The answer is 'smash reformism.' Now, what was the question?
I occasionally get leftists who tell me we can't have universal health care in the U.S. *until capitalism is overthrown.* I point out all the capitalist countries that have it (in the OECD it's Turkey, Mexico, and the U.S. which don't) then I brace for the argument that the banks and insurance companies here are all interlocked and you're really attacking big capital (a worthy response)... instead they mumble something about 'who wants to deal with western medicine anyway' and wander off. Or they give the elitist line, Americans will never go for that, they're too brainwashed/stupid/bought off etc.
Those who want health care, meanwhile--not just as a political theory but for themselves--perk up and ask good questions, happily unaware that there are unfulfilled historic preconditions.
Jenny Brown