Matt Taibbi has a good general article on the healthcare issue in Rolling Stones. One paragraph in particular pretty much sums up where we're at:
Just as we have a medical system that is not really designed to care for the sick, we have a government that is not equipped to fix actual crises. What our government is good at is something else entirely: effecting the appearance of action, while leaving the actual reform behind in a diabolical labyrinth of ingenious legislative maneuvers.
The U.S. political system allows subtantial change if and only if it doesn't hurt some wealthy interest, which is of course just about never. As Taibbi points out (if you look closely between the lines here, you'll see a faint smirk), the rightwingers, in their rebuttal make a good case for the public option:
The logic behind the idea was so unassailable that its opponents often inadvertently found themselves arguing for it. "Assurances that the government plan would play by the rules that private insurers play by are implausible," groused right-wing douchebag George Will. "Competition from the public option must be unfair, because government does not need to make a profit and has enormous pricing and negotiating powers." In other words, if you offer a public plan that doesn't systematically fuck every single person in the country by selling health care at inflated prices and raking in monster profits, private insurers just won't be able to compete.
Obama clearly hasn't done what he promised.
One of the reasons for this chaos was the bizarre decision by the administration to provide absolutely no real oversight of the reform effort. From the start, Obama acted like a man still running for president, not someone already sitting in the White House, armed with 60 seats in the Senate. He spoke in generalities, offering as "guiding principles" the kind of I'm-for-puppies-and-sunshine platitudes we got used to on the campaign trail — investment in prevention and wellness, affordable health care for all, guaranteed choice of doctor. At no time has he come out and said what he wants Congress to do, in concrete terms. Even in June, when congressional leaders desperate for guidance met with chief of staff (and former legislative change-squelcher) Rahm Emanuel, they got no signal at all about what the White House wanted. On the question of a public option, Emanuel was agonizingly noncommittal, reportedly telling Senate Democrats that the president was still "open to alternatives."
As the title of the piece goes, this is all so sick and so wrong.