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In my imo there's no way out unless more typical medical costs are shifted towards self pay (such as with HDHP/HSA and similar). Otherwise your "insurance" for a huge percentage of times is just paying out thousands of dollars for mundane everyday costs. It's effectively a horribly inefficient way to passthrough those costs, plus actual insurance.
The most important uses that medical insurance is actually needed for people who actually work is for accidents and heart attacks, as well as catastrophic chronic conditions as well. We should be able to buy this. And for the poors who can't afford everyday care, they can get some kind of subsidies or whatever.
The Obamacare plans in New Jersey are so bad that there's a lot of self-pay involved. The problem is you can't just self-pay it all (or self-pay and buy catastrophic coverage). You still have to pay the sky-high premiums for basically nothing.
But Democrats are dead-set against any rollback of universal, comprehensive, coverage with no real underwriting, and the Republicans don't care enough. And no one but evil libertarians wants to let anyone die because they can't afford treatment, even if that treatment is hundreds of thousands or millions of dollars. So the only solution available is the only solution that was ever available, which is more socialism. With the usual failing result, but that doesn't make it go away, it's a positive feedback loop.
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