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> So why didn't they all vote for Obamacare and for the public option, subsidized by higher taxes?

Did it come up for a national popular vote where you got five options and you picked the one you liked best? I don't remember it happening this way.

And let's just say that it did. If everyone didn't vote for that option, well, that's not what gets enacted and you're SOL. Government isn't pick-and-choose, it's all-or-nothing.

Well, in this particular case, there was no popular vote for any part of Obamacare. But there were a very large number of congressmen elected before the bill passed, during its negotiation and even now well after it's been cemented as law by the Supreme Court who had a major policy platform of reforming or completely rolling back the ACA.

Which is precisely the point. You don't get to TELL your elected officials how to vote. You just get to try and elect people who will HOPEFULLY do what's in your best interests. There are no guarantees in the system, anywhere.

That makes the question you asked rather disingenuous.

> You just get to try and elect people who will HOPEFULLY do what's in your best interests.

You get to do a bit more than that, though few ever do.

Making full use of representative democracy means continuously contacting your representative, not leaving them alone until you're convinced they'll act in your interests, and not leaving your friends/family/community alone until you've got as many other people as you can badgering your representative just as much. It's very time consuming and won't work at all if there aren't enough people with the same problem but, in the case of the author of this article, the relevant problem is quite widespread.

Which is why the 40 hour work week and dog-eat-dog economy seem to really suit those representatives just fine. No one has time or energy to make full use of representative democracy, unfortunately, except for some of the well off with resources to spare.

You're working a lot more than 40 hours per week if you don't have an hour a day to spend on advocacy.

The problem being that if you're in a job with standard hours, the hour a day you have to spend on advocacy happens during the time your representatives and their staffers are not available.

I have trouble imagining a realistic job (in the USA, anyway) that wouldn't allow you to take 20 minutes for a phone call during business hours or get a free afternoon every month or two.

And at least half of your advocacy will consist of writing and research and recruiting other citizens to your cause - all of which can be done just as easily outside of normal business hours.

Uh, I used to be a cashier at McDonald's (reasonable job? you decide), I can tell you that they would never have let me wander off to use the phone for 20 minutes randomly, other than at my lunch break, which I needed to use to, y'know, eat lunch.

Sure, you get to call an intern in their office who will put a tally mark in a spreadsheet. The congressman may use this "how many people called about X" data to make decisions on what to vote for, or they may not.

Yes. But you can do this weekly. And spend tons of time getting others to do this weekly. Dozens of calls about X have more than dozens as many timed as much impact as ome call about X.

If you get a bunch of people with the same concern to form an ”organization“, and then you spend weeks making repeated requests for your congressman to meet with your group, they'll eventually do it. You can write a op-eds and publish content on the internet to try to generate political will. You need to convince your rep that (to go with the example from the article) thousands of their constituants think that the ACA is a terrible idea and that they would enthusiastically support this other policy in its place. If there is a sensible policy that a large fraction of the country would support that hasn't been proposed in a bill yet then they might consider trying to look good by being the one to propose it.

I'm not saying it's easy or that it's guaranteed to work. I'm just saying that most people's civic engagement is about 0.001% of what it should be if they really want a voice in the government.

Picking a candidate for President (a position which isn't even in the legislature) is not the most effective way for you to drive policy.

"The problem with the way you advocate is that you don't act like professional lobbyists"

I wonder why it is, that normal citizens with jobs and kids and mortgages, aren't able to effectively lobby the way full time paid lobbyists (with expense accounts!) are?

> why didn't they all vote for Obamacare and for the public option

In substantial quantities, they did. That's what Obama in the general election (and with slight variations, he, Clinton and Edwards in the Democratic primaries) campaigned on.

But they didn't get it, because by the time the health care bill got through Congress it had no public option, because while it was in the version passed by the House, it was killed in the Senate. Killed, that is, by a minority in the Senate -- it was the threat of filibuster, not losing an up-or-down vote, that did it in.

And who elected those filibuster-threatening senators? Were the senators acting of their own accord, or on behalf of their constituents' desires?

The Senate is ridiculously undemocratic. Because every state gets two senators regardless of population, a vote by a Wyoming resident is worth 65 Californian votes.

Wyoming is one of the state's hit hardest by the unnecessariat phenomenon. Thats the tragedy.

The House is supposed to make up for this. A vote by a California resident is worth 3.6 Wyoming resident votes.

No. Where did you get that number from?

California has 53 representatives for 38.8 million people or 1 per 730,000 people. Wyoming has 1 representative for 584,000 people. So Wyoming is over-represented in the House as well.

Does it really matter? Senators representing around 10% of the population are enough for a filibuster.

Exactly: its unsurprising that people give up on solving problems through "representative democracy" when the system of government they have, whatever it claims to be on the tin, is poorly representative and functionally very far from democratic.

I think it's worth noting that it is very hard to understand or see the world of the disempowered. Having actual empathy for their situation becomes increasingly harder the further away from the situation you are.

If you start from that vantage point, you can try and operate from a opinion of "help me now today" which almost always comes back to "tax me less now."

In the same way that most uber drivers don't understand that buying a new car to drive uber is simply trading away future profit for cash today, many of the disempowered do not have the tools to think about money, voting, or political movements in terms of a long term future.

So why didn't they all vote for Obamacare and for the public option, subsidized by higher taxes?

Because there was nobody to vote for who offered that. McCain's proposal was to deny that the problem existed. Obama's proposal was Obamacare without an individual mandate. Clinton's proposal was Obamacare with an individual mandate. Those were the only entrees on the proverbial menu. No candidate ran on a public option, so you couldn't vote for that even if you desperately wanted to.

Ironically, one of the first moves of the candidate who got the most votes, Obama, was to decide that Hillary Clinton had been right after all and include an individual mandate. So if you voted for him over her because you opposed that idea, you were officially SOL.

> Obama's proposal was Obamacare without an individual mandate. Clinton's proposal was Obamacare with an individual mandate. Those were the only entrees on the proverbial menu. No candidate ran on a public option

Actually, all of Obama, Clinton, and Edwards ran on a public option. They differed on other points (as you note, during the primary Obama opposed and Clinton supported an individual mandate, and there were various other differences between the three plans, but largely Clinton and Obama cribbed their plans from the same place Edwards did first, so they all looked pretty similar.)

They sometimes mentioned a public option, but it was never central to either Obama's or Hillary's pitch.

See here for an evaluation of Obama on the issue: http://www.politifact.com/truth-o-meter/statements/2009/dec/... It was included in his platform, but as an "also, too" kind of thing. And if you took your evaluation of his position from what he said on the stump, you'd never have known it was in his platform at all.

(I'm omitting Edwards from this discussion because he flamed out so early.)

My recollection is that it was included, but then traded to the relevant industries for their acceptance of the plan we have now. Whether it was always intended as a chip or was a serious part of the plan is open for debate I suppose, but the best chips are ones that are serious, so I'm not sure there's much difference in practice.

Kind of, in that opponents of any bill were joined by some Senators that were closely tied to the insurance industry to threaten to filibuster the bill (which passed the House with a public option) if a public option was included, looking several attempts (both passing the form the House did and putting forward different public mechanisms) to include a public option in the Senate version, and dropping the public option was the only way to secure Senate passage.

The public option was specifically killed off by insurance industry lobbying by Karen Ignagni, as were reductions in Medicare drug prices by the equivalent guy for the pharmaceutical industry. As I understand it, Obama wanted a public option, but had enough difficulty getting Obamacare passed at all, and those sacrifices (along with requiring the individual mandate) were the price of preventing hundreds of millions of dollars of anti-Obamacare attack ads from those two industry lobbies.

I'm not sure how much more to the story there is than that, but for reference, see: http://www.pbs.org/wgbh/frontline/film/obamasdeal/

There was one primary candidate who offered better than that: [Dennis Kucinich campaigned on a single payer platorm][0]. However, for various reasons, he never topped fourth place in primary polling.

[0]: https://en.wikipedia.org/wiki/Dennis_Kucinich_presidential_c...

I don't think you're really putting yourself in their shoes.

For most people, things are were better for them before required, high-cost health plans. Most people don't get seriously sick in a given year; that's why health insurance works at all.

And for those with required health insurance, it doesn't really help.

Take me as an example: I'm 29 in NY and the healthcare plans I have available to me basically fall into a spectrum ranging from $170ish/mo with a $6000ish deductible to $600ish/mo with no deductible. At the low end of that range, health insurance does nothing to prevent a person making $15K/year from going bankrupt; $6K in medical costs is more than enough to bankrupt such a person and you don't get extra credit for going bankrupt by $6K instead of $50K. And at the other end of the spectrum, $600/mo is enough to drive many people bankrupt in itself. The plans in the middle don't strike a good balance; they just cost enough that a poor person can't build up savings so they'll go bankrupt if something does happen to them.

I'm lucky enough to have a job that pays much more than $15K, and I can actually afford my health insurance with relative ease. But for most, it's better to just take the risk and not pay for health insurance, because it's not going to prevent you from going bankrupt anyway. Except, now you can't.

And yeah, they can vote for Obamacare, but keep in mind that when you're living paycheck-to-paycheck, it's very hard to look at anything other than proximate causes of your problems. You see the tax coming out of your paycheck, you don't see the pointless military equipment it's spent on or the "privatize profits, socialize losses" companies that your taxes could regulate. And all the help the government promises you comes to nothing most of the time. You don't read the newspaper and spend mental energy on that because you're watching junk television to recover from your day, or just plain going directly to bed. You also don't have a ton of education (which doesn't mean you aren't intelligent). So you vote for the guy who promises to take less of your money in taxes and do less that you don't see.

All of this isn't finding ways to rationalize acting against their own self-interest (although that does happen too). It's a rational understanding of what's in your self-interest given the information you have, the time you have to research, and the experience you're allowed.

And when using democracy to improve your life doesn't work for decades, can you blame them for giving up on using democracy to improve their lives?

At 15000, you are making < 138% of the poverty line (https://aspe.hhs.gov/computations-2015-annual-update-hhs-pov...), and are eligible for medicaid, or large subsidies in other states. The details really matter here, and my sense (though I'm very open to correction) is that the people who the ACA is most burdensome for are high enough income that they qualify for smaller subsidies, but still can't afford healthcare.

Right, and if that person lives in a state that did not participate in the Medicaid expansion, they are exempt from the uninsured penalty.

That's true, but a lot of people (I'd bet it's most in very poor areas) don't know that, and the IRS doesn't send you corrections if you pay tax you didn't need to pay.

>are eligible for medicaid

Depends on your state. Where I live, you can't get medicaid, regardless of income, unless you're elderly or disabled (not sure if low-income parents qualify). Thanks, Republicans.

This is true, but subsidies are only useful if they are discoverable and truly available.

I grew up in a poor neighborhood, and the only reason I'm not poor is my parents were both educated and made sure I was too. But I know a lot of people who were poor and uneducated.

You might be able to take time off between the hours of 9AM and 5PM to apply for programs in person, or have time to fill out a lot of forms, or know what programs are available, or speak/read the language that's on the forms fluently, but a lot of people don't.

When you are motivated for an ideology it's rarely for short term self interest like you imply. If that were true there wouldnt be any rich people voting for Democrats, which isn't the case.

With first hand account of a family member that would benefit from Obamacare but didn't vote for Obama, it was a matter of disagreeing with many other policies. E.g. You wouldn't vote for a politician promoting the elimination of the Jews if he/she promised a thousand dollar bonus for everyone remaining.

> If that were true there wouldnt be any rich people voting for Democrats, which isn't the case.

I don't know about that. You can be completely self-interested, wealthy, and still vote liberal/progressive Democrat if you think the alternative is a Reign of Terror or Red October. Or, to dial it back a bit from that, if you think progressive policies will grow the economy of the nation in the long term (and, by extension, your own wealth) as opposed to looting it.

>You can be completely self-interested, wealthy, and still vote liberal/progressive Democrat if you think the alternative is a Reign of Terror or Red October.

The same logic applies the other direction. A party is promising free health care, but in their view that comes at a cost of a massive government that oversees every aspect of their life. Either that or they think it's fundamentally unsustainable and will lead to massive losses elsewhere.

Basically if you think people vote against their self interest, you don't understand the perspective from which they are voting. To be baffled by it is to fail to recognize your own ignorance.

> Basically if you think people vote against their self interest, you don't understand the perspective from which they are voting. To be baffled by it is to fail to recognize your own ignorance.

Didn't you just write that people can be motivated by ideology instead of self-interest?

Yes, you can be altruistic (essentially the opposite of self-interested) and decide not to support universal health care, or basic income, or whatever, because you believe it will be a net loss for society. This line of reasoning is pretty common in conservative circles, in fact, and I didn't consider it worth mentioning.

I suspect you are working with a definition of "self-interest" that is so broad as to lose most of it's meaning. I take it to mean the opposite of altruism: working to help others at the expense of your own material well-being (or, perhaps, just without seeing any personal gain). My point is that you need not be altruistic to support these policies (though it does seem to help), if you think enacting them will improve or defend your well-being.

So why didn't they all vote for Obamacare and for the public option, subsidized by higher taxes?

Forgive me for my ignorance, but was there actually a general vote about it? Weren't the elected representatives actually voting? If so, one could argue that the agents of the voters made a poor decision, but then one could hardly blame an common citizen for actions of the politician they voted for.

I seem to recall hearing about it being rammed through the Senate during a midnight vote. Barely a matter of having our elected representatives having a swing at it, let alone the American public at large.

99 out of 100 Senators voted on the issue. The abstained vote would not have changed the outcome.

Is that rammed through?

It was not a midnight vote (or at least, not what the term implies), but yes, it was definitely rammed through. I've never seen such an absolutely-will-not-take-no-for-an-answer ramming job ever on anything.

How so? Obama didn't force anyone to vote a particular way, did he?

Force? No.

Strongly twist arms? Absolutely. Google "Louisiana purchase" for one example; there were several.

Now, to some degree, that's just normal politics. But I've never seen it done that hard, for that long, on a bill that passed by such razor-thin margins.

Sure, the Democratic House, Senate and President acted in a somewhat hasty manner to utilize the power that they possessed, but all the complaints about not respecting the process or whatever are dumb.

The press statements made about the Supreme Court confirmation needed right now are a nice illustration of how stupid the process complaints are. Pretty much every person that has made a public statement about what respecting the process means had previously made a public statement taking the opposite of the position that they have taken now.