Maggie's Farm

It's about political strategery. From James Bowman's Tactical Progressivism:

Nobody really believed that Obamacare would do anything to improve our health-care system or, even more absurdly, "bend the cost curve." By vastly increasing the number of insured and therefore of demand for medical care, it could only drive up costs. Remarks like Nancy Pelosi’s about having to pass the bill in order to see what’s in it showed that they weren’t really interested in what was in it — and nor was the President, who left all that up to congressional Democrats. What they cared about was the establishment of the progressive principle that the government should be in charge of overseeing health care. The details would be worked out later as history pursued its inevitable course of increasing government control over people’s lives.

Leftists take the long view, the Gramscian approach. At one bite at a time, their growing Leviathan wants to consume all that it can of private life in America. It's never enough, and never will be.

That's the essential problem: there is no end-point.