It is not a "Single -Payer System. That is the politically correct way of saying government run healthcare. So of course it is going to require a LOT of bureaucracy and six-figure-income government employees to manage it.

For a great read on this, Hayek's Road to Serfdom lays out why even incremental socialism is steps on the path to despotism.

What is interesting to note is that even most socialists balk when it comes to the point at which they must either assume tyrannical control or see their entire system crumble under its own weight. This happens because they have bought into the lie that socialism can long maintain a working relationship with capitalism.

Progressive policy is not determined by reason, it is determined by emotions. These people do not bother to take into account the effects of their policies, but simply their stated purpose; rather than worrying about the unintended consequences of meddling in the market, they only care about the "benevolent" intentions of their legislation. Their policies are designed to make people feel good - free healthcare, free housing, more jobs, safety, security - by playing on their fears and insecurities (or simply creating a problem through other action) and then offering a government-sponsored solution to a problem that would otherwise have not existed. They are the antithesis of reason; they are passion alone, and while passion itself is not a crime, passion without reason is a child playing with a grenade.

To them, it would be just to see the world burn, if only lighting the fire was for a good cause.