Wishes, to be contrasted with likely reality.
I saw several statements by Dr. Claudia Fegan that are worth questioning.
Fegan "A plan that enriches insurers with hundreds of billions of taxpayers’ dollars – and empowers them to impose draconian restrictions on patients – is not OK."
-- Questions: the insurers aren't, in net, getting tax dollars. And the compelled premiums and the refusal or inability of so many to pay those compelled premiums compared to costs haven't been profitable. This is why United, Blue Cross/Shield, Humana, Anthem and more have pulled out of so many markets. They were losing money, not getting enriched.
-- Back when it was adopted someone I correspond with wrote that the Obama exchanges would "lower market barriers, large numbers of new insurers would compete for our business and premiums would go down." It hasn't worked out that way; instead the opposite.
Fegan "For what we’re now spending we could have Canada deluxe: a free choice of any doctor and any hospital, and no co-payments or deductibles, like they have; but without the waits for high-tech specialty care that some Canadians experience."
-- I have met a lot of veterans who like the nearby Veteran's Hospital, but that still doesn't explain the mysterious hidden VA wait lists that were all the scandal a few years back, and apparently haven't been fixed....
Fegan "Under the ACA, each year millions of patients must navigate a bureaucratic thicket of insurance exchanges that offer thousands of plans with opaque and varying coverage restrictions."
-- Potentially an incomplete comparison. How does now and prospective compare with private coverage health insurance shopping before PPACA?
Fegan "But the costs of that care would be fully offset by huge savings on bureaucracy and drugs."
-- The historic record runs the other way, as reported by Dr. Max Gammon regarding the British NHS and by others regarding the NHS and other systems. A key relevant question: Did switching to a Single Payer system lower the costs of any country from what they had been? Are those other countries lower cost than us because they price-fixed at an earlier point? Why should we think that an American single-payer system would lower reported costs of $10K / person here to the $5K reported in Europe?
Fegan "Cutting out the insurance company middlemen would save hundreds of billions on their overhead and profits, and even more on the paperwork they impose on doctors and hospitals."
-- Overhead is spent some on marketing and some on preventing fraud. Every business in almost every industry knows that overhead is a cost and seeks to reduce it. In contrast, historic experience is that governments don't control their own overhead. And it is documented that Medicare and Medicaid have serious waste fraud and abuse issues and money down the drain.
Enough. I could perhaps put more paragraphs here, but ... enough.
The first problem with Single Payer is that it is a 'one size for everyone' system, where there is a hierarchy of pleasing, with customers at the bottom, and the system more likely to please doctors, clinic operators, hospital administrators, system administrators appointed by the government and politicians and political hacks ahead of customers and patients. The first problem with the old system is the inequality obtained according to ability or inability to pay, that offended many people, some of whom weren't willing to pay for it themselves. The horns of a dilemma and hard to resolve. (We may have been better off when everyone was more equally impoverished )