There&#x27;s a very simple answer: the middle class pays very low income taxes in America. Nearly all of the income tax burden is on the top 25%. If you want to shuttle over half the population into a new single payer health insurance system, they&#x27;re almost all going to be a (big) net drain. It&#x27;s an inherent consequence of a highly progressive tax system.<p>Your typical middle class single person is now spending $300 to $400 per month on health insurance (employer sponsored is closer to $100 per month, but that&#x27;s merely subsidization), and you want to shift them into single payer, then you have to recover that $300 to $400 via taxation.<p>The median in the US has an effective income tax of about 3% to 5%. Put another way, putting all of that toward their new single payer insurance, wouldn&#x27;t come close to covering how much they&#x27;ll cost you (and that&#x27;s before getting into family cost structures).