I too would prefer some type of single payer system. But what we're doing now in debating M4A has little place in the actual world because it has no chance of passing in the foreseeable future. There is absolutely zero Pub support for M4A at this time (hell, they're hell bent against the mandate, which was supposed to help control costs), and they control the senate now and will likely control it after 2020. Even if the Dems get it in 2022, we won't have a filibuster proof majority. So the best that we can hope for in the near term is to patch up the ACA and hopefully find some better way to control costs. Dem candidates can savage each other to their hearts content over the next year and a half debating what M4A really means and how much it will cost. It's just not happening in our next president's term. Maybe the best thing about M4A is that we're at least openly talking about a single payer delivery system, which is a baby step in the right direction.
The other thing I'd say is that, until we do finally adopt a single payer system, yes, the insurance industry has a seat at the table. Back in the 70s and 80s when I was a kid, when congress was considering legislation, they'd bring in the groups representing the affected industries and consumers and hold hearings. But 2 years ago, the only group the Pub congress spoke with concerning their proposed legislation was the insurance industry, not the AMA, and AHA or consumer groups. And hell, they even excluded the insurance industry on their last try, and even the insurance industry came out against their last bill because of their block grant to states proposal. So until we're actually proposing to pass some kind of single payer system, yeah, they get a seat at the table along with the AMA, AHA and consumer groups.