Oddly enough, in spite of your nominal agreement it has failed - we disagree critically on the details.  A lawyer (advising the Hotel and Restaurant Workers), who needed 30 months to read all the law, plus the 30,000 pages of regulations, advised that the law would KILL insurance companies.  You may be right about Big Pharma, however.  And medical clinics are a very mixed bag;  often they do what is necessary and wise, without regard for if it will be paid at all, never mind paid at the level it cost.  It is too complicated for any simple theory to accurately describe, but probably claiming they 'benefit' is only rarely true.  The 2000 page statute was passed in a couple of hours, before anyone could read it (as Pelosi said at the time).  It was written by different law firms without consultation and was not coordinated, reviewed or integrated by anyone.  Advocates either are ignorant of the details or they have been deliberately misleading people.