When people are arguing about healthcare reform, it is worth thinking a little about what the word means. Taken literally, reforming something only means changing it, putting it into a new form. In that sense, both the institution of a U.S. version of national health care and the abolition of all government involvement in health care in the U.S. would be reforms—just different ones.
The word is used in practice, however, not to mean "make different" but "make better." Which means that if I disagree with you about what changes would make something better then, from your standpoint, I am against reform—and from my standpoint you are.
Not a usage of language likely to promote productive dialogue.