M4A may be an attractive goal, but the first goal should getting coverage for all Americans and there are many ways to reach that goal without destroying one system and replacing it with naive idealism.
We are in this health care mess in large part because we gradually removed real insurance and replaced with near full reimbursement for even the most routine expenses. That helped drive up costs and spending and now we have reversed direction by cost shifting via high deductibles and more.
Why does anyone think that removing all cost sharing by the patient under a government run plan will result in a better outcome, especially with accumulated demand by millions of Americans? You simply cannot do that and manage costs unless you employ all the techniques used by insurance companies and governments around the world. If you don’t know what that means, you don’t understand M4A or health care spending.