Sprawling bureaucracy is a byproduct of what you get from investing the government with additional functions. Every office you open whether Civil Rights or Agriculture or Patent Office needs staff. If we had a single payer system, there would necessarily be an enormous bureaucracy attached to it, most likely an expansion of the existing Medicare/Medicaid bureaucracy.
You just don’t get one without the other, even if you cut the staff down to the bare minimum that can still efficiently manage government programs you still end up with a sprawling bureaucracy.
There’s a difference between sprawling bureaucracy and necessary bureaucracy. Are you really suggesting that all bureaucracy is inherently bad and defaults to wasteful sprawl?
Are you saying a “necessary” bureaucracy is necessarily not a sprawling bureaucracy?
In any case, if the function invested in the government is a misapplication of public money then the bureaucracy servicing it would also necessarily be unnecessary. If the function is necessary, that does not mean the bureaucracy servicing it isn’t sprawling. The military has what could be termed sprawl, but that’s a function of the broad scope of its missions and global reach.
Correction: it would replace multiple competing staffs (“bureaucracies”) of private insurers with the ability to take losses and go out of business with one bureaucracy with a chain of command spearheaded by the POTUS backed by the full faith and credit of the United States. My example was not an invitation to discuss the merits and demerits of single payer healthcare in a different topic, but to point out that for every function you invest the Federal government with, you get a corresponding bureaucracy ultimately subordinate to basically one guy. Doesn’t matter what the function is, you’re expanding his staff.
You just don’t get one without the other, even if you cut the staff down to the bare minimum that can still efficiently manage government programs you still end up with a sprawling bureaucracy.