If the pursuit of happiness is the basic right, good health arguably is essential to happiness. For the poor good health is often illusory and expensive when management has viewed employees as disposable tools. Coal miners had to struggle to get health benefits and one knows the history of urban factory workers and sweatshops of the early 20th century. Health care for the poor added to an expanded and upgraded V.A. system is the better approach.
If good health is a basic human requirement for happiness global sweatshop management often view it as a costly externality. The President in being more concerned for coddling a prosperous middle class with expensive and perhaps unrealistic promises of cheap insurance neglected to structure a practical health care system for the poor off-the-plutocracy agenda. Does the government need to spend money philosophically in order to keep the people happy? The answer may be only if the poor might otherwise revolt and hang the political leadership.
The U.S. Government has no constitutional requirements for spending anything at all. It was the need for producing salt and paying bonuses to private producers to do so early in the nation's history and later Abraham Lincoln's need to pay for the civil war that required taxes and income tax. In either case the private sector might have funded their own civil war without redistributionist government help if they had allowed mercenary plundering of the south though obviously an undesirable practice with burning and pillaging without tribute. With mercenary plunder and the booty available in southern banks and mansions innovative new methods of war might have developed that would have forestalled the need for anew standing army and the onerous government spending required for that.
Insurance for the rich and middle class is really a separate is than that of the poor using Medicare that is something of a mystery to the hypothetical working poor users getting fewer than 15,000 dollars annually in earned income that is where the divide for Medicare and Insurance Exchanges lay.
What is interesting is the idea that Federal Government workers will be using the new health exchanges too instead of the existing insider federal insurance program. It will be a matter of time I suppose before Wal-Mart and Exxon start selling insurance on exchanges too in order to catch some of the torrent of cash upward flowing to the global Plutonomy of the .01%.