You may not understand that many federal spending programs are unconstitutonal, these programs having been established under Constitution-ignoring socialist FDR in the 1930s and 40s. FDR was reelected enough times that he was able to nominate state power-ignoring activist justices who promoted FDR's unconstitutionally big federal government.
Can you name one judge or one member of the House or the Senate who is willing to claim that Medicare is unconstitutional? I can't think of even one - not one.
We have a huge and growing glut of seniors right now and they vote. Maybe when they're gone, our politicians and judges will take a fresh look at the constitutional limits of federal power. Until then, the federal government will continue to be up to its neck in our healthcare system unless the people themselves boycott that system to force change.