the reason big health (providers, big pharma, insurers) generally support government mandated insurance (individual, employer) is because mandates are bastardized, multi-payer versions of single payer that preserve their current status in the system to recover gross, unnecessary, additional cost extracted from consumers - the part that real single payer eliminates when it cuts cost in half
mandates put the focus on risk pooling and take it off overpricing, overspending and overtaxing, under a ruse that if everyone could just be forced into a risk pool, costs would decline - they won't, they didn't under Massachusetts reform, because risk pooling per se is not the problem
private health insurance essentially destroyed the concept of risk pooling by concentrating low risk in its favor, scaling premiums in proportion to provider payouts and most egregious - denying coverage once it was seriously used, through contracts designed to change most or all terms and conditions at will, even retroactively
the result is non-catastrophic health care grossly overpriced with the addition of an insurance component, and catastrophic insurance - the part for which insurance is supposed to be designed - is little more than a las vegas crap game of chance - for anything serious, no one knows anymore what will be covered or how much until after the fact - it's designed that way
health providers participated in the problem by throwing everything they had for treatment, particularly high-cost high-tech procedures, at anyone who managed to get past the front door - once inside, the patient was a mark for the parasitic health care mob of big health to extract mountains of cash over and above that necessary to cover cost of necessary treatment, depending heavily on insurance as a bill collector
today, an American can have a health emergency and even if a false alarm, in 24 hours see a bill that could constitute financial ruin for years, insured or not - it's the flip side of what private insurers do - instead of denying service, providers throw everything against the wall to see what sticks for payment, whether from insurers or patients
mandated private insurance does little or nothing to correct these failures, because they're largely irrelevant to risk pooling, while true single payer, a mandate by definition, strips out the massive market failure of private insurance and replaces it with successful risk pooling, while replacing grossly overpriced premiums with taxes
what's left is excess provider cost, whether by overpricing or overspending, and true single payer without private insurance has demonstrated proven solutions for the problem of excess-cost providers, which are no more "socialist" than the use of competing private contractors by all levels of government to supply most any good or service
since true single payer has been taken off the table, its bastardized sibling - mandated multi-payer - should be buried under the table - the only added value it has is negative - either have true single payer or don't have it at all, and allow consumers the freedom to deal on their own with obscene overcharges from providers, without adding insult and injury of useless, mandated payments to private insurance
