I completely agree. However, when I try to discuss it with anyone who objects with “How will we pay for it?” I find that they flip their lid when I respond with, “It will pay for itself.” And to be fair, usually anything that uses that line is full of poop.
What I like to point out is that, even if it is cost neutral, the current level of care (which they usually insist is “teh Bestest”) can be covered by a single-payer system by simply shifting the amount individuals and employers currently pay for private health care from private insurers to taxes, 1:1, then also add the savings of the 15% or so that goes toward all the people who will be put out of work in the private health insurance industry (or we can just keep paying them, to pick up the administrative gap) and the profit of that industry.
It used to be that there was a pretty big number of uninsured people who would represent an increase in coverage that would have to be picked up by universal single-payer, but that’s pretty much gone away with the ACA. If, however, universal single-payer does increase the coverage pool, that increase in coverage would be paid for by 1. the afore-mentioned profit zone of the private health insurance industry, and/or 2. relatively minor increases in taxes to the wealthiest Americans, if needed. Frankly, if that’s needed at all, it would be simple enough to just eliminate the cap in Medicare taxation limits, which are pretty low.
Any improvements in efficiency or costs would just be frosting. As you pointed out, once the system equilibrates to the standard efficiency demonstrated in other single-payer systems, there should be more frosting than cake.
