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I was thinking about your post a little further, and it brought to mind another part of this problem about having a civil discourse: all too often, people who are in broad general agreement about the ultimate goals of a policy or program wind up in virulent argument over one particular way to achieve it.
For example, suppose you and I both agree that, for those poor people who want a job, we want to help them: maybe we both acknowledge that some people like the dignity and sense of self-worth that accompanies being able to support oneself, and we both want to promote that goal.
Suppose further that we agree that some poor people will need transportation assistance to get to the workplace.
I suggest that we give them cars. You point out that there might be a problem with that idea, at least at the outset: (a) if the expenses of maintaining the car are "too" high, it might defeat the goal of helping people support themselves, because too much of their earnings will initially be diverted away from self-support, and (b) if the cars are unreliable and break down frequently, that also might defeat the goal because it would give the people a reputation for being unreliable, which is not helpful to them.
Suddenly I start calling you a heartless uncaring snob because you are undermining efforts to help poor people become self-sufficient!
In this example, it seems that my reaction would be extreme, yet that is exactly the same situation that occurs with healthcare reform in general compared to the actual textual language of PPACA in specific: in effect, PPACA tries to put 10 cubic feet into a box that is 2 feet wide, deep, and long: it cannot possibly work in the long run because it violates the laws of mathematics. Oy, so many potential allies who could combine to achieve actual workable effective healthcare reform suddenly become red-faced and short of breath in the violence of their denunciations. Anyone who says PPACA is flawed in any way must be excoriated, even if they are merely describing its underlying math.
If I ask my die-hard Republican friends, this past one, when I voted Johnson. They told me it's a vote for Clinton.