Not surprisingly, the same Commonwealth Fund survey found that US adults were the most likely to endorse major reforms: Three out of four called for fundamental change or rebuilding. Yet, a November 2013 Gallup survey found that 56% of U.S. adults say that it is not the federal government's responsibility to make sure all Americans have healthcare coverage. Unless this dichotomy can be blamed on the recent politicization of the issue because of Obamacare's rollout, there is a major disconnect. While not a root cause per se, it is a serious impediment.

How is it possible that Americans endorse major reforms, but don't want the government responsible for making sure that all Americans have healthcare coverage?
Are they naive enough to think that the so-called free market forces will somehow magically bring about reforms?

Market forces are quite capable of bringing about reforms if it is a level playing field. The problem is that in healthcare it is not a level playing field. The market power of insurers to fight high prices against consolidated hospitals and pharmacy benefit managers in most market areas is very limited. So, they offer illusory discounts to employers and individuals hidden inside inscrutable insurance products. Even large employers with clout are helpless; they have been reacting by simply shifting costs to employees through higher premiums, reduced benefits, and higher deductibles. So, it boils down to a couple of major problem areas: 1) exorbitant prices because of the leverage providers have and 2) overall lack of price transparency.