Single-payer healthcare is my hot-button issue since my wife's diagnosis of cancer and the subsequent draining of a lifetime of savings we managed to accumulate. She was diagnosed with pancreatic cancer and given 3 months to live in 2007. A new pharmaceutical treatment was her only chance of extending that, but the cost was $5k per month for just the pills, not including Dr or hospital costs.
The treatment stretched her life by 2 extra years and I wouldn't trade a minute of that for all the money back, but I had to remortgage the home we built and go through all of the savings we had worked our lifetimes for. The economic crash and the extended unemployment benefits from that allowed me to spend most of that time with her and we did make the best we could of a terrible situation. I also had a lot of time to research our healthcare system and those of other countries. I was shocked to learn many of the things I discovered.
1) The US government already pays enough in healthcare costs to fund healthcare in almost any other country per capita. This includes Medicare, Medicaid, VA, and various contributions made to private insurance for federal and state workers. In other words, we are paying almost twice for single-payer benefits but simply aren't getting them.
2) That means that "ALL" other payments to insurance plus any deductibles and co-pays paid to providers is "UP AND ABOVE" what we should expect to pay for single-payer. This doesn't, however, suggest that insurance is that profitable. It is simply that costly, including the extra cost to providers who must hire and train more staff to deal with insurance than they do to deal with patients in many instances.
This means that single-payer healthcare would result, at least in the short term, in a deflationary event losing up to a million jobs in the private sector. Some of those could be picked up by the government sector to handle the workload, but not enough to matter.
Others could be slotted into filling some healthcare positions that would be created by increased demand in some portions of the system, but many of those would be filled by shuffling workers between existing departments as clinics would take up a lot of first patient contact now done in ER's, the most expensive place in the world to diagnose and treat minor illnesses.
For workers with fewer than 5 years left before retirement that isn't fit into the new system, it would be more cost-effective to fund their early retirement than to train them in new fields, or they could be offered opportunities to perform public service in their communities as part of a guaranteed job program kickoff that could end involuntary unemployment as a way of fighting inflation.
3) I also learned much about our economic system and that the worst possible thing we could do to initiate a single-payer system would be to attempt to "pay for" it with added revenue in the government sector. You simply don't pay for a deflationary event in the economy by depleting more monetary assets from the private sector, unless you want to start a serious recession in the process.
However, anytime you discuss single-payer with even a liberal/progressive politician they immediately jump into the funding and how it would be paid for. In doing so, as with any benefit suggestion for the private sector provided by the federal government, they take on two battles. One to justify the program and another to gain "funding" when the only thing needed to fund anything at the federal level is votes in Congress.
With the strongest sovereign fiat currency on earth in unlimited supply to them, they are not made any more able to "fund" any program by gaining revenue from any source. There simply is no "infinity+1" in math, but politicians are used to equating all things to the processes voters are familiar with. Few voters are familiar with the ability to spend for their necessities and other items with only inflation to worry about.
Our obstacles in providing universal single-payer healthcare to all citizens will be somewhat daunting at first. These will only be made worse if we insist on "paying for" it, regardless of how we might feel about that. There may be a case made for charging some a premium if they currently pay above the average for insurance, but that should be approached as inflation control, not the funding of the benefits.
