This is true. Most of them won't scale up sufficiently, or rather if you try they will be captured by corporate interests.

But that doesn't mean we can't look at what others are doing and try to fix things here.

Single payer works on a small scale by giving groups of people effective representation in collective bargaining, something that private insurance doesn't do. It also works by giving that same group collective bargaining regarding drugs and medical devices. It doesn't work by creating this huge insurance pool which is what we are told.

We could take the PPACA and change it, requiring that all insurers qualified under the plan are owned and operated by the insured, and then we could require compulsatory licensing of patents for medicines and medical devices.... And then we could take on the AMA's role in accrediting medical schools.

But pigs will fly first.