I think the key to making government-insured health care work is through a transition by consumer demand.   McCain was right about moving health care benefits away from employer-sponsored plans:  give tax breaks/credits to those that do move away from employment based insurance.  BUT:  this will then raise premiums for people with pre-existing conditions or ill health that are dependent on current plans.

To compensate for this, the government  should create a baseline guide for insurance encompassing premiums/deductibles/co-pays.  Those with shitty primary plans that fail to meet the all of the criteria, will qualify for a cheap, single-payer co-pay assistance plan as secondary insurance insurance.  Those that have this co-pay assistance will, after one year, qualify for a premium deduction for a Medicare buy-in.

It will keep primary, private insurance costs in check, and fix the problem of people feeling like they don’t have a choice.