I don’t think it is quite that easy. I think what is going to happen is that we are probably going to get down to about three or four insurance carriers - Aetna, Blue Cross, United Healthcare and maybe Cigna. Aetna has just merged with Coventry, Cigna and Great West have joined forces, United keeps taking over a larger share of the market, including handling claims for a huge group of military recipients who were covered by Tricare. And, of course, you have AARP which is also part of United Healthcare. Blue Cross is in every state. Will all the Blue Cross plans merge? Who knows. But I do believe that at least three of these carriers are setting themselves up to be in a position to handle a single payor system and most likely United for everything except Federal employees who will remain with Blue Cross and School Districts who will remain with Aetna.
Doctors getting out of networks, refusing to take any insurance and a basic lack of providers is also going to play into this scenario. OTOH, medical care may end up being like it was when I was growing up a long time ago and people didn’t go to the doctor unless they really were ill.
But that essentially is what already exists no. Coventry was just purchased by Aetna. Kaiser is the largest insurer in the state, followed by Anthem Blue Cross, Blue Shield, and Health Net. Health Net lets all of it's over 65 business get run by United Health Care which is already the provider for all the plans offered by AARP. The state has driven out almost every other insurer.
Cigna and Great West are very small providers here and the vast majority is controlled by the big players. When the end comes for private health insurance in the state, it will probably be run by a combination of the large insurers who already have a bureaucracy in place to do so. They allow them to administrate the system until a state run infrastructure can be created.
The joke is that it all may collapse of its own weight and the private insurance companies will be invited back to pick up the slack. Then we will have the two tiered coverage most of the socialized world has. Crap coverage for the average man, and private coverage if you have money or clout. Bleh