The political debate over healthcare reform in the United States has been extremely heated despite the reality that the actual policy debate is rather tame, even boring. Constitutional, public policy, and healthcare policy experts are NOT really divided on the relevant legal and policy questions. The controversy and conflict over healthcare policy has been introduced and maintained by those with narrow economic and/or rigid ideological interests.
Every political science 101 class learns the three primary functions of ANY government, 1, Maintenance of ORDER; 2, Regulation of PROPERTY; & 3, The provision of PUBLIC GOODS. No one disputes the appropriateness of these three functions of government. The United States has a liberal constitutional system in which the government performs these functions with as little interference in peoples' lives as possible(or practicable).
The relevant question about access to health care is; is it a "public good?" In our system, a public good is anything the nation needs that cannot be adequately distributed by the free market. If we conclude that access to healthcare is not adequately distributed by the market in America, then we must decide the manner and extent to which the government must subsidize or facilitate the distribution of access to healthcare in order for it to be adequately distributed.
While the initial question of whether or not healthcare is a public good IS debatable, no one in the present political debate is EXPLICITLY debating this point. Even the strongest opponents of reform have conceded that reform is necessary and that the government must act. Advocates of reform have largely succeded in framing the debate around how much the government should do, rather than whether or not it should do anything. Advocates for reductions in government involvement or retention of the status quo have gotten zero traction with their substantive arguments and have been forced to mask these substantive positions in generalized anti-government, pro-free market rhetoric.
The actual range of options for the adequate provision of healthcare access are, from left to right (with left as total provision and right as total deregulation) as follows:
Nationalization >> Single Payer >><< Subsidized Market << Total Deregulation
The political debate is entirely contained within the "subsidized market" category of reform. Advocates for nationalization, single payer, or total deregulation have never really had a seat at the table. Since the proponents on the left, who really want a nationalized or single payer system, have essentially allowed Obama to take these off the table, the loudest complaints are coming from the far right.
With a Democratic Administration advocating a market friendly approach, reasonable conservative criticisms have been coopted, leaving the lunatic fringe to suck up all the opposition energy and attention. Its important to note that the actual businessmen and women who make their livings in any market are NOT free market purists, especially in the health insurance industry. They know that if the governemnt did not subsidize health insurance it would become a MUCH less profitable enterprize.
President Obama's strategy on health care reform, which has frustrated just about everybody, may turn out to hinge on inevitability. With every opposition argument gradually emploding when compared to the status quo, and the White House refusing to push hard rhetorically on its policy preferences, meaningful reform will simply outlast the weak arguments of its opponents. Reformers have the high ground on reasonable arguments and the President has refused to jeopardize that high ground by pushing his offensive, leaving opponents with no easy targets and only ideologically extreme claims and arguments.
Its only a matter of time before wavering Democratic Senators realize that popular opposition to the reforms in the House passed bill are VERY thin and easily subdued by credible information. This leaves folks like Joe Lieberman with only two choices; they can make it clear to all that they are bought and paid for by the insurance industry, or they can stall for now, hoping for minor concessions that will appease their pay masters, and eventually allow reform to get a straight up or down majority vote in the Senate.
You don't have to be a psychic to know that in this case, light will eventually win out over heat.