Putting aside the animus many feel toward Obama, the Dems and the ACA, what are folks general thoughts about addressing the access issue by means of single payer vs. a private insurance system supported by "fascist mandates"?
Wouldn't an ACA that's fixed so it actually provides affordable options be superior to single payer? Why or why not?
The ACA as it currently stands is an "end justifies the means" sort of thing. The ACA echoes the authoritarian tendencies of the people who wrote it: only the bureaucracy, armed with the power of financial coercion, is capable of fully comprehending and addressing the true needs of the people.
When you look at it, the utter failure of the ACA can be laid at the very feet of the authoritarian solutions; hence, the millions of people who were thrown out of "non-compliant" plans that were nevertheless sufficient to their needs, and forced to less suitable and much more expansive plans.
Part of the problem with health care costs in general has to do with the whole "insurance model" of medical care. There is no "free market" in medicine -- it's already controlled by large, inefficient, and intractable corporate bureaucracies. A single-payer system doesn't fundamentally change the economics of the current system, except probably to make it even less responsive.
There is a good moral argument to be made for ensuring that everybody gets some basic and sufficient level of care. Probably the least intrusive approach would be some sort of means-tested subsidy for plans that meet some basic standards of service; and those subsidies are almost certainly best applied at the state rather than national level.