Unfortunately, American exceptionalism is deeply embedded in a lot of the population, all across the political spectrum. Fix that, and we could actually look at other countries approaches to health care and adopt useful alternatives. And it's not the case that all other countries, or even all other developed countries, have the same solution.

When ACA was being considered in Congress, partisan politics was a major roadblock. Democrats bent over backwards getting bipartisan input. Republicans wrote a lot of it, and then unanimously voted against the bill that was essentially RomneyCare. Blue dog Democrats and the Senator from the insurance industry blocked a public option. If there had one more Liberal Democrat in the Senate, we could have had one, and ACA would have evolved into single-payer by now.

Maybe in February we will have the Congress that can patch the loopholes and add a public option, and also designate it as out of the jurisdiction of the courts.