The insurance company have a contract that typically requires them to provide whatever treatments are available for a medical problem and are not experimental.

The insurance company have a contract that typically requires them to provide whatever treatments are available for a medical problem and are not experimental. It's competition in the insurance space that creates such a large market for pharma and other medical companies to bring products to market. If you had a monopsony (single-payer healthcare), where the only buyer is the US government, then the only treatments available are those it has approved via bureaucratic process. Nothing about single-payer healthcare prevents private options from existing per se, but so many people will go without private insurance, greatly reducing the market for medical innovations and shrinking the size of the R&D market. Take a look at these graphs: https://www.quora.com/Which-country-develops-the-most-effective-drugs https://www.quora.com/Which-country-develops-the-most-effect... Single payer healthcare will dramatically shrink the US contribution to medical innovations. In a way, the US healthcare system is socialized medicine that benefits the other 7.2 billion people on this planet at the expense of the 40 million uninsured people in the US. This is a trolley problem. The WHO publishes a list of essential medicines. http://www.who.int/medicines/services/essmedicines_def/en/ http://www.who.int/medicines/services/essmedicines_def/en/ 96 new pharmaceuticals were developed since the list was first published in 1977. There are 306 today, so 31 percent of essential medicines have been developed in just the past 40 years. How many of those 96 were developed in the US? How many fewer would we have developed under single-payer healthcare? It's possible that we still develop as many medicines under single payer healthcare, but simple economics suggest that's unlikely enough that we really want to be sure it won't decimate the R&D market for new drugs because that is what is at risk here, if we are wrong. Are you willing to take the gamble of depriving your future self and the other 7.5 billion people on the planet of the medical innovations we'll lose without the US system. Once you hand people single-payer healthcare, there is no way politically to go back.