Healthcare bill: What just happened?

The House just passed on a modified version of the Senate's health care reform bill. It seems likely that the Senate will approve their modifications, meaning that we're probably less than a week away from this becoming law. There's a lot of misinformation floating around, so if you're interested, you can see the differences among the three bills here.

I'm not exactly a fan of this bill, nor are a lot of other people.* It's one of the most comprehensively massive changes to the lives of every American that the federal government has executed in recent memory. The last year has been a gigantic series of compromises to reach this point. I'd like to trace the reasoning process as I understand it.
*I also have a slight tendency to understate matters.

Keep in mind, I am not defending this reasoning. I don't believe in calling people my enemies, but Sun Tzu's advice still applies: if you want to win, you must know your enemy. I present what I perceive to be each stem in this enormous compromise in bold, with my commentary interspersed.

Problem: lots of Americans don't have access to health care.
So far so good. This is indeed a problem. Slogans you'll see from other candidates like "The US has the best health care system in the world!" do nothing but distract from solving this problem. I'm still waiting for many candidates in this election to admit that there's actually anything wrong with the American health care system, much less propose a solution that will have any significant effect.

The government should make sure all Americans have health care!
Here's the first mistake. There's not enough digging into the problem. Why don't so many Americans have access to health care? Because it costs so much! Why does it cost so much? A combination of administrative costs, prescription costs, malpractice premiums, and pay-per-patient driving up practitioner costs. None of these are addressed in the final bill. The process went off the rails from day one, focusing on the symptoms instead of the actual problem.

How about single-payer? No, can't do that, it has a bad reputation in the US.
Years of propaganda about how horrible single-payer countries are has apparently paid off. Ask most people living in those countries and they're perfectly satisfied with the general quality of care. I oppose single-payer because I believe a market system can do better. I don't need to make it look worse than it actually is, because I fully believe people are capable of deciding based on facts. If you have to lie and manipulate the people to achieve your ends, it almost always makes you worse than the people you're trying to beat.

Okay, so we leave the market in place. How about as part of that market we create a publicly-operated health insurance company for those who can't get private insurance? No, we can't do that, the insurance companies don't like it.
I'm not entirely clear on how this died, but I believe it was primarily due to the interference of insurance companies in the political process. Some criticisms make sense: if the government directly competes with private insurance, private insurance can't keep up. But we're not talking about direct competition, we're talking about covering people that private companies don't want to cover anyway, the poor and those with pre-existing conditions. I suspect most of the opposition was because insurance companies thought they could get a better deal by the one remaining option:

Well, all that's left is to mandate that private companies cover people regardless of pre-existing conditions. But if we do that, people will just wait to buy insurance until they get sick, and that doesn't work. So we'll also have to mandate that everyone buy insurance from a private carrier. And if they don't? All we can do is fine them.

So we got here through a combination three of factors:

• Treatment of the symptom, lack of coverage, instead of the problem, high costs. This is due to a combination of ideological demands for universal government-provided coverage, and major corporate influences fearing lower costs will eat into their profits.
  
• Decades of propaganda about how bad single-payer is.
• Corporate influences spreading lies about how bad a public option would be.

And the worst part? Washington has wasted over a year debating a bill that, while it may have some merit, will almost certainly be shot down in court before it goes into effect in four years. Ideology and corporate influence killed any chance for the real, meaningful health care reform that we so desperately need.