Liberals have tried, moderates have tried, conservatives have tried, and our healthcare system is still broken.
In spite of thousands of hours of Congressional testimony, hundreds of pages of legislation, and millions of lobbying dollars, our healthcare system is still, for far too many Americans, incomprehensible, unaffordable, and unfair.
The reality is we don't have a healthcare system. Instead we have scores of ill-matching components, each offering different levels of coverage to subsets of the population. Employers choose employee coverage, some self-insuring, others buying insurance varying from generous to skimpy. Seniors accept traditional fee-for-service (with or without private supplemental coverage) or choose among a multitude of private plans. The less well-to-do may be eligible for one of fifty different state Medicaid programs, or possibly for Obamacare exchange subsidies. Plus there's TRICARE for military dependents and retirees, the Veterans' Administration, the Indian Health Service, and state and local programs as well. Good luck figuring it out!
Americans face far higher costs for insurance coverage than the citizens of any other industrial nation. An average family of four, with no other source of coverage payment must pay close to $16,000 a year in the individual market. Four adults in ten have difficulty paying deductibles, one in three have difficulty paying premiums, three in ten have problems with medical bills, and one in four have put off getting tests or treatment. Even the over-65s, with Medicare, can face bankruptcy when faced with multiple hospitalizations.
Coverage and costs vary wildly, with little relevance to the needs of the individual. Keeping the same benefits while switching jobs can cost thousands of dollars in increased taxes, while taxpayers may subsidize one senior's care by $5,000 more than another in the same city with the same health status, and unfortunate low-income individuals may discover they've lost all coverage by managing to increase monthly incomes by a dollar or two. The Affordable Care Act added its own inequities with fines for those without coverage, mandated benefits for those who don’t need them, and base coverage levels that are unaffordable for many.