“Medicare-for-all” is a total pipe dream.

American exceptionalism holds that we are a singular country on the international stage, and with regard to healthcare this is a natural fact.

Never mind the solid arguments regarding Americans and her diversity of healthcare needs (unlike Sweden), nevermind the gargantuan landscape of America and its own challenges in instituting a healthcare-for-all plan (unlike Denmark), we’ll set those things aside for now.

America will never have healthcare for all… ever. As a reformed progressive I’ve come to realize this, but perhaps I’ve come to realize it in different ways than others. To me, there are mainly three reasons America will never have healthcare for all.

The first reason is because the idea that “doctors become rich” is embedded in the American system from the top down. From institutions to banks to shopping malls to automobiles to real estate: the American capitalist system is partly based on the idea that … doctors become rich.

To try to somehow extricate that from our systems is basically impossible, and, perhaps more importantly, why would we want to remove that motivation? Don’t we want our doctors to achieve success? Don’t we want to reward those who are in healthcare with nice houses or nice cars? Isn’t it in our best interest to keep in place a system where the healthcare worker–the doctor, the nurse, the hospital, the system itself–is motivated to buy things, to get things, to be

rewarded? Isn’t that a good thing for a healthcare system? Seems like it is.

The second reason that Americans will never have a healthcare-for-all system is something I’ve not yet heard argued anywhere. You see, the reformed progressive in me has a new appreciation for the Constitution. The reformed progressive in me has come to a different perspective on the American way of life, and my new perspective all began when they campaigned to remove the Second Amendment. The thought that we’d repeal the second amendment — the amendment which makes us truly, wholly unique as a nation in the world–turned my whole perspective inside out.

So that’s the second reason.

Logically if every American owned a gun, which is their God-given right to do: to defend their family, to defend their children, to defend themselves,* to keep the right to bear arms… If every

American had a gun (perhaps every American should) and every American had guaranteed healthcare: the United States of America would become a shooting gallery.

Even just for fun we might shoot at each other, catching someone stealing a we might shoot their hand, chasing someone down the street because they called you a name we might shoot their foot, even just shooting things in the backyard, our hospitals would be overrun with people who have gunshot wounds.

Thirdly, and most interesting to the Reformed Progressive: America is a diverse country and proudly so. This leads to problems in health-care decisions but not just of the physical variety.

While the plethora of body types is one thing, our diversity of opinion makes health-care decisions very complex. Will we allow for female or male circumcision to be covered by the plan? What about abortion? What about third-trimester abortion? What about gender reassignment surgeries? What about surgeries that reverse gender reassignment? And how does our freedom to practice religion factor into all of this? Can Muslims have the same healthcare plan as Mormons? Would the Amish and Christian Scientists be exempt from this plan? The prismatic nature of the American experience makes the implementation of a nationwide healthcare plan not just confounding, but basically impossible.

America is exceptional. The reformed progressive has come to understand that, and we are not exceptional because we can have healthcare for all, we’re exceptional because we can’t.