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At the end of the day, after the shouting, it comes down to Republicans - and some Democrats, it must not be omitted - protecting powerful special interests.
Whether those interests are good for the commonweal or whether they actively harm us is not part of the equation for those (purportedly) public servants.
Yet: the will and needs of the American people, our generosity of spirit, our investment in our American future, render those interests a speck of dust.
Either health care will be a right for all American citizens, or it goes on being a source of profit for a few.
It is personally painful to me to see how the money spent by those few has so effectively managed to pollute our discourse. Sometimes I don't think I have the energy to face the outrageous selfishness and greed that drives it all.
But at the end of the day, it's a fight worth fighting. The status quo is unsustainable for each one of us individually, and for the America's leadership in the world.
(Also, and in respect to the specifics of the way forward, I'm linking to Lakoff's prescription. Perhaps if it gets around enough it can even broach the high walls of Castle Rahmuel.)