re: Why does the healthcare debate essentially revolve around like 4% of Americans?

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There is no sustainable healthcare system anywhere where providers aren't at the whim of administrators and ultimately politicians.

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First, everything in that statement is relative. Second, in the US, as I've already pointed out to you, that is not true. Third, history demonstrates economic success comes from changes in accepted "system" paradigms.

Major examples?

Prior to 1315 absolute authority of monarchs was the absolute rule.

Prior to 1776, monarchy was accepted as the only workable government.

Prior to the 20th century, female suffrage basically served no role in governance.

Prior to 1966, US medicine achieved greatness via a private model.

We won't ever be able to unwind Medicare/Medicaid, but we certainly could alter mechanisms of remuneration, and reapproach a system taking advantage of the exceptionalist spirit innate in American entrepreneurs.

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Commercial insurance is tightly regulated.

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Correct! and as we all know overregulation equates to inefficiency 100% of the time. Look no further than the cost of US Medicine as proof.

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We have to be accountable to politicians

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bullshite! Total bullshite! Politicians have to be accountable to us!

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We have to be accountable to the public.

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Yes we do. So why are you set on undermining that responsibility?