Here's a parallel. This is how "change" truly occurs:
http://en.wikipedia.org/wiki/Social_Security_%28United_States%29#Expansion_and_evolutionIncluding amendments concerning who was covered:
Dates of coverage for various workers
* 1935 All workers in commerce and industry (except railroads) under age 65.
* 1939 Age restriction eliminated; seamen, bank employees added; additional domestic workers and food-processing workers removed
* 1946 Railroad and Social Security earnings combined to determine eligibility for and amount of survivor benefits.
* 1950 Regularly employed farm and domestic workers. Nonfarm self-employed (except professional groups). Federal civilian employees not under retirement system. Americans employed outside United States by American employer. Puerto Rico and Virgin Islands. At the option of the State, State and local government employees not under retirement system. Nonprofit organizations could elect coverage for their employees (other than ministers).
* 1951 Railroad workers with less than 10 years of service, for all benefits. (After October 1951, coverage is retroactive to 1937.)
* 1954 Farm self-employed. Professional self-employed except lawyers, dentists, doctors, and other medical groups. Additional regularly employed farm and domestic workers. Homeworkers. State and local government employees (except firemen and policemen) under retirement system if agreed to by referendum. Ministers could elect coverage as self-employed.
* 1956 Members of the uniformed services. Remainder of professional self-employed except doctors. By referendum, firemen and policemen in designated States.
* 1965 Interns. Self-employed doctors. Tips.
* 1967 Ministers (unless exemption is claimed on grounds of conscience or religious principles). Firemen under retirement system in all States.
* 1972 Members of a religious order subject to a vow of poverty.
* 1983 All federal civilian employees hired after 1983; members of Congress, the President and Vice-President and federal judges; all employees of nonprofit organizations. Covered state and local government employees prohibited from opting out of Social Security.
* 1990 Employees of state and local governments not covered under a retirement plan.<58>
We do not need to be so pigheaded about the progress and scope of current health care insurance reform.