Obamacare will continue. And if a Republican wins the Presidency in November, I think it is highly likely that the gains we’ve made from Obamacare will be erased. And sadly we will be starting over.

I also think that it is more likely that should Obamacare somehow get repealed, we are going to see a stronger push toward a single payer system down the road. Because once we start reversing the progress made by Obamacare, things will rapidly begin deteriorating again, and I think more people are going to come around the single payer idea.

Time will tell.

http://www.nytimes.com/2016/02/05/opinion/who-hates-obamacare.html