Good analysis. The Ds' measure of ideological purity prevented a single-payer system, from what I heard, which was that at least one Senator, Lieberman from CT, was the reason why a single-payer system wasn't created. So, instead, we got a watered-down health care plan that didn't have enough cost control, e.g. buying prescription drugs from Canada, competition across state lines, malpractice reform, standardizing coverages for all health plans (vs. tens of thousands of variations, which costs tens of million$ to administer).

Another mistake: if the ACA collapses as the Rs think it will, that the blame will go to the Ds. Instead, it will be the party in power, the Rs (who control the House, the Senate, and the presidency), who will get blamed for not doing something. The collapse of TrumpCare is probably a positive for the Rs in the short term, as many of the president's supporters won't realize that they were about to get hit with the higher premiums.