I'm not disinterested. I work in healthcare, and my livelihood depends on people having health insurance. The industry will implode sooner or later if costs aren't reduced in the near future, as healthcare costs, as I'm sure you're aware, have outstripped inflation since, like, the 60s, or something ridiculous. My point is that there has to be an engineering solution out there that one can search for dispassionately without screaming "socialist" on the one end or "fascist" on the other. Elitist or not, empiricism is the only thing that can help inform good policy making on this type of complicated issue.

I would argue that it's not rational to think that a large government program can be created from scratch and then, after five years, get a good course correction to make it work better. I am completely unable to think of any such thing ever happening in the US. The Donk's gave us 1200 pages of turd to eat, and eat it we will

You're probably right that government programs are rarely cancelled once they are initiated. The problem (why we got this bill instead of any other) is that health costs are an important issue; it's not an invented issue like so many other political topics. It needed some solution, and this subpar exercise was the only thing that could squeeze through the cumbersome rules and procedures of Congress (cough...gifts to individual legislators districts...cough).