Moving away from health care for a second, at the macro level, the country is involved in a major ideological struggle, that hinges on two primary beliefs.
The first one is globalism. Globalism means employers can deploy capital anywhere in the world and access labor anywhere in the world including the US in order to maximize profits.
If as a worker, you make something, your job is constantly under threat of being exported to a country where labor is cheaper. If you work in services, illegal immigration is producing a supply of workers that are prepared to work for less. Many highly educated people feel "insulated" from this global labor competition, but that is a fallacy. It simply takes longer before those earning less can afford to pay for the services of those earning more.
Trump's policies of securing the border and imposing tariffs will help reduce the impact globalism is having on the standards of living of American workers by giving them more negotiating leverage over wages in the future... if they work. So, while the media argues that Trump's policies will cost consumers more (which is true, keep in mind, that is because workers will be earning more).
The second struggle is over socialism vs capitalism. Capitalism is imperfect, but over the long term it produces the greatest amount of prosperity. The challenge is getting that prosperity to be better shared by workers that helped to create it. Again, the best way to achieve that is to give workers greater negotiating ability when it comes to wages (back to issue #1).
However, many believe the way to achieve a fairer distribution of goods and services in our system is through various entitlement programs which take from the wealthy and businesses in the form of taxes and gives to those less well off. Except the problem is that kind of system does not produce prosperity, so while the distribution of goods and services might appear "fairer" to many, the absolute amount of goods and services are far less, leaving everyone on average worse off.
Compensation and benefits in the Midwest came about at a time that America was the world leader. The South wage and benefit structure emerged at a time global competition began to dictate US workers earn less. And so, while America is hurting as a whole, due to globalism, the Midwest is hurting more while the South is hanging on to jobs, but at a cost of lower wages and benefits.
Simply said, at the moment the US is funding the rest of the world's economic growth at the expense of its workers. Until we find a way to make "workers more valuable" by restricting the supply of labor and combine that with an educational/industrial policy that rewards people more for acquiring important skills and working harder, we are going to see our standard of living decline.
