-Unions with well-run funds could have a reason for opposing single-payer. -Like a lot of other people, if they are happy with their current coverage, -there is less reason to rock the boat for an unknown alternative.
Part of my disaffection from single payer schemes is my experience working on the single payer initiative in California back in 1994 (my then girlfriend was statewide administrative director so I did a lot of work and had an inside view of things). At a certain point in drafting the initiative, the progressives running the show caved in to anti-immigrant sentiment and explicitly excluded undocumented immigrants from the proposed system.
The janitors locals from SEIU basically walked out of the campaign at that point, since their members, including the undocumented folks, had coverage and many of them would have been worse off or completely uninsured under the proposed single payer system.
With ten million undocumented folks, any government-run health care system that doesn't include them will be worse for many of them than the present system. A national health care card could easily become THE national ID system and you better believe that it might even lead to undocumented folks being excluded from emergency rooms for everything other than absolutely life-threatening health care.
Our fragmented health care system has large minuses but unless we fix some of these fundamental inequalities, a more unified system might just unify state attention on excluding more people from what health care is currently available.
Nathan Newman