This would not be creating another bureaucratic layer. It would be replacing the portion of the system that is currently a private bureaucratic layer (insurance

This would not be creating another bureaucratic layer. It would be replacing the portion of the system that is currently a private bureaucratic layer (insurance companies), and replacing it by expanding (and modifying) the existing governmental bureaucratic layer. If you don't like the switch from private bureaucrats to public bureaucrats then please state that and make your argument why. Don't pretend the private ones don't exist.