Now that Bernie Sanders has brought forward his progressive agenda, including real health care reform through a single-payer universal Medicare for all program, the knives are out from the Republicans as well as Hillary Clinton to distort and discredit this option with false information and voodoo numbers.
Rationing, the hated R-word, evokes widespread resentment and debate whenever mentioned in connection with health care in the U. S. There are many who hold that we don't ration care now, never want to, and that the free market will work its magic and be fair to all without rationing if we just keep the government out of health care.
There is a pervasive myth generated by conservatives that the private sector is more efficient and less bureaucratic than government. This is perpetuated by those seeking to continue the "free market" in U. S. health care, which simultaneously exploits public programs through privatization of Medicare and Medicaid.
While it is tempting to look at just one metric--the decline in numbers of the uninsured, this is a trap if used to deceive ourselves as to the success of the ACA. As the above examples indicate, we still have a long way to go before we can say that we have reformed U. S. health care in the public interest.
You might think that we learned the lesson of discredited managed care in the 1990s. The term "managed care" is confusing to many, but really amounts to managed reimbursement rather than managed care, whereby a set prospective annual payment is made by federal/state governments, as in the case of Medicaid managed care (MMC), to cover whatever services patients will receive over the coming year.