Single - payer systems do not seem to be faring well either. In fact, many such systems, including the Canadian system, appear to be ready to explore market - based alternatives.
http://www.civitas.org.uk/pdf/Canada.pdf
I would also challenge you on a couple of points:
First, that single - payer is disconnected from the regulatory enviroment. Rather, single - payer is the ultimate regulation of the health care delivery system. It removes the free market almost completely from the equation, and fully regulates the delivery of care in the market: who can deliver care, under what circumstances the care can be delivered, the timing of the delivery of care, and the cost of delivery.
Second, that PPACA is "little more that re-arranging the deck chairs on the Titanic. PPACA does little in the near term to impact the delivery of health care. It gets at cost in a rather hopeful way - that requiring individuals to purchase health care will increase improve overall funding by increasing the amount of incoming premium dollars. I'd suggest that there are still plenty of holes in the funding scenario that could likely result in further - you guessed it - regulatory intervention to plug the holes.
PPACA utlimtely could change how most poeple in this country buy health insurance. In the extreme, it could signficantly reduce the number of individuals who buy health insurance in the group market from an employer. On its face, this isn't a bad thing in and of itself. I've often said that if I were King for a day, I'd outlaw employer sponsored group health insurance. (I might even go so far as to outlaw health insurance, but that's a whole differnent thread). It creates an uneven playing field where the largest groups can puchase coverage more economically than smaller groups, and subjects small groups to more unpredictable year over year health insurance premium cost increases. PPACA doesn't necessarily solve this. It does, however, create a powerful incentive for employers - and I'd suggest in partcilular smaller employers - to get out of providing group health insurance coverage. This could result in dramatic change in how the health insurance market, and ultimately the health care delivery system, might operate.