I was surprised to see these guys advocating all-payer, I thought it had been tried in Maryland and wasn’t all that great. Turns out I misunderstood what Maryland was doing. Maryland does have an all payer system, in which all patients pay the same price regardless of insurance. The ratemaking however is handled by the state, not the hospitals. Presumably that leads to a less dynamic, static system without incentive to innovate. That’s better then totally unregulated providers, but not as good as if they competed on service or price.
Key question: Hospital pricing is regulated, but what about everything else? Outpatient surgery? Imaging? A lot of money get spent in places that aren’t hospitals.