You can't seriously be proposing everyone needs to pay twice as much for health care, so support the for profit insurance industry as a make work program?

No. This is not an argument about what should be done. It's an argument about what can be done.

It's hard to pass bills that eliminate people's jobs. Even if their jobs are "make work," they're still incredibly valuable to them.

There aren't enough people who work in health insurance and medical billing to be dispositive, or course. But those folks together with all the union members who don't want to lose their platinum-plated policies, and the retirees who were pretty much certain they were done paying health care taxes, and all the other folks who might be hurt by whatever the specific plans are.

Those folks are the reason we don't have a single-payer system in this country. Not just the insurance companies.

We are already paying for everyone's health care, and paying twice what is really necessary.

And you can't pay half of what we're paying without cutting provider reimbursements. The delta between our expenses and those of other countries isn't entirely, or even mostly, due to the way we pay for health care. We pay double for health costs for the non-elderly adult. We also pay double the health costs for the elderly, even though they are almost entirely covered by a single payer system today:

https://jamanetwork.com/journals/jamanetworkopen/f...

Yep. The U.S. pays $24.6K per capita for people over 65, while the average of comparable high-income countries is about $12.3K. Even with a single payer system.

Which, again, gets us to the main sticking point - you can't pay less for health care without paying less for health care. Paying less to the people who actually provide the health care: cutting the amount of money that goes to hospitals and clinics and diagnostic centers and labs and nursing facilities and everywhere else. There's no way to do this without cutting down the money that flows to all those facilities and institutions and groups. Which means economic pain, closures, job losses, and a host of other things that the people affected will be enraged by. And since people care more about losing something than gaining something, and since large losses on a small population are more keenly expressed in our politics than diffuse benefits to a large population, the wrath of the electorate on the politicos would be even bigger.

Which, again again, is why we don't have single-payer health care. Not because of nefarious insurance companies, but because no one can make the dollars work.