Yes, the Affordable Care Act, while good, isn't the step that we needed in this country to ensure that the system was going to work. We have costs that are out of control and, unfortunately, the ACA doesn't do anything to handle that. Our only option is to join the other industrialized countries in this world with a single payer system.
All the civilized western nations have some form of single payer system of health insurance and of course medicaid and medicare work like that too. So that would have been the logical next step if the Republican congress had not scared everyone out of that choice and refused to consider it.
I believe a single-payer system would have been a better method for health care reform rather than handing it over to private insurance companies as Obamacare has done. I think we have effectively increased the cost of health care across the board, but at the same time we created a lot of jobs. There are trade offs, it will be interesting to see if this method works.
No, America should not have adopted a single-payer system when it did health reform, because people do not want the government to be the one deciding whether a person is worth treating. There should still be some individual choice when it comes to allowing a loved one to die or paying a large medical bill.