There is much speculation about what is going on in the public policy debates that are afoot these days. But no one to my knowledge has noted that a particular philosophical position may be very influential in all the discussion. This is that idea that moral/political judgments cannot be provided with rational defense. This is the famous is/ought controversy, unleashed in the modern era by David Hume, the famous Scottish philosopher who argued that judgments as to what is morally/politically right versus wrong just cannot be rationally proven. So, accordingly, no matter how long they debate the matter, whether Obama's healthcare policy is sound or not just will never be resolved since it is about what ought to be adopted, not about what is the case.
In much of twentieth century moral and political philosophy it had been emotivism that became prominent at prestigious centers of learning. The idea is that when one states what ought to or ought not to transpire – e.g., implement Obamacare – there simply is no way to demonstrate one way or another. All one can do is express an emotion of approval or disapproval about such matters. And one cannot show such a thing as being right or wrong. It is just how one feels about the matter and that's the end of it.
One consequence is that public policy or moral or other normative disagreements cannot be adjudicated by reasoning. All that is left is attempting to discredit one's opponents, most often by ad hominem charges, name-calling, besmirching and the like. The atmosphere that dominates in such disputes is essentially irrational.
Unless this is understood, one will be baffled by what is transpiring during public policy disputes such as those that permeate current politics. Each side will declare the other's motives devious, a matter of ill will, etc. Opposing parties will be demonized and one side will not listen to the arguments of the other since argument assumes the possibility of a rational outcome.
If you are one of those people who believe that ideas, especially those of philosophers, do not matter, please reconsider.