That was outside pressure but the change occurred because Congress and legislatures enacted them.. the changes won’t happen without engaging people who run for office.
We can have “universal health care” and still have insurance and pharma — — Germany does.. those two entities don’t oppose universal care- they are actually in favor of it. What they oppose is regulations and price controls — which is different than universal coverage
Again- we need to be more precise with terminology
I reject the manichean concept of “the political” class… classic “us vs them” approach and NOT accurate. Had I got elected last fall I’d be part of that and I don’t consider myself captured or owned by corporations. In fact at one town hall the NAACP people asked what I would do if intimidated by lobbyists…… My wife flat told them I don’t get intimidated
Maybe some elected officials do get intimidated- or more worried about re-election than doing the right thing…but the right thing can involve compromise if it advances us toward our goals.
Maybe I am too much of a pragmatist? LOL