I think it should be a single payer system. I fight with insurance companies every day to get services approved and denials overturned. I watched a documentary called Fix It Healthcare At The Tipping Point and the money spent on administrative cost is 30-35% of health care cost. Going to a single payer system would bring that down to 3-5%. I live in a state that did not expand Medicaid under ACA and if you make less than $12,000 a year you can't get insurance on the health care exchange. When filling out the application income under $12,000 is supposed to qualify you for Medicaid but in the states that did not expand you can't get it. The health care exchange plans offered in our state by one company have monthly premiums of over $500.00 if you don't qualify for a subsidy. And these plans are high deductible in addition to high monthly premiums. I encourage everyone to watch the documentary Fix It Healthcare At The Tipping Point.