So going through your points…

1. As you point out at some point people would have all the health care they could possibly want, but the level of that health includes a lot of unnecessary and at a very high cost. So the impact on your wallet and my would be brutal. Already Medicare considers about just under one third of all health care delivered is unnecessary. Unnecessary is defined as it does not improve the quality or the length of life. Government health care programs tend to be more abused than private health care programs because of how government health care programs are designed. With private health care an insurance company is losing “profit” when the health care system is overused, so they try to prevent that. Government has no equivalent reason and the abuse can be pretty bad. If private health care systems try to “cheat” people of the health care they need, since most employers monitor the quality of care their employees are getting, the change carriers. Every wonder why not a single employer opts for a health care benefit design that looks like government health care?
2. If you charge employers for health care on payroll, then why put their employees on a government program in the first place? Many unions have worked very heard to get benefits including wellness benefits the government does not pay for. This is a key difference between government and private health care. Private health insurance profits by keeping people under their plans healthy and so they try hard to save money by pushing cost effective preventative care which also improves the quality of life. The government operates a very efficient claims paying system. So do you want a health insurer trying to make money off of you by keeping you healthy or one that simply pays the bills when they are presented? Already, one third of seniors have opted to move out of single payer traditional Medicare to private health insurance (Medicare Advantage), each year that percentage has increased for more than 20 years.
3. You are prepared to dig deeper into your paycheck, but clearly most people are not. Three of the most liberal states in this country, California, New York, and Vermont explored single payer at the state level. Everyone was defeated… technically, California past single payer subject to figuring out a payment mechanism. The treasurer came back with the numbers and the Democratic governor, Jerry Brown, said no way. So even in states with huge Democratic majorities, the price tag tends to shock citizens. What sounds nice, just doesn’t translate when it is price out. Ideally, at least one state would figure out how to make single payer work before we screw up the country… Massachusetts did have universal health care before ObamaCare came around, but it was not single payer… it is hard to make single payer work. Instead, Massachusetts had a sliding state subsidy program based on income and people purchased their insurance on an exchange… I lived there at the time… not perfect… but better than ObamaCare.
4. As I mentioned the inherent problem with government health care are three fold. The first as mentioned is the government has no “profit” incentive to keep people healthy or push for innovation to lower costs. As mentioned I was CFO of the largest Medicare contractor. We tried a few times to protect the taxpayer by curbing abuse and promptly got a call from a Congressmen telling us to back off his or her constituents. Government health care is inherently political, this is the second problem. Reimbursement decisions are based on Congress approving fee schedules and billions are spent lobbying to politicians to influence those schedules. The third reason is the government can’t “police” for quality. When I was an executive for a private health insurer we would eliminate physicians from our networks who had bad outcomes. Bad outcomes are bad for patients and they are also expensive since correcting a bad surgery is far more expensive than a good one done once. Under all government programs the political nature of those programs mean any provider willing to accept Medicare or Medicaid reimbursement and properly licensed can participate. The only exclusion are providers who have been found guilty of committing fraud (not abuse)… and even they in many cases reappear in a different corporate guise.
5. The Constitutional issue relates to mandating private insurance. The government can give an entitlement passed by Congress. What taxes it collects to pay for that entitlement is up to Congress. But individuals can even opt out of Medicare, there is no reason to accept “free health care” and many don’t (mostly because they already have health care from somewhere else, that they like better. But that is becoming less common as those “other places” try to avoid providing health insurance to those that are eligible for Medicare.

Here is an article I published on universal health care, you might like…

https://medium.com/@mschund/a-unique-american-solution-to-funding-universal-health-care-2d3f1b4c3ef9

The key is universal health care could be achieved today if we used the strengths of government and private health insurance. Government’s best tools are the ability to set “fair pricing for health care products and services (if you can get Congress out of the price setting process) and private health insurance’s best tools monitoring the usage and quality of care delivered.

Government also has a role to play in funding health care for the poor and those with pre existing conditions. Private health insurance other big advantage is “profit”… profit pushes health insurance companies to keep people healthy and use preventative care to save health care costs. It also pushes them to innovate… step down facilities and surgery centers grew out of the private sector’s desire to reduce hospital costs.

Government is very good at “pure” medical research, the kind that goes on at major medical schools and universities… but the private sector is much better at identifying emerging standards of care that result in better outcomes.

So a private health insurance system where government does what it does best… is the better option if universal health care is the goal.