It was a compromise within the Democratic Party. Half the party wanted public healthcare, the other half wanted a market based solution. The Republicans wanted tort reform and insurance across state lines - none of which were ever even considered for the bill. The Democrats met all by themselves, Republicans weren't even at the table because they knew nothing they had to say would even be considered for the bill - the Democrats had the majority, they didn't need any Republican votes, so they just didn't care. Thus, it got rammed down our throats without a single Republican vote or Republican option. The only ones the Democrats compromised with was other Democrats.