That's not a good analogy. There are trillions of dollars of physical infrastructure that would have to be replaced, starting from power stations, through every refrigerator and light bulb, and the wiring and electric panel in every home.

Why isn't it a good analogy? There are trillions of dollars of physical and human capital that have been invested in expectation that the current system will remain (mostly) in place going forward. That's why you can't just go and cut reimbursement for medical services by 30%, or whatever.

All it takes is political courage, which the Democrats lack too often.

It's almost impossible to do things that are going to be massively unpopular within a decent-sized portion of the electorate. Again, that's why the doc fix kept getting passed, even though it would be to everyone else's advantage if the federal government flexed their monopsonistic power against medical providers beyond the dastardly pharma companies. The doctors and nurses and lab techs and everyone else in the system would revolt. To say nothing of the patients and communities that depend on marginally economic medical providers, like rural and inner-city hospitals. If you try to exercise that kind of political "courage" (read: malpractice), you just get voted out of office and the proposal reversed immediately.