"If you could figure out a way to pay doctors better and separately fund research … adequately, I could see where a single-payer approach would be the most logical solution,” says Gunn, Sloan-Kettering’s chief operating officer. “It would certainly be a lot more efficient than hospitals like ours having hundreds of people sitting around filling out dozens of different kinds of bills for dozens of insurance companies.” Maybe, but the prospect of overhauling our system this way, displacing all the private insurers and other infrastructure after all these decades, isn’t likely. For there would be one group of losers — and these losers have lots of clout."

A big lesson here is that once you create an industry - no matter how destructive it turns out to be - you cannot easily get rid of it without huge political costs due to the number of people who would wind up unemployed if you got rid of said system/industry (and who would wind up hating your and your political party, which may mean you start losing elections.) Who is going to risk that except for fanatics?