I find the distinction between the administration of health care and the payment for the administration of health care impacts the patient just the same.

I'm not clear how a distinction can impact the same?

But where is lies at the moment:  All of the control of access is in the hands of the private insurance industry (unless a person has oodles of his own money) who make the decisions, the decisions propelled by profit.  When it comes to health care, just like in a time of war, decisions to safeguard and protect, should not be propelled by profit.  The emphasis is, of course, to have a health care program be cost effective and self-sustaining as a goal.  Leave the "profit" to the private sector medical community who would be involved with a one-payer or public option, and would be negotiating with them, as well as negotiating with the private insurers.  The private insurers will have to compete.  And some of their profits will diminish.  A CEO who gets 50 million a year, may have to settle for 500 thousand a year. 

The result?  Fairness.  Health care for the sick.  Preventive medicine.  An end to extreme anxiety about becoming ill.  Right now, medical bills account for upwards of 70% of personal bankruptcies.  Right now, a person who loses a job, lose insurance, not only for him or herself, but for their children.  Right now, a pre-existing condition will not be insured.  On and on.

With America 37th in the world in health care, it's time for US to get onboard with the rest of the industrialized nations concerning universal health care.  Why are we content to pay twice as much per person, but are sicker and die younger (47th in life expectancy), and are ranked 41st in infant mortality?  What kind of bang for the buck is that?

the bruce:    Just more middle men to pay off and to  separate you from the service your trying to get. In short what does it matter.

No, with a one-payer system or public option, the middle men diminish.  For example, those on Medicare seldom if ever have to go through a gauntlet of middlemen.  For most, they just show up for their appointments, show their Medicare card, and that's it......both the medical community and the Medicare option know the ropes, unlike a medical community having to communicate with a ton of different private insurers with different guidelines, etc.