Correction: it would replace multiple competing staffs (“bureaucracies”) of private insurers with the ability to take losses and go out of business with one bureaucracy with a chain of command spearheaded by the POTUS backed by the full faith and credit of the United States. My example was not an invitation to discuss the merits and demerits of single payer healthcare in a different topic, but to point out that for every function you invest the Federal government with, you get a corresponding bureaucracy ultimately subordinate to basically one guy. Doesn’t matter what the function is, you’re expanding his staff.