Single payer would be a catastrophe. Why not regionalize health care into pseudo-autonomous ‘Fed’ like regions that provide Insurance. With no Federal money going to or from the general funds of the government.
The only way a state sponsored Insurance program would work is to keep politicians hands off it.
If the Liberals in California who have been chomping at the bit to do Single Payer for decades can’t figure out a way to pay for it, my sense is that NOBODY will figure out a way to pay for it.
May sound good to them on paper, but won’t survive First Contact with reality in a country of 330 million.