I would completely disagree with your point about Democrats making no movement on healthcare. Obamacare was a huge improvement. Close to 20 million people got healthcare for the first time. It enacted a ban on denying healthcare because of preexisting conditions or because you got sick, and a slew of other needed reforms. Saying there was no progress on healthcare is flat-out wrong.
Secondly, people conveniently forget that progressives didn't win back the house for us in 2018 and progressives won't be the one to win back the Senate in a few months. It was a slew of moderate candidates in purple and red states. It's the people who are hesitant on universal healthcare and court packing.
You speak of Democrats needing to get power. Well the way we did it 2018 was not by appealing to progressive values or getting down and dirty. It was through moderation and focusing almost solely on healthcare.