Health Care: the Big Picture

So I haven't really been following the Health Care Reform debate very much because it's feels like conflicts in the Middle East: it's been going on forever, and I don't really know the underlying issues behind the problem nor do I know the parties involved.

However, Robert Reich has a good summary of the history of the debate and where we stand now, which is that "moderate" Democrats in the Senate are fighting to remove any single-payer feature out of any reform bill (ostensibly to assist their wealthy doners in the insurance industry). He writes:

First there was Medicare for all 300 million of us. But that was a non-starter because private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it was too much like what they have up in Canada -- which, by the way, cost Canadians only 10 percent of their GDP and covers every Canadian. (Our current system of private for-profit insurers costs 16 percent of GDP and leaves out 45 million people.)

So the compromise was to give all Americans the option of buying into a "Medicare-like plan" that competed with private insurers. Who could be against freedom of choice? Fully 70 percent of Americans polled supported the idea. Open to all Americans, such a plan would have the scale and authority to negotiate low prices with drug companies and other providers, and force private insurers to provide better service at lower costs. But private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it would end up too much like what they have up in Canada.

So the compromise was to give the public option only to Americans who wouldn't be covered either by their employers or by Medicaid. And give them coverage pegged to Medicare rates. But private insurers and ... you know the rest.
...
what more can possibly be compromised? Take away the word "public?" Make it available to only twelve people?