Often, when the “smash the state” position is invoked—especially among those less familiar with the state as an institution—further investigation reveals a dangerous lack of precision about what exactly the state is.
Even during their most bloody and repressive years, progressives praised Mao's China, Cuba, and the USSR, because they offered "free" healthcare. Progressives are simply uninterested in any argument in favor of private healthcare.
The goal of the human economy is to gain greater control over the means of satisfying human needs. We start with the most immediate needs, but thanks to saving and investment, we can move onward and upward from there.