Just not having that legislation, letting employment & insurance decouple and a sane market for healthcare develop might easily be better than the ACA.
Maybe? But what is the mechanism by which employment gets decoupled from health insurance? That would require a different law, I suppose?
But that wasn't what I suggested: I said having the ACA is better than not having it, not that having the ACA is better than other possible alternative laws. I can think of quite a lot of alternative healthcare reform laws that would be significantly better than the ACA.
And I think it's reasonably safe to say that in "ACA vs. nothing else", ACA wins, if we judge by the millions of people who will lose healthcare coverage if the ACA were to be repealed and not replaced with anything new.
It seems to be the only way to interpret what you suggested. How could it end up in a situation where there aren't other alternative laws? There are automatically laws governing what people do - laws exist. The conversation is entirely about which laws are best. In this case, I'm arguing that generic rules (not specifically tailored to healthcare) are probably better, since a generic market seems to outperforms the US healthcare system.
> And I think it's reasonably safe to say that in "ACA vs. nothing else", ACA wins
Well I can't control what you think but I can point out that it is a hard stance to provide evidence for. Healthcare is fundamentally less important than really urgent and essential services like food production or utilities and they manage to get great coverage with relatively limited fuss. The reports I've heard are that people find the situation in healthcare to be quite substandard.
Unregulated market is an oxymoron. It’s always regulated by someone, warlords being the extreme devolution.
For a medical emergency it does make sense for a doctor to ask if you would like to voluntarily consider an interesting bargain.
And I'd still rather have a private option in the event of a medical emergency. Ironically, insurance in a free market is actually really good at sorting out that sort of risk. The insurance company has strong incentives to negotiate what will happen in an emergency and it isn't that hard to make agreements with people in advance.