It must be very difficult to do as only every other industrialized country in the world has done it except the U.S.

Almost no other industrialized countries have done a transition from a private system that's grown as large as ours into a public system.

It's easy to project a trillion dollar savings if you cut compensation to providers of medical services, equipment, and drugs by $700 billion. But that's incredibly unlikely to happen under our political system. Or that we would be willing to endure the chaos that would cause among existing providers (particularly ones where there's already access problems, like rural hospitals or obstetric care).

The lesson of the doc fix tells us that we're simply not going to do this under a single-payer system. The nation's doctors, nurses, hospitals, med techs, and other service providers will form the nation's largest special-interest group, dwarfing even the defense contractors or the AARP. And they will it their life's work to make absolutely sure that medical spending never goes down.