The key to any reform is going to be whether power is centralized or dispersed in a free market. The more healthcare decisions are determined by rules or central planners, the more problems there will be.
The more power is left to individuals acting in a free market, the more innovation and choice will be allowed. The government should be there to make sure there is honesty and to facilitate viable markets for catastrophic care and other big ticket items. But the key to the system is to use competition and innovation to drive the everyday healthcare quality up and the price down.
Democrats should promote a Universal Healthcare system that allows as much choice and freedom as possible. This will allow for new models to emerge, and for the American people to remain in as much control as possible.
Therefore I'm against a single payer system run by the government because the essence of America is freedom and choice. I'm against unnecessary mandates and rule-making. We need to allow the dollars of individuals and small groups to direct the healthcare decisions rather than dictates from central planners.
The quicker democrats accept the value of a free market the easier it will be to succeed at Universal coverage.