The key to the system is to have decentralized providers, and price sensitive consumers, when it comes to medical care, with care for everyone at some level within that system. But it will cost more money, and the dirty little truth, is that giving everyone the best medical care available, particularly the aged, will grow ever more horrifically expensive, and is unsustainable. In the end, there will be triage, one way or the other. We can at least stop American drug consumers subsidizing drug research for the planet, but that too is just a palliative -- helpful but not dispositive of anything.
employer provided health plans are already moving to making the recipients more "price sensitive" to low level care through higher deductibles and co-pays - but there is a limit to which that works with health care - a sick person wants care, they don't want to shop their MRI or open heart surgery like buying a car. that's just the reality of life.
if the employer provided system collapses - there will be a consensus amongst americans for universal medicare. the Dems will promise to fund it by "taxing the rich", and americans who fear the loss or dilution of their employer provided plan, will be more then willing to hand them their votes.