People forget about these unintended consequences. We have to make these changes more slowly. Start by passing legislation to cap cost increases so the job losses and valuations fall more slowly.

We also need to revisit end of life care. I see so many commercials for drugs that offer 9 months of life vs 6 months of life for existing treatments and there is little to say the quality of life is maintained. We can't afford to spend $100Ks for elder people with some kind of aging related cancer to have 3 extra months in hospice care. People can buy with their own saving but we need to unburden the system.

Assuming that it were to happen all at once, yes. But instituting these types of changes would probably take the better part of a decade, or at least several years to phase in.

Based on my understanding, that contraction in the pharmaceutical industry would put money back in the hands of the middle to lower income brackets who are currently impacted most. And given that the velocity of that money is higher for them than it is for the upper classes, it would theoretically lead to higher consumer spending, and growth, for the economy.

I think the comparison to other developed countries suggests that the 8% is inefficiently allocated, and with a more efficient system that 8% spent elsewhere would have economic growth elsewhere.

I don't have the figures in front of me, but I think public health indicators (maternal mortality rates, for instance) suggest we aren't getting great ROI on the extra 8% we spend.

Umm, no I don't think so. I regularly check my IRA and 401k's portfolio and I can't recall ever seeing a lopsided investment in healthcare or pharma like you're saying. And index funds track indices. Is the S&P 500 really dominated to that extent by big pharma?

Second largest sector at 14.7%. Click sector breakdown in the top right.

http://us.spindices.com/indices/equity/sp-500

There are a lot of middle men that would get absolutely crushed or go out of business if single payer were passed. Others would have to slash margins in order to meet whatever cost cutting is needed.

Yes, but the other 85% of the sectors would likely benefit a reduction in costs (i.e. insurance premiums for their employees) that would positively affect their bottom line.

The 8% contraction would be concentrated in a single sector. The money unspent on healthcare would go elsewhere.

Besides, the way DC works, there would be plenty of time for markets to adjust, short-sell, etc.