According to this article in Vox, The United Nations has a goal of achieving universal health coverage in all countries by 2030. I doubt they were really thinking of the United States when they came up with that, but here we are.

I tend to blame the the situation on lobbying by the insurance industry, because they see public health insurance as an existential threat, and in this country of legalized corruption, big business gets to write our laws in its favor. I knew the American Medical Association, the special interest lobby for doctors, played a role, but I didn’t realize it was as soaked in disinformation and propaganda as this article makes it sound.

The AMA-WB campaign had two key components. First, they used mass advertising to associate NHI with socialism, while the private (or voluntary) insurance option was described as the “American Way”. These advertising efforts of the AMA were complemented by tie-in advertising from other industries fearing a return to war-time price controls. In addition, the strategy called on AMA doctors to discuss private health insurance with their patients and to distribute pamphlets echoing the individualistic advertising message (see Figure 1). Through local and state medical organizations, physicians looking to defray medical costs had organised their own insurance product, which came to be known as Blue Shield, and they were eager for enrolees. All told, approximately $250 million (in current terms) was spent to sway voters, an unprecedented amount for the time. Doctors were also instructed to use their prestige to urge local civic organisations to pass resolutions against national health insurance.

https://cepr.org/voxeu/columns/why-us-doesnt-have-national-health-insurance-political-role-ama

“WB” is a public relations, aka propaganda firm.

I still like to think that individually, most doctors chose the field because they care about human beings. But somehow, as an organized group, they can add up to something evil. And before I cast the first stone, yes I am also thinking about my own profession of engineering (what could be more wholesome than public infrastructure and public health – yes, water treatment probably saves more lives than all the world’s medicine, but that’s a digression) and our unholy alliance with the highway/auto/sprawl industry.

This article also takes aim at unions. By its telling, they wanted to saddle the private sector with the cost of the health care system so they had something to negotiate on behalf of their members (and therefore get people to want to be members). This is also twisted and evil.

What puzzles me a bit is that if big business is really so powerful, why don’t they want to be freed from the burden of providing health insurance? It would seem only to benefit a fairly narrow slice of the finance industry. But it appears that this slice, along with the organized lobbies of doctors and unions, has been powerful enough to keep the American public from having a real health care system for over half a century now.