How would Medicare for All Work? Medicare today is viable because people have paid 30+ years into

[graeme_macquarrie]

71. Medicare has been "contracted out" since day 1..

That's because the federal government was incapable of developing the enrollment, claims processing operations and claims payment functions in time to roll out the program in 1966. That was under a Democratic administration. Enrollment, premium collection and other functions went to SSA, the claims and payment functions went to Blue Cross and Blue Shield plans across the nation.
It has remained contracted out since then under both parties budgets because of capabilities and expertise, not some nefarious motive.
Private health insurance employees do not determine who does or does not receive care. Health insurance payments are made retrospectively after care is provided and billed. Insurance company employees don't walk into a hospital or doctor's office and prevent you from receiving care.
Insurance is a shared risk product. It is a contract to provide payment for costs if certain events occur. If a health insurance company violates that contract you can legally enforce it. People constantly confuse the provision of a healthcare service with the payment for such services.
If a health care provider, physician or hospital, refuses to provide treatment because of a patient's inability to pay, that is not a private health insurance issue, but one much deeper.

Blue Cross and Blue Shield plans are chartered by state, so the question that Governor Rendell should have asked is how many billions is the plan paying out in claims and how many days or months, or years of claims payments do those reserves represent? Generally, if the insurance regulators in the state determine they are excessive, premium reductions or refunds are ordered. Did that happen or was this another political sound bite?

By the way my experience was not just in "private health insurance"
I worked for and with:
Medicare Intermediaries and carriers;
Medicaid Fiscal Agents;
State Medicaid agencies;
HHS (HCFA);
Indian Health Services;
Federal Employees Program, (federal government employee health program)

My perspective is much broader than working in the industry- I've been both sides of the issues for more than 20 years of my career.
Left to do other things that made me happier.
You could end all private insurance and government payment programs tomorrow, and it would not change your ability to obtain healthcare. The infrastructure and professionals to provide those services still exist
What is the key component that might be missing? Hint it's a nearly $4 trillion dollar industry.....