[jkingsbery]

I definitely see where you're coming from, in terms of this being a worthy goal. But I think there are a lot of challenges:

* While a government system could cut out administrative paperwork, that doesn't mean they always do. Many government agencies have a lot more paperwork than their private equivalents.

* Negotiations are tricky things. On the one hand, negotiating for a lower price is great, because it means you save money. On the other hand, it also means you are paying a lower price, and that can come with a different set of consequences. Yes, loss of jobs as you indicate, but also potentially less supply of health care. The fact that government is the negotiator doesn't mean that the effect of supply and demand gets suspended.

* I haven't read deeply in the area, but everything I have read indicates that this comes at the expense of wait times. I think, for example, I heard the stat recently that the average wait time for an orthopedist in Canada is 22 weeks.

* I get the moral argument that we should provide care, but I think the single payer raises other moral issues. If the goal is that if a doctor and patient agree on a particular treatment, it's evidently not the case that in socialist medicine that's enough for it to happen (see e.g., https://www.independent.co.uk/news/health/nhs-rations-operat... ).