Your arguments against single payer are not convincing, Charles.  You say that controlling costs is the only long-term solution, and I certainly can't argue with that.  There needs to rational controls on specialist physician and hospital billing (and that includes non-profits, which appear to be equally capable of price gouging as for profit providers), control of pharmaceutical and medical equipment costs and some control of the cost of litigation in health care.  Conservatives, though, need to come to grips with the fact that we do not have a free market based health care system in the U.S. now, haven't for many decades, and will almost certainly never have it again.  Rather than arguing that repealing ACA will allow the free market to work (which is ridiculous, because the loss of free market controls in health care predated ACA by many decades) They need to think about what mechanisms CAN enforce cost controls. I believe that can only be achieved through a single payer system.