Here’s a typically insightful article on the Affordable Care Act (so-called) by Joseph Moore, the proprietor of Yard Sale of the Mind. I highly recommend reading the whole thing, but the opening paragraphs are, I think, the most interesting:
As is characteristic of virtually all political decisions, in health care policy, we cannot choose ends. We can only choose means. We are not choosing and cannot choose between Wonderful Affordable Health Care for All (WAHCA) (1) and Misery For All But The Rich. All we can do is chose to support or oppose a particular next step, in this case, continuation or repeal/fundamental modification of the Affordable Care Act.
The ACA is not, in itself, WAHCA. Do not go on until you, dear reader, grasp this. Voting for the ACA was not voting for WAHCA. Passing the ACA did not achieve WAHCA. WAHCA is an *end*. The ACA is a *means*. We all may *hope* that the ACA results in better, cheaper health care – but that depends entirely on those pesky details of *how it works in practice*. You know, those details we had to pass the bill to see.
I think this one distinction would, if understood, eliminate a goodly part of the confusion and hostility that currently grips so much of the American electorate: We don’t choose ends, we choose means. We may agree on the end without agreeing on the means.
This, by the way, is one of the reasons that the ends do not justify the means: the means are real and immediate, while the ends are only speculative. Over the last century some hundred million people were murdered in order to bring about a utopia that never came. The people were real; the imagined utopia of Karl Marx was never more than a dream (and not a particularly likely one at that). To sacrifice freedom for some imagined end of prosperity or safety or (worst of all) equality is a fool’s bargain: the thing you sacrifice is real; the end is only speculative. Indeed, often your only guarantee that the end you are bargaining for is the one intended is the word of someone you have no reason to trust.
Anyway, read the whole thing for a sober breakdown of how and why the ACA isn’t WAHCA, probably will never lead to WAHCA, and may not even have been intended to lead to WAHCA.