Instead of passing Obamacare several years ago, what if we had just kept everything the same as it was and instituted a policy of Medicare for all who had pre-existing conditions that met certain criteria? Premiums would have decreased for everyone who did not have pre-existing conditions and those with the conditions would have Medicare. The government would have been picking up the tab of many expenses but they wound up picking up the tab regarding Obamacare subsidies for all anyway.
Medicare-For-All, single payer, public option, all of these were initially discussed and were presented as a larger part of the effort toward healthcare reform, but all were shot down. So all we were left with was pretty much what constitutes the ACA as it is today, which I admit is flawed.
A public option would have gone a long way toward correcting a lot of those flaws, and so would a Medicare-For-All approach for a selected risk group.
None of these, by the way, amount to "socialized medicine", where a government builds and operates clinics and hospitals, because all of these options would use the existing infrastructure, doctors, clinics and hospitals, that we currently have today.
It doesn't amount to "the government getting into the health care business", it amounts to the government being a client of the health care business, which to some extent, it always has been to a greater or lesser extent for much of the modern era.
You made some excellent, and moderate, points in your above statement and I find myself in agreement, but unfortunately, as you've probably heard, there is a saying: "You don't want to know how the sausage gets made."
Well, we got "sausage", because by the time the excised bill went to the House and Senate, the insurance lobbies took it up and baked what they wanted into the bill instead.
I would like to believe that, if we can put aside a great deal of the current tribalism and have both sides work together, we can get something accomplished that meets the generalities you expressed. Of course, that has been the desire of many Americans on both sides all along anyway, down through successive administrations.
This is going to require everyone to put aside the squabbling and accusations over past history. The ACA eliminated some egregious issues but it created some new ones. But rather than trying to repeal it, we should try FIXING it instead. A Medicare-For-All option, or a public option, could be ADDED to the existing system.
The existing system could even perhaps transition to a dual tier single payer system, with elective procedures covered by free market policies, or "gap coverage", and basic health care covered by single payer.
Any number of a wide variety of approaches can be considered.
Personally, if we enact a Medicare-For-All system for selected risk pools, I happen to think it will cure a multitude of sins.
