It's not too early to assume that we will win. On every front. Specifically, on health care: I believe that, at minimum, a public option added to a somewhat tweaked ACA (with, for example, built in negotiations for pharmaceutical prices and medical equipment prices), plus lowering the enrollment age for Medicare to 55 and adding Vision and Dental, all paid for by increased taxes on the wealthier among us, is what we must fight for. (Since people in the higher end of Middle Class will be paying less in health care premiums, the increased taxes will be largely or even entirely offset; only the very rich will pay dramatically more, AS THEY SHOULD).
Then, gradually, Medicare enrollment can be narrowed from both ends. First, Medicaid for children can be rolled into Medicare (to age 18). Then the enrollment age for Medicare can be reduced to 45 and increased to 25, then, a few years later, Medicare for All can be rolled out.
Private Insurers will be impacted, of course, but Switzerland, France and Germany have a regulated NONPROFIT private insurance system, and so do we (minus the nonprofit part, but that can be mandated), even for Medicare. It's called Medicare Advantage. Personally, I think a pure socialist system is better, but the entrenched interests in this country probably preclude that for some time at least. And Medicare for All with ZERO SUBSIDY Medicare Advantage would work out pretty well. In the long run private management can't really compete with public options for paying for medical care, and fewer and fewer people will elect to pay high added premiums for relatively little value. (Right now, thanks to Republicans, Medicare Advantage amounts to a large subsidy for those people well enough off to pay a portion of the added cost for private plans... Medicare Advantage patients cost about 20% more than baseline Medicare patients. You rarely hear that mentioned in all of this). But if it does compete, then fine, I have no objection to private management. Many state Medicaid programs are managed by health insurers already.