[king_jester]

I agreed with what you said up until the last paragraph. Providing a system in which individuals and families more directly choose their health care spending from providers is not a solution to health care access problems. There must be some kind of program available nationwide that serves those that would never be able to purchase health care on their own, due to poverty, homelessness, and disability (among other things). However, this is the fundamental issue for health care at the moment: many government officials simply do not believe that those people should be served at all and that no program should be created or expanded to do so. In fact, those politicians actually want to go the other way with it and reduce the effectiveness of Medicare and Medicaid. This is the real political environment in which the PPACA was introduced and passed.

We can argue whether other approaches would have worked for new health care legislation, but the whole point of any reforms is that it can actually be achieved. Universal health care systems and privatization schemes do not have enough support politically to be feasible, which has a lot to do with other political and social issues in the US.