Adam, I agree with you--the single payor should be the patient, at least in primary care. We have seen what a 3rd party single payor system in the US would look like (See: Medicare & Medicaid) and this would be pretty bad for physicians. And alot of patients won't like that either--unless they can pay for extra services. But usually when you have a single system run by the gov't, they refuse to allow competition so you HAVE to take it. I will never advocate such a system in the US unless doctors also have the right to directly charge the patient for the "gap" between their fee and the reimbursement (at least or primary care).
