But unlike many other developed nations, the United States seems likely to keep its mix of employer coverage, government programs and individual responsibility instead of adopting a government-run model for all.
The Obamacare debate touches on a long-running debate in America about the idea of a "nanny state" — when the government goes too far in protecting people from themselves.
Does the mandate to obtain health insurance just concern the person who is forced to get it? Or does it benefit the health care system and the economy to make sure nearly everyone is covered? That's part of the debate over the health care law.
Prohibition said no to making and selling booze — in the Constitution, no less, until another constitutional amendment made it easy to get plastered again. Washington pushed for state motorcycle helmet laws, with mixed success, and mandated seat belts in vehicles.
Hillary Clinton earned plenty of ridicule from the right for asserting that "it takes a village" to raise a child. And in the face of substantial childhood obesity, Michelle Obama has taken some hits for her campaign to get kids to exercise and eat healthy food.
Polling suggests that Americans value personal choice over government involvement when it comes to behavior, but it's not quite that simple. In an Associated Press-NORC Center poll out this year, 8 in 10 favored government policies that make it easier for people to make healthier choices, such as providing nutrition and exercise guidelines, and three-quarters supported government money for farmers markets and bike paths. But most didn't like government mandates on their choices.
RED vs. BLUE
Obama came to national attention almost a decade ago on the strength of a keynote speech to the 2004 Democratic National Convention that rejected the notion of red states and blue states and declared "there's not a liberal America and a conservative America; there's the United States of America." Many times since he's played on that theme of a nation not split by those party colors, in what can only be called wishful thinking.
What's happened in the budget impasse, the struggle over the health care law and much else in Washington is very much a product of red vs. blue, sometimes to a point where each side can barely talk to the other.
Of today's political divisions, Mackenzie says: "They're about as hard as they can be."
Not because the middle ground has necessarily disappeared but because it is not what counts the most to some ideologues at this time. (Check back on that when the 2014 elections roll around). Republicans who have placed their opposition to the health care law at the center of everything are responding only to a slice of public opinion, Mackenzie says. "They're thinking about the people who elect them and the people who fund them and those people are very supportive of what they're doing."
To be sure, bipartisanship is still a feel-good word in Washington, but it's thrown around loosely. Everyone ideally wants the political cover that can come when hefty chunks of both parties agree on something, and they claim it even when it isn't there.
Several Republican lawmakers did just that after a series of polarizing votes leading to the shutdown, particularly the one on the House resolution that sought to pass a budget only on condition that the health care law be stripped of money. Sen. Ted Cruz of Texas claimed a "strong bipartisan majority" in the vote; Rep. Kevin McCarthy of California said: "It was a bipartisan moment because we're all Americans."
It was actually more of a bipolar moment. Only two Democrats voted with the Republican majority and one Republican voted with the Democrats.
IT'S PERSONAL, TOO
This is a political and policy dispute that's also personal.
The tea partyers' disdain for the president is unrestrained, with talk of impeachment all the rage.