Make no mistake, I have no faith in the common sense of the American public as a group.  I do however have faith in their self-interested nature.  I don't mean that to disparage people at large.  Quite the contrary.  I think the predictable self-interested behavior of people is generally a good thing.  

It takes some huge and obvious problem for that nature to kick in and actually motivate citizens to impact policy and/or elections but this issue is just such a thing.  

What's going to cause people to recoil from this, or at least away from single-payer alternatives, are the things that mostly haven't kicked in yet.  Insurance companies are canceling plans by the hundreds of thousands.  The premiums that were supposed to go down, or at worst stay the same, for those who already had insurance are actually going up.  In some cases dramatically.  Those who have to sign up or who want to sign up, generally can't still.  

These are the big obvious things that will actually draw people's ire.  Whatever your position on this Presidency, most of its issues so far (the various scandals, the foreign policy blunders) have been arcane issues that don't hit citizens' personal self interest.  Not so with this.  

If they can get it fixed in a hurry and the early indications about the structural issues with the demographics of the population who are actually signing up turn out to be wrong, they'll be able to fix this and in the long run it probably won't be that big of a deal politically.  But those are two GIANT ifs.  Most indications are that it won't be fixed quickly (meaning they'll have to take some action to avoid penalizing people early next year for not using a system that doesn't work) and, the bigger problem that isn't getting much attention yet, is that the demographic issues of those signing up put this thing on a path to collapsing.  They are massively behind where they need to be on signups and what information there is so far says that the majority of people who are signing up are either Medicare recipients (who are essentially being directed right back onto Medicare) or are those who can't get a policy anywhere else because of medical history or pre-existing conditions.  

In other words, the expensive side of the population is signing up in droves.  The profitable side of the system is NOT signing up at all which, if not corrected, will cause this thing to fall apart under a wave of skyrocketing premiums that, and this is key, will be passed on to everyone with an insurance policy, not just those who get their insurance through the exchanges.  The entirety of the individual mandate was to give insurance companies a way to avoid losing money in the face of all the new coverage requirements (particular treatments, no denying pre-existing conditions, etc).  If the individual mandate is ignored by those whom it applies to, ACA explodes.  

These are the things that make the switch to single payer a bridge too far.  This is doubly true when you compare the results that people will feel with the very well known and well publicized statements about the impact of Obamacare on the healthcare market.  

• If you like your insurance, you can keep it.
• If you like your doctor, you can keep him.
• We will lower premiums for the average family by $2,500 a year.

This is going pretty far afield of the original topic, but school vouchers DON'T benefit those who could afford to send their kids to private school already.  There are economic caps on who is eligible (just like any other form of welfare).  Voucher programs are entirely directed at the poorest echelon of society so that they can choose to get their kid out of schools in poor neighborhoods, which are generally terrible schools, and send them somewhere where they will receive a more competitive education.  A good example of the positive impact this has can be seen in the Louisiana voucher program that the President's administration is suing to put an end to for a bunch of nonsense reasons (really because successful voucher programs are a threat to the government monopoly on education, which means its a threat to teachers' unions, which are a core constituency of the party). 

Except that this isn't making healthcare more affordable.  It's going to make it more expensive.  As time goes on, it will compound until the system collapses.  That's the whole point I was making about the demographics of the people signing up so far.  If the young and healthy don't sign up and opt to pay the fine instead then the system becomes financially not-viable.  Even with those people most plans, including those not on exchanges, were going to get more expensive as insurance companies sought to subsidize the cost of the new high risk plans they are forced by law to offer.  Without those people insurance companies will HAVE to raise rates on everyone in order to pay for the mandated coverage of those who have pre-existing conditions or health problems in their history. 

It's also worth noting that your second paragraph sets up a classical ACA-supporter (or generally progressive) false choice.  You're saying that failure to support the ACA is akin to wanting healthcare to be more expensive, less available and generally wanting people to be sick and die (if you extrapolate your argument to its logical conclusion).  Of course, this is bullshit.  You can be against the ACA, think it is bad for the healthcare industry, bad for the health of the American people and bad for the economy and STILL support alternatives that will guarantee coverage of pre-existing conditions and will expand coverage and bring down rates.  The ACA isn't the only possible idea out there and to imply otherwise is typical progressive response to make it look like those who disagree are greedy, evil mustache twirling assholes who just want people to die in exchange for profits. 

It's dishonest crap and it's a big part of the reason we can no longer have real conversation about issues in this country.  Opponents can't possibly honestly disagree on the best way to solve a problem.  No, if they don't agree with my personal favorite solution they are clearly evil baby eaters.  

How do we know the republican billionaires aren't funding denial of service attacks and then walking to the pulpit and saying "lolz see I told ya Obamacare and abortion must be repealed!"

Seems a likely scenario to me.

if cisco employees can sort of ddos their own company via email reply-to-alls .. what do you expect would happen to any gov site? technical difficulties or disaster is par for the course of any IT project. especially public sector ones.

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Well, there is certainly evidence that some of the American public are dumb.

The problem with healthcare costs isn't the insurance companies and what they allow or disallow, it's with the doctors and hospitals.

Without going into detail, I have personally been given unnecessary test and asked to come back repeatedly for what where unecessary visits. I have gone for standard annual visit and have seen addional charges on my bill that had nothing to do with the visit. (they insisted it wasn't a billing error). Multiply these slimy practices 300 million times, and the cost becomes substatial.

It should be up to a patient and a doctor to decide the treatment, but all too often, the doctors and hosptals take advantage of the patients reliance on them. "they must know what they are doing".

If there was some way to actively monitor these dishonest practices, it would go a long way to reducing costs.

Tempting to lay the blame at the feet of one or two culprits, but it ain't that simple.  The healthcare environment of today is the result of a very complex ecosystem evolving over a long period of time, influenced by too many variables, the unintended consequences of which may not have appeared for decades after the variables kicked in, for any one or two actors to be assigned 'blame'.  Oversimplifying it won't help fix it.  The vast majority of physicians and hospitals, I'd venture to say 95% or more, do what they do every day in good faith, attempting their best to do what's right by patients within the confines of the system in which they find themselves working.

Mind you, there are dishonest actors among physicians and hospitals, but to contend that they aren't 'actively monitored' is an indication of lack of knowledge.  Even if there were a way to do so, completely eliminating the truly bad actors, an exceedingly tiny fraction of physicians and hospitals at most, would have measurable but negligible impact on healthcare costs.  Not saying they should be ignored, but the ROI on increased 'active monitoring', beyond the scrutiny already in place, is not great. 

For another 9 days yet I happen to work for the largest Hospital Corp in the US. Let me tell you, it isn't at ALL about what's best for the patient anymore. It is all about making windfall profits and pleasing the stockholders. PLAIN AND SIMPLE.

Top Corporate Management bring down millions per year in salary and bonuses, realize record profits and then over inflate their budget so they can justify cutting hours of the people in the trenches doing the REAL work. The Dr's are forced to meet "quotas" and see "x" number of patients per day. They don't have time to actually listen to the patients or become genuinely concerned about the personal aspects of the individual. 

Every year we take at 15% price increase every quarter. The profits just soar.

I've seen the corporation commit fraud with Medicare and just get a tiny slap on the wrist for it.

But alas.. the liberal media sure as hell isn't going to report that! 

If hospital costs were forced to be transparent and a real market existed this behavior wouldn't fly, because the hospital's prices would not be competitive.  Anyone who thinks that single-payer or greater government involvement in healthcare is going to have any positive affect on healthcare costs doesn't understand just how much Medicare fraud exists and how little it gets punished.  In this case "liberals" are relevant because they are the supporters of Medicare status quo.  Any attempts to reform the program are met with nonsense commercials of Paul Ryan look-a-likes pushing old women in wheelchairs off cliffs.  

What!!!!

Just one of the reasons I'm not a fan of big hospital chains or big multi-state banks.  Too easy for HQ to lose sight of the 'mission' for which the individual hospital was built in the first place.  There is a whole 'nother argument about the benefits and disadvantages of for-profit vs. not-for-profit hospitals.

Having said that, success, when achieved legally and within the rules one is given, is not a 'windfall' no matter the amount of money involved.  When achieved illegally or in disregard of the rules of the game, it's fraud and you would stand to reap a sizable reward for whistleblowing on some of that fraud you've witnessed.