OTOH, I'd say that the people who got really nailed with the ACA were the middle-class individual policy holders.

If all procedures performed were done at Medicaid-like prices, hospitals and physicians, and pharma firms, and, by proxy, insurers and medical schools would have to tighten their belts, and figure out how to cut costs. That's the entire point of such an exercise. We can't let health costs grow in an unbounded manner.

Dunno how 'Medicare for all' will work out if you simply start paying providers what Medicare currently pays. Dictating a price might work in the long run but would be plenty hairy in the short.

I can sympathize with the on-the-ground employees but the businesses they're keeping the lights on in are leeches on the healthcare market - I posted separately on this article going into the specific functions of PBMs, Pharmaceutical Manufacturers, Providers and Insurers if you're curious about the details, but there is a ton of inefficiency here.