When the ACA came out, I was convinced that was the answer. Not colored at all by the fact that I was working on a product that needed the ACA to be viable or anything, of course. The ACA has kind of gone belly-up because that's what happens when participants in price fixing get tired of having their prices fixed. Single payer would be ideal, but that money has to come from somewhere, and at last count it would cost anywhere from $2-3 trillion per year for the first ten years. You want to talk about a deficit? Because it's either that or a huge tax spike for everyone. I mean, dumping the easy to manipulate income tax system in favor of a flat consumption tax that's much harder to avoid would help. So would ending Social Security, but that's a different discussion. Point being, if the US wants to find it, there would be enough money out there to go for single-payer.

Assuming that's off the table, because Democrats will throw a hissy-fit about Social Security and amending the Constitution to do away with income tax takes years, something close to the ACA involving vouchers is probably the best we can do right now. I do think that basic health coverage should be extended to all residents in a country as advanced as ours, and I don't think it should be the responsibility of employers to provide it. From there, it gets into all kinds of messy contingencies regarding income level, employment status, family size, and how the hell those things would be verified in a post-income tax society. So let's just go with "the open market has proven that it can't be trusted and single-payer would be a decade-long disaster to implement, so vouchers are probably the best we can do for right now."

---