Healthcare should be a utility, viewed in the same utilitarian light as firefighting coverage and police. It is however big business in America, for that reason you will see heavy resistance to throw the system into the utility category. The rent-seekers in pharma, the AMA and the insurance cartels, will kick and scream to keep it from happening. And from the vibe in congress I believe they will once again get the upper hand. Oh the wonderful tool of lobbying, such the equitable and "open-to-all" process eh?
The mandate aspect of the proposed reform scares the jesus out of me, BUT BECAUSE of the abscence of a public option. If you're not going to effectively extend Medicare to people under 65, I don't want to hear of a govt "mandate" forcing the proverbial 60K/yr family of 4 to buy !!PRIVATE!! insurance. Absolutely fascist, in the very literal definition of it no less. As a late 20-something, if I didn't have access to government subsidized health care (military-Reserves) I'd straight up take the tax penalty and get real educated on medical tourism. No way I'm being forced to pay more than I pay in housing every month for a de facto catastrophic only coverage, to a private cartel, heall naw. The hell with the baby boomers and what they think they're entitled to, if Medicare is good enough for them it's good enough for me. We all know medicare will collapse at the present rate, but the utilitarian point remains, what's good for the goose is good for the gander.
So that's really what it boils down to. A young nation with philosophical resentment towards their brother in a never-ending battle to further define the social acceptability of living in de facto Brazil, the land of haves and have nots. Otherwise, the utilitarian value of healthcare wouldn't be so contested in a world where much older nations have put the issue to bed long ago. Even Brazil, the archetype for the disenfranchisement of the majority, has a universal public system in place, alas grossly underfunded (it is after all Brazil, where the haves care not for the have nots). So even if a nation built on the socioeconomic apartheid of Brazil recognizes the utilitarian value of healthcare, it is beyond a mystery the possible reasoning why a place that argues itself to be socio-ethically above brazil (the US) has such a tissy over the very matter. People in the end vote with their money.
"FU I GOT MINE" ---The new "E Plurubus Unum", might as well change the dollar bill engraving 'cause that's what we are today.