It comes down to a huge misunderstanding about how the health care system works, and a blindness caused by an inflexible ideological belief. Ideologically, people believe in what they think of as free markets. The misunderstanding is that there is a free market in health insurance.
The Federal Government already pays for 40% of health care in the country through the Medicare and Medicaid programs. Perhaps you notice that the poor and the elderly are the least healthy people, and they consume the most health services.
What that means is that we, the public, pay for the health care of those whom it is impossible to make money on, and we leave the healthy people for the private health insurers to fight over. Of course, this raises administrative costs horrendously, but hey! At least we have some free enterprise.
The opposition to health care reform is not based on science or economics. It has nothing to do with finding the most efficient way to provide all the services Americans need. It is all about ideology, and about “freedom.” I.e., the freedom to pay health insurers through the nose.
Honestly, I don’t understand why the blue dog Dems are also blinded by this illusion, unless they are more Republican than Democrat. In any case, it’s ideological, and the polarization was there long before Obama came into office. It’s just that he is actually trying to fight the ideologicals, and so they come out in force, and make the polarization painfully obvious to all of us.
Anyway, it hardly matters. Any reform that is not Single Payer will fail. The Democrats will get the blame for the failure, and the Republicans will try to undo anything that actually worked. After that, who knows what will happen, politically, but it’s hard to imagine it will be good for people.
If we get a public plan, it is possible that it could eventually lead to single payer. We can only hope. It is just as likely that any failure to control costs while expanding coverage will be blamed on the plan. But given the ideological nature of the discussion, facts become irrelevant (except those that benefit one’s own side), I don’t expect any significant coming together of the parties.