The push for a public option or single-payer scheme for healthcare is alive and well, but critics say people are failing to take things into account.

Single payer is a healthcare system in which one entity – the government – collects fees and pays for healthcare. That's different from a public option, which is a government-created and controlled health benefit plan that Democrats want to offer to create competition among private insurers on the exchanges. 

Speaking of the exchanges, co-ops have collapsed and many insurers are again raising premiums. Some insurers will not offer coverage on many exchanges. Recently, Blue Cross Blue Shield of Tennessee announced it will not be offering ObamaCare exchange plans in Memphis, Nashville, and Knoxville next year. Blue Cross Blue Shield of Nebraska said it was exiting that state's entire exchange. BCBS cites financial losses for the decisions

"Everyone understands the ACA is a failure," says Hadley Heath Manning, director of health policy at Independent Women's Forum. "The question is: Why – and where do we go from here?"

Manning acknowledges that people on the left are pushing for a public option or single payer.

"Unfortunately, what they fail to realize is that the ultimate failure of the Affordable Care Act is that it doesn't foster market competition," she says. "When people have competition, when there is competition in these exchanges, that's when we can expect to see some downward pressure on price. But until that happens, we're headed in the opposite direction with insurance companies leaving the exchanges." 

In a related article for the Hill, Manning writes that a public option would do more bad than good for women, especially low-income women.