When did so many of our elected leaders become so uncompromising on health care?

Was it the moment when many in the Democratic field raised their hands in support of providing subsidized health insurance to all undocumented immigrants? That’s a position that even our peer countries with better coverage rates have yet to embrace. Maybe it was when President Trump and the Republican-controlled House celebrated their temporary takedown-without-a-replacement of Obamacare back in 2017. Their plan would have deprived an additional 24 million Americans of coverage had it cleared the Senate. (It thankfully didn’t.)

It’s hard to pinpoint the exact moment when the pursuit of the perfect — Single payer no matter the cost! The free market will fix it all! — has become the enemy of actual political progress in reducing the high cost of coverage.

What is marketable on Twitter has come to overshadow any incentive to focus on what’s truly achievable in the short term. Joe Biden’s health care platform, progressive by many standards but bounded by reasonable limits, was actually deemed “a giant gamble” because it isn’t progressive enough, even though it supports a public option and bolstering Medicaid expansion.

If this is a gamble, what does a bipartisan theory of health care reform even look like?

Let’s start by moving past the endless debate about the proper role of government in American health care. The right wants less government, the left wants more. We’ve tried since the Truman administration to reconcile these opposing views, and until our politics fundamentally change, it’s time to shift focus.