Healthcare is ~17% GDP

Slavery was estimated at ~12% and "hey, you need to lose a few % of your margin and actually pay those people" started a war.

Now, there's an argument to be made about ideology, geographic concentration of industry, etc. doing a fair bit of lifting kicking that off (their own neighbors telling them to stop surely would have gone over better than a bunch of smarmy northerners in their ivory towers telling them the same thing). But the fact remains that you cannot make a large fraction of the country take a haircut without causing strife.

The only way to fix this "nicely" at this point is to boil the frog over decades.