Charles Lane of the Washington Post makes a very good point in this brief online column. He suggests that the reason comprehensive national healthcare reform is so difficult to enact is because of the basic structure of the Constitution itself. Because the Constitution was written by men who lived in a time when the power of the states was dominant and the power of any central government was to be feared, the system put in place by the Constitution made it extremely difficult for any significant national legislation to be passed (except during a time of war, when partisan rivalries might be put aside).
It makes for some very interesting reading. Perhaps those people who want significant healthcare reform would better use their time in their own state capitals rather than in Washington D.C.