The biggest trade-off is between a constitutional republic, with all its checks and balances, and a centrally-planned healthcare. The two are fundamentally incompatible. The future will yield many more convulsions. Many more Halbigs.Read the whole thing.
The optimism surrounding the ACA, summed up by President Obama's promise "if you like your doctor, you can keep your doctor," gave many the impression, myself included, that healthcare reform can be Pareto optimal; a win-win for all.
Regrettably, trade-offs are a fact of life. Which means there are winners and there are losers. This is not unusual. But by not acknowledging the trade-offs we have created resentment in the losers, and widened the partisan chasm.