[tptacek]

The conservative objection to single payer health insurance is that single payer may be a terrible way to achieve cost negotiation. In a system of guaranteed issue private insurance, people could tune their exposure to risk by selecting plans with greater or lower deductibles, and then use HSAs to set up a rolling facility for paying their day-to-day coverage costs.

The fundamentals of the system we're moving towards in the US is actually a conservative plan from the '90s: an exchange-based market for private health insurance coupled with guaranteed issue and a mandate for coverage. That plan was itself a response to the original liberal vision of universal health insurance: nationwide government-run single payer insurance.