The Establishment doesn’t want citizens to know that single payer would actually work and be cheaper. As long as Big Insurance is an enormously profitable industry in the US, just like Defense is, there is no real motivation by the powers-that-be to get rid of the health care system we have now. After all, the ACA wasn’t permitted approval until the insurance moguls got their piece of the pie. And Ms. Clinton has a practical and emotional investment in keeping the ACA.
The real obstacle to single-payer in this country is what to do with all the people who work in the insurance industry if it pretty much gets eliminated. And there will be elitist hangers-on who want a “higher” level of care by paying private medicine for their services. I live in a Midwestern city that sustains itself partly from insurance employers. It’s not going to be easy to change that, and it will be divisive.
But fact is, we cannot go on this way, subsidizing the insurance industry with artificially inflated medical costs that are devastating for the economically compromised (a class growing as we speak). Paying decent salaries to workers transferring from the insurance industry to federal (and state?) employment is essential. There will be others in the insurance industry who would be unnecessary in a single payer system and will have to find new jobs. And quite a battle with the top echelon making obscene profits currently.
That should not stop us. We must attack this problem or insurance will only become more bloated and unworkable with time, and we will continue to be slaves to an unbalanced system of feral capitalism that eventually will lead us into feudalism.