Answer:
There are several factors that have historically prevented the United States from having a more universal health care system, including political ideology, industry lobbying, concerns about costs and taxes, and the complexity of the health care system.
Step-by-step explanation:
Political ideology has played a significant role in shaping the U.S. health care system. Many Americans and politicians are philosophically opposed to government-run health care and believe in the free market approach to health care delivery. The strong influence of industry groups, particularly the pharmaceutical and insurance industries, has also contributed to the resistance to a more universal system.
Concerns about costs and taxes are another factor that has hampered the establishment of a universal health care system in the United States. Some argue that a single-payer system would be too expensive and that taxes would need to be raised significantly to pay for it.
The complexity of the U.S. health care system has also contributed to the difficulty in achieving universal coverage. The system is fragmented and involves multiple layers of government, private insurers, employers, and individuals.
The most promising policy reform being discussed in American politics is likely the expansion of the Affordable Care Act (ACA). The ACA, also known as Obamacare, has already extended coverage to millions of Americans, but many remain uninsured due to various limitations of the law. Proposals to expand the ACA include creating a public option, which would allow individuals to purchase government-sponsored health insurance, and lowering the eligibility age for Medicare, which would allow more people to access the government-run health insurance program for seniors. These reforms would build on the existing framework of the ACA and could potentially lead to a more universal health care system in the United States.