"i still see you as willing to trust insurance companies to handle bargaining. while im not crazy about regulations, I think that is the only way I would allow insurance in the ring again, since they have proven themselves duplicitous."

The only way one can trust insurance companies to handle bargaining is if they can compete across state lines. By allowing this, you enable the patient to vote with their dollars. In that scenario, people will soon begin to migrate to the greener pastures, i.e., they will switch to the insurance company that provides the best benefits at the most affordable rates.

This natural competition compels these companies to bargain well and thrive by gaining new customers as a reward for good and healthy business practices. If they don't, they'll end up going out of business. Single payer will still be an insurance company. The only difference is that all other competitors will be eliminated, and the government will be in charge of running it.

If people are forced to pay for a single payer plan, and there is no competition between entities, there will be no motivating factor inspiring the government to create, innovate, and get good. Just look at the progress in the commercial space industry in comparison to NASA. NASA is run by the government, and it's essentially a massive money sink.

Now compare that to the likes of Elon Musk and Richard Branson, how come they can exceed further and faster than our government? It's because they have the ambition and drive, their ass is on the line with every move they make. There is passion behind it, the passion and will to succeed. A government single payer plan is akin to a roundup ready plant that should have died the moment it started soaking up the glyphosate, and we will be the shmuck's charged with eating the poisonous food.

"Insurance companies are still, at the end of the day, a business, which is all about profit. Ethically I feel like profit has no place in health care. Salaries and costs paid, ok, but a business whose end game is making shareholders rich and upholding doctors and pharmas exorbitant fees - thats not about taking care of people, its taking care of the players. that needs to be taken out of the equation."

Government is also a business. The United States is a Federal Corporation. Every act of foreign and probably domestic policy as well, is geared towards making a profit. Many of these profits are raked back in the form of the income tax to pay our owners, the Federal Reserve Bank, another corporation who is neither Federal nor holds any substantial reserves. Their shareholders are private, and thus there is no way to hold them accountable as far as I know. That's the result of one monopoly, the monopoly on the nation's currency. Realistically if you want to take the profit out of health care, you have to convince college-aged students to go to school for 8-12 years and become a doctor in exchange for mediocre pay. So although I will agree that prices are ridiculous and out of hand, most of this can be attributed to existing regulations which prevent competition among the many States.

"While single payer may have issues, the benefits imho outweigh the issues we have now. Single payer emphasizes prevention and makes the patient somewhat responsible for their own day to day care. You seem to be under the illusion that without competition there is no advancement or improvement. I disagree. I think the only way to improve is to throw out "for profit" motivation and concentrate on efficiency and education. Keeping citizens dependent and beholden to a system that is profit motivated does them no favors."

I agree that the system would be far more desirable if it were not profit motivated. However, the problem with that, is how does one lure people into becoming doctors and nurses if the pay vs. time investment ratio is not on par with each other? Generally speaking the longer you have to school for occupation the larger the payday you'll have and the more expensive the class will be.

"I would rather wait a month for an appointment (I usually wait 2-3 weeks anyway) and have the peace of mind knowing that I can afford what I need to function physically. Right now, that isn't the case and as time goes on, I don't see the free market making it any more affordable. Rather I see free market leading to monopolies and putting independent doctors out of business."

I've heard some real horror stories about the system in Canada and the UK, people waiting for months on end or receiving substandard care when they finally are seen. You said you don't see the free market making it any more affordable. I guess that's what my point is, what you are witnessing in America today is not a free market, it's not a free market because the various insurance companies are not allowed to compete for each other's customers and therefore customers are left with only an option between one or two providers, essentially a monopoly or close to it. You might find some more insights on the topic here.