The problem I see with the current mess is that it’s often cheaper to pay high insurance rates because healthcare costs are astronomical, largely because they are subsidized by the high insurance rates. A perfect storm.
Many people (especially those covered 100% by the government, and even those only paying a copay) visit doctors and get prescriptive medicine when they wouldn’t otherwise if they had to pay for it OOP. This attributes a great cost that everyone ends up paying for with higher rate insurance coverage and overinflated care. Entitlements aside, if there is no extra cost or only a small cost for medical care, the ‘I’ll get mine’ attitude is predominant.
I’ll be the first to admit that I took a much harder look at the necessity of taking my son in to the doctor when we were covered under a $15k OOP HDHP than now, where we pay a higher premium plan but only pay co-insurance and very small OOP. I believe most all of society looks at things this way when they don’t have to front the entire bill. This mentality is largely what has lead us to our current crisis.
Obviously there are many in our country with bad health that need better coverage but if medical bills weren’t inflated as they are due to the above, they actually might be more affordable for everyone. Though I’m sure doctors, providers and drug companies would not be fond of this idea.
Clearly though, a one size fits all is not going to cover it. There are really no good answers for everyone. Someone will foot the bill for those that can’t afford their catastrophic care, even in a purely capitalistic situation. We obviously can’t leave those who can’t pay cash upfront or get a loan for their $50k bill to die in the streets.