From my perspective there are a couple of forms of wealth. One is the product of creating significant value through research, innovation, high-risk and subsequently reward. Wealth and value creation through this method generally rewards investors, executives and in a business that is structured well -also creates wealth for its employees.
The second (and shadowy method) is related to transfers of wealth -not creation of value. An example of this would be a $200 million dollar estate that's divided among a couple of heirs. No societal value or innovation occurred -the heirs just receive massive trust funds. While it could be argued that the estate was created through innovation -it's likely that it was accumulated through major advantages such as being subjected to very low tax rates for many years or in the case of some -no taxes at all (much lower rates than a working person would have to pay). In a post-Citizens United America -each generation of wealth becomes more insulated and removed from the hardship and challenge of everyday life. At the same time -they become far more powerful and influential in the political process.
This NY Times article titled "Behind New Obamacare Repeal Vote: ‘Furious’ G.O.P. Donors" helps describe why wealth accumulation (and wealth inequality) is important. If asked, the majority of people in America (whether GOP or Dem voters, conservatives or liberals) would likely say that we need a healthcare system that provides effective patient outcomes, is affordable, provided timely care and left no person without access to care -most people would say "yes, we want that". The challenge would then shift to cost containment and massive system redesign (including Big Pharma and a cultural shift from reactive care to preventative) to provide high quality, cost-effective care for all.
While much of the focus until September 30th will be on the Graham-Cassidy ACA repeal bill (that by all accounts from non-partisan analysis would have disastrous consequences for millions of Americans) there will also begin to be pressure upon "tax reform". There are many obscenely wealthy people dictating these policies to the GOP -so they can save billions of dollars in taxes -and shift the responsibility for our federal budget and national debt to working Americans as well as our impoverished. These serve as important examples of why extreme wealth inequality is antithetical to a representative democracy. When a very small percentage of the privileged few can drive legislation and policy that benefits no one except for themselves -"We the People" are no longer being represented by government. If we study Kansas -we can see the impact of the "Trump/Ryan/McConnell" version of "reform". It's tax cuts that provide massive benefit to their wealthy benefactors, followed by massive deficits -which translate into slashing public education, social safety nets, elderly and youth programs, affordable housing and other vital programs. (Originally posted on https://civ.works)