Of course the Democrat Party's ultimate intent to implement a single-payer scheme is no surprise; it has been their intent for decades and this public statement of it is not nearly the first.
A single-payer scheme as Reid describes it would not mean that insurance companies go away; the federales would continue to contract with insurance companies and perhaps other types of administrators to operate the single payer scheme. What it would mean is that the concept of medical insurance largely ceases to exist and would be replaced by a medical care welfare system.
In a medical care welfare system people will, in theory, be entitled to medical care simply because they are citizens (excuse me, that should be: simply because they are present in the room). The government - the single-payer - will finance most of this entitlement thru taxes excepting only amounts that politicians deem appropriate cost-sharing.
An insurance-based system requires a certain amount of personal responsibility so I suppose its demise is inevitable in this country at this time. That troubles me, but not nearly as much as the unstated agenda behind the political posturing: namely, the federales desire to control an additional 18% of the economy. Economic control is political control. Polls continue to show that most Americans remain uncomfortable with all this, and I think most Americans will live to rue the day it happens.