There are definitely benefits to scale, for example, negotiating drug discounts. Single payer creates a single customer that desires to survive politically. It

There are definitely benefits to scale, for example, negotiating drug discounts. Single payer creates a single customer that desires to survive politically. It becomes very easy to manipulate this desire to survive to achieve your own goals. For example, keeping salaries high by artificially restricting supply. Look at the two major components here: https://www.fin.gov.on.ca/en/reformcommission/chapters/ch5.html https://www.fin.gov.on.ca/en/reformcommission/chapters/ch5.h... These are the only two components that can very effectively manipulate the political entities at election time and not surprisingly, they have the most budget attached to it. The per-capita cost is about $2000 but the related taxes are much higher. Add onto that the debt attached to every healthcare dollar, which I last recall was about 30c and it is unsustainable.