Nature of the matter in question. They can't even discuss this stuff openly. Anybody who describes the real goals, content and consequences of the reform will become politically dead in no time. They can't talk to people frankly about the rationing, about saving resources on end-of-life care, about prioritizing, about all the additional taxes, direct and indirect. Hence all the fight under the rug, compromises, and petty populist moves - with totally expected results.