I dunno.
Like Doel says Biden is heavily funded by the health insurance industry (and this is true of all politicians in opposition to M4A) and all it really takes is the same politicians that voted for trillions of dollars to bail out huge corporations who rake in the massive profits with little tax going back into the system, to vote for the taxpayer to get their own money back in the form of paying for their health... a bit like, I dunno, medicare.
"A bit difficult" means weaning the leeches that are the insurance companies from the veins of the American people allowing their taxpayer money to get to where it needs to get to and that's out of the pocket of all leeches, politicians included.
What does the insurance industry really offer the client, apart from telling them what they can have as an op, which doctor they can use and where they can have it, all whilst syphoning off a great deal of money for the privilege...?
You're clearly someone who believes what they're told by Govs about the state of play for their citizens. I think you call this being "pragmatic"...?
Good for you. There is nothing to see here. Move along citizen.
All is well...