jbog,
I have my own opinions on the topic, which lean more towards HSAs and then perhaps group catastrophic insurance, and then focusing on Medicare, but I don't want to create a huge debate on that on these boards.
There certainly are Constitutionallly permissible ways to improve the system without trashing the Constitution in the process to get there.
Frankly this whole Obamacare bill, in my opinion, not only trashes the Consitutional and expands the scope of government to the point where there are practically no limits, but is going to make medicine both more expensive and of lower quality, not to mention what it is going to do to the deficit.
But from here to there we need to get through the legal issues, and then political issues, as clearly the bill is not going to be rescinded with the current make up of the White House and Senate, before we can get back to addressing these issues.
Single payor is one solution that many believe in. I do not believe in that system. The current Obamacare is designed to get us to single payor however, as its entire effect is to diminish competition until you are left with just the government plan, and a few very large private insurers who will be in essence quasi-government agencies. So in the long-run, without doing anything else, if Obamacare survives that is where it will go anyways for all practical purposes.
Tinker