If you could magically wave a wand and instantly replace a multi-trillion industry, maybe. But you can't. And so even the most radical of possible reforms will

If you could magically wave a wand and instantly replace a multi-trillion industry, maybe. But you can't. And so even the most radical of possible reforms will necessarily be incremental. The other part of it is that Americans want mutually exclusive things--low prices and end-of-life services that will spare no expense. In the end any equitable system will have to choose the former, just as every other national system has. However, the people in those systems were never given the choice; their healthcare systems just evolved in that direction decades before modern revolutions in incomprehensibly expensive medical care. So Americans are being forced (by partisan politics) to make a decision no democracy can be reasonably expected to make. The ACA was largely based on Hillary Clinton's 15+ years of footwork. The ACA is based on extensive examinations of foreign healthcare systems. If Democrats can't make the ACA work--because they can't overcome Republican opposition, because they're fickle and have turned their backs on it--then what hope is there of even more radical reforms? I'm not saying single-payer isn't possible in the U.S. It's just not possible now. We'd have to wind our way there. But that's too much of an ask from our modern politics. The ACA could have been a stepping stone, instead leftist and populist Democrats just want to chuck it and start over, ignoring the fact that they'd be facing all the same impediments and problems of the ACA and a whole lot more, yet without any better answers. "Other people do it" isn't an answer. Can I expect you to become a Warren Buffet or Bill Gates merely because they and you both exist? It's a non sequitur. You can't simply ignore path dependencies.