The alternative is a national Single Payer system where competition is negotiated in advance of any patients having a need (based on the historic rates of and future projections of patient needs).

You do this by making 'basic insurance' something everyone has, and a negotiating pool that more or less dutch-auctions per market with the practitioners. You might also include quality control measures like allowing patients to see any doctor they prefer from within the list (of doctors that met the group bid rate), and also allowing criminal mal-practice but not financial liability as a means of stripping titles from those who should not practice medicine. (The liability would be implicitly recognized as social; no big payout, but what life there is that is left you would be some degree of retired.)

I would love Single Payer, but you know as well as I do that it won't be on the table for some time.

No, the alternative is not to double down on madness. The alternative is to stop regulating healthcare out of existence while giving free handouts to billionaires.