Single-payer is the only option anyone in the public has or ever has had. Even the wealthy person who covers himself with two high-cost (read F-22 Raptor) plans will use only one plan.

While there's no way to prevent the wealthy from buying extra coverage, it should be a breeze to make the cost of such purchases non-deductible. Think of it: Every year, this same guy will purchase a new jet, and he can't deduct/withhold from us the cost of a single one of its nuts.

We're all already in a one-payer system. When the wealthy person learns he has an incurable disease, he secures his will instead of investing everything he has in a search for a cure. The wealthy won't spend their own money even to save their own lives.