So the dysfunction and unaffordability of the Affordable Care Act has brought us farther away from single-payer, not closer. The health-care solutions of the future are more and more high-tech, expensive, and personalized, requiring creative payment plans including installments, expanded health savings accounts, or payments that vary according to how well a patient responds to treatment. One-size-fits-all insurance is becoming less useful all the time.

The failures of Obamacare have helped inform both doctors and patients about what we wouldn’t like or want about single-payer coverage: restricted access to doctors and treatments, long waits, underpaid providers, higher taxes.