Discuss what would have to take place in the United States for passage of either a single-payer system or budget caps in total payments to providers

Discuss what would have to take place in the United States for passage of either a single-payer system or budget caps in total payments to providers under the Medicare program. Address questions such as the following: 

1. How will political ideology affect such a consideration?
2. How will out-of-pocket costs affect such a possible change?
3. What would be the transition challenges of making such a change?