Here’s a thought that might provide the basis for an agreeable compromise on health care: Switzerland was the right place to look. But the architects of the ACA took the wrong lessons.
In Switzerland, health insurance and the delivery of health care are entirely private enterprises. There is no Swiss NHS, no single-payer, no “public option” — none of that. Switzerland has health care that is by European standards 1) excellent and 2) expensive. Insurance coverage, though entirely private, is universal. …
… We could do something along these lines:
1) Adopt two things from the Swiss practice of insurance regulation: First, enable interstate competition. (I’d work hard to enable international competition, too, but I’m one of those zany libertarians.) Second, specify an intelligent, thoughtful minimum-coverage policy and oblige all insurers to offer it on the Swiss model: on a nonprofit basis with a universal premium irrespective of age, sex, or health status.
2) Also adopt an individual mandate with a Swiss model of enforcement: Coverage is an individual responsibility for adults and a family responsibility where there are minors, meaning those younger than 18 years, not 26-year-old graduate students. (Those I will deal with below.) Write the regulation in such a way as to forbid the termination of coverage until new coverage has been secured. If there should be a lapse in coverage, then the customer will be assigned coverage and charged retroactive premiums, penalties, and interest.
3) Simplify the collections problems implied by No. 2 by instituting a universal premium voucher.