Imagine Single-Payer Healthcare and what the reaction would be.

[TheKentuckian]

45. That matters little. What we need is universal subsidized access to the exchanges

it hardly matters what options are there if virtually no one can choose.

Then if competition is the idea then we would have to make sure some exists and that can't reasonably be expected without ending the predatory cartel's antitrust exeption.

Seriously, who can delude themselves that an industry allowed by law to collude, set territories, and fix prices is going to be seriously regulated and I think it is foolish at the very best to be working under the assumption that market competition will bring down prices under such an arrangement. That is way beyond wishful thinking.

Then if you are going to have a public option then it can't be handcuffed to death to prevent phony "unfair competition" to the cartel and essentially be for nothing but a coverage ghetto for the cartel to dump "undesirable" into like ours was being turned into before they just killed it completely.

Of course even before any of that an environment has to be in play that doesn't result in the inmates running the asylum. Nothing good is going to come from the industry calling the shots and their lobbyists writing the laws and regulations.
Also, not even a market based approach is going to work when regulators are afraid and vastly out resourced nor can much of anything be accomplished with the first order of business being to not disturb the status quo.