"This is why I'm interested why so many people are obsessed with the idea that we need to completely burn down our system and start anew to improve it."

I don't see how the current system can be reformed realistically. There are way too many well funded groups who benefit from the current situation and will fight any kind of change tooth and nail.

In my view Medicare for All is the only realistic path. It works already and could be tweaked to accept more people. Unfortunately Biden doesn't want it so that opportunity is gone for the next decades probably.