The ACA is badly flawed, and Hillary’s plans to fix it won’t help with the fundamental problems.

If you are unable to afford to pay for health care on your own and your employer doesn’t provide it, the ACA forces you to jump through too many hoops to get it. You have to provide intrusive and difficult to get data to prove that you are poor enough. You have to negotiate the maze of health care providers to find a plan that you can afford and that is not fatally flawed, and the next year you have to do that all over because your insurer probably cancelled or vastly modified the plan you are on.

In a single payer system, it’s easy. You go to the doctor and they take care of you. That’s the way it is in the UK and that’s how it should be here.

Having employers pay for health insurance is a primary driver of age discrimination in the workplace. All else being equal, older workers are more expensive to hire because their health insurance costs more. The Sanders plan takes that off the table and replaces it with a flat tax on employees. The tax is not dependent on age, sex, race, disability, pre-existing conditions, or any other likely cause of discrimination.

Fixing the ACA also doesn’t address the inefficiency of the current system. It has been estimated that 30% of health care spending goes to administrative overhead; insurance companies eat 20% and the rest goes to pay all the people at the providers who handle the insurance paperwork, dunning people for not paying their co-pays, and so forth. Medicare, in contrast, has only about 5% overhead, and the cost to medical offices will also drop because they will only have to deal with one payer, so the total overhead of the system will fall to about 10%. That 20% will pay for health care for a lot of people.

Moving to a single payer system is something we need to get done; the advantages are compelling. Hillary Clinton knows that we can do better but she has given up on actually getting it done. Bernie Sanders has not given up.