The insurance industry plays a major role in the American health care system and absorbs a significant portion of the health care dollar. A single payer system whether it is a private company or the US government would eliminate the complex insurance paperwork burden and free substantial funds that could be diverted to support care for the under-served. In ACA debates a public option was defeated by lobbyists. Identify some reasons why resistance to a single-payer concept used in every other developed country has continued in the U.S.