I would propose a 3 tier system: - You pay the first thousand or so a year out of pocket with an HSA-like vehicle to make sure people aren't overconsuming. -

I would propose a 3 tier system: - You pay the first thousand or so a year out of pocket with an HSA-like vehicle to make sure people aren't overconsuming. - Government program pays 100% of everything over like $20k or so a year - Optional private insurance fills in the gap between the $1K out of pocket and the $20K where the government starts picking up the tab, and would be very affordable since their liability is capped at both ends. They actually have something roughly similar to this in Singapore.