I think the #1 problem is that we don't know what the problem is.
We've had studies by doctors, like the AMA and New England Journal of Medicine identifying why our costs are so high yet no one pays it any attention. Those reasons never entered the political debate AFAIK. If you don't correctly identify the problem(s) you can't fix it/them. (Reminds me of my sig.)
We often hear of other countries' HC system, yet I've seen no real discussion of why their system is capable of providing HC for less. Hint: it isn't about whose name is listed as payer on the check (i.e., "single payer").
Now, it may be that some yelling "single payer" know the 'score', but don't want to discuss it for fear of people freaking out etc and rejecting it. A real "single payer" system comes with a bunch of substantial changes that I bet people won't accept and couldn't be implemented with out great upheaval to our HC system and economy even if they would.
Fern
I think people may accept it if it means somebody else pays all the costs. We're rapidly losing the ability and inclination to stand on our own two feet, and I think worse care without ant non-hidden costs would appeal to a lot of people.
You're alluding to one of the 'ugly secrets' of single payer, no?
If we go single payer price fixing, along with other elements of single payer likely to be hugely unpopular among many people, will have to be implemented. I predict a shortage of HC providers as they flood out of the profession or are forced out due to bankruptcy. This will likely also result in a bailout: the govt's go-to solution when they screw something up big time.
Fern
A temporary shortage followed by a general lowering of quality. Right now many of our best and brightest go into medicine, although that's changing as doctors more and more are advising their children and grandchildren not to go into medicine. The absolute worst case would be we keep our ability to sue but go to single payer, so that doctors stand to top out at a hundred grand or so but the lawyers stand to make millions suing them. But government can always find warm bodies to be doctors by relaxing requirements for foreign doctors to come here and practice, by subsidizing college and medical school costs, and by mandating lower standards. That's what happened in the UK, where they not only have a shortage of doctors but have comparatively few native-born doctors.
Lol. Look at the percentage of GDP spent on health care and the outcomes. Then come back and argue against efficiency some more.
Conservatives are only against waste in government if it's spent on things they don't like. They are totally fine with ideologically compatible waste. Makes you wonder which part of the equation they are actually against, eh?
If you think our higher costs are purely inefficiency due to not being government-run then obviously thinking is not your strong point. We also have more and better doctors, far more specialists, more and generally much better diagnostic equipment, much more access to specialists and advanced diagnostic equipment, and much more drug research and development.