In his post at The Hill after noting that properly reckoned Medicare administrative costs aren’t that cheap, Charlie Katabi gets to the crux of the problem:
If Congress can’t muster the votes to slow the spending of a single health program, why would single-payer advocates assume they could enact a whopping 40 percent pay cut across America’s entire health care system? If Sanders’ plan was ever enacted into law, interest groups would ensure they continue to receive high compensation from the new single-payer plan, which will increase costs even further.
That’s basically what I’ve been complaining about for the last two decades. I realize how appealing grand solutions are but you don’t solve a difficult problem by making it intractable which is what M4A would do.
Rather than searching for grand solutions why not approach reducing health care costs like the old wisecrack about eating an elephant. Take it one bite at a time. Let Congress take one government program and reduce its costs. Choose a small one. My guess is that they don’t have the stomach for it.