Step1: There is no “problem”.
There is no solution to the so-called health care problem because there is no problem. The first step is to realize that this is not a problem in the traditional sense with a fix or a solution. It took Bill Clinton 70 years to have this epiphany, but at least finally someone has.
Step2: The role of government.
Now, is health care (whatever that means to each of 330 million people) not just a philosophical right, an ought to be? Or is health care a political, from the government right to members of the society? Should the development and delivery of health care related products and services be a for profit, private sector industry or entirely a non-profit, public sector “right”, or a public-private partnership?
Step3: The real issue(s).
The next step is to admit the issue is control and management of costs, access, quality, timeliness, and outcomes. No one time fix, no final solution, no silver bullet. The goal of course is for the system to “work”.
Step4: A framework.
Once the real issues are accepted, a framework, like the current ACA (mandatory) shared cost pool can be decided on. All private, all public, a combination.
Then finally, back to the operative trigger word, CONTROL. As usual, what liberties will people sacrifice, what control will they relinquish, in return for security? What shall be controlled? What must be controlled? Who shall decide?
There is a long list, but generally two often conflicting categories. Patient behavior (discretionary and non-discretionary) and Provider products and services.
No pre-existing conditions. No risk adjustments other than age. No cancellation. No lifetime caps. No rationing. No behavioral controls. No price controls. No effective mandate. Kids stay on until 26. Sign-up or don’t, get sick, then sign-up, get treatment, quit paying, again. Good asset protection for the rich. Deductibles so that many essentially have NO insurance, only a very expensive catastrophic policy.
There is not enough money in the world to provide the quality and timeliness US citizens will demand of their health care system that the Fed govt. says is their right.