Obama did research into single payer in 2009 and quickly abandoned it. Doctors were not interested in becoming government employees on a fixed salary. Without them, there's no deal.  He also became overwhelmed when he discovered that getting rid of a decent size of the economy won't be easy either. Those hundreds of billions have to be replaced somehow or the economy craters. Obama's biggest concern became taxes. To pay for it, he'd have to tax everyone at least 15%. That includes the lowest incomes, which couldn't survive losing that amount of income every paycheck and still afford the necessities. Nobody wanted it more than Barack, but even being the hardcore progressive he is, he knew the math didn't add up and couldn't be accomplished without destroying the economy and hurting millions of people.