Good point. The biggest reason the U.S. didn’t get a single-payer system under ObamaCare is that Pelosi is owned by the insurance industry. She’s going to have enough trouble dealing with the growing lunatic fringe in her own party.
If she's elected Speaker (likely, but not certain), she'll have no problems. She's no slouch in that department.
She has no morals, ethics, or principles. She's a consummate totalitarian. Just what her party craves.