Universal healthcare doesn’t happen in the US because a certain subset of the American population would rather have worse health outcomes than guarantee abortions, HIV prevention, and gender-affirming care.
Also, ~150M people with employer coverage plus seniors on Medicare fear disruption more than they value expansion.
There's also a racist element (I know that's a politically incorrect word here, but such things happen). People don't want to fund services to the lazy ______s - fill in one or more of many groups toward whom hate is promoted.
When a similar bill was voted down years ago, someone I was with laughed and said, 'no way were we paying for healthcare for the Blacks'. It fits the divide and conquer strategy to divide poorer people with hate so that they don't unite and vote for all these things - why do you think leaders promote hate?
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You can easily drop those from a universal healthcare system - look at the NHS and gender affirming care across the pond. So it can't only be that part - I think it's wanting the undeserving to not have healthcare.