Obviously, those of us that want Single Payer did not get our pony.
Not yet anyway.
I believe that we have taken a step on the road to it.
But it's not what I hear so many of my compatriots voicing.
Medicare Vs Medicaid.
The mantra on the Left (and I have said this myself countless times) has been "MediCare for All". It's not a bad idea, but it has problems.
The phase-in for a M4A system would be to gradually lower the eligibility age, adding more, older people to the system and commensurately, increasing the cost of that system. That cost would be borne by younger workers from their wage withholding, while they don't benefit from it for decades. And I don't doubt that younger workers can see the value of paying in to a system that helps their aging family members, but the potential for a propaganda campaign to make this a wedge issue is massive.
Plus, not all MediCare recipients are poor or even middleclass. That's what keeps it safe from class warfare but it means that it's not focused on helping those who are most in need.
As far as I can see, the problem with providing healthcare to everyone is better addressed on an economic foundation than an age one.
Try MedicAid for All!
The phase in for this would be to increase the eligibility by incrementally increasing the percentage of Federal Poverty Level. Currently, the ACA makes people 138% of FPL ($10,830 for a single, $22K for a family of 4) eligible. That includes young workers and old people in need and everyone in between that is struggling financially.
By adding more young people to the rolls, the system expands, it's economy of scale is increased and it's costs are not as rapidly accelerated as they would be with MediCare for All.
What I would propose is that MedicAid eligibility be increased to 200% FPL then 500% over a couple years. Then expanded once again by allowing anyone who wants, to buy in to the system. The cost of the Topper would be considerably less than the cost of 4P insurance.
Increasing the size of an already smoothly functional system, with high efficiency, would overwhelm the resistance to MedicAid patients by Doctors and Hospitals, because refusing them, eventually, leads to having no clients.
It overwhelms resistance by young workers because it is accessible to them right away.
MedicAid for All will still be a pinata for the Greeeds, anything that helps poor people survive is against their "principles". But this gets us to Single Payer and does so without becoming a generational warfare issue.