My solution is the same as yours. People usually flip out when you suggest getting rid of government health care involvement - including medicare/medicaid.
It’s ultimately the only way it will work in a free society, and if you don’t believe that - then you have to accept the government solution of getting only the care they allow you to have, and cutting off care when they say.
But.... absent government, people have to arrange for their own care, and if they don’t, won’t, or can’t then it is up to charity, if it is available - and if it is not, then the result is rather drastic, but less so than with government involvement, I’d submit.
Still, it’s the only way.
However, when I retired early to take care of my parents, I qualified for insurance under HIPPA. The cost would have been $3000 per month. They suggested I apply for an individual policy and go through underwriting.
An Insurance company' thus gets around the portability by making the insurance so costly that people are forced into underwriting.
Hubby qualified for the best rates, at about $200.00 per month, but I had some pre-existing conditions, so I currently pay almost $900.00 per month for my $5000.00 deductible 80/20 policy with no dental and no Rx coverage.
I have never paid more than $500 medical experiences since then, but Hubby was hospitalised more than once. So much for their underwriting.
To me it is just like Life Insurance companies used to do.
People paid for years and years. Once they got pretty old, the company would come up with some reason to cancel the policy, and the people were too old or ill to get a new policy.
HSA accounts might be helpful. It is a way that companies can save on premiums by having high deductible policies. They can share part of that by giving part of the savings say $1000.00 to each employee. Which would take care of about 85% of their employees cost.
They could set aside some more of the savings in a hardship fund for those who had unusually high expenses. The money would be pre-tax. The individual policy and the individual fund go with the employee.
Employees can put additional money into the fund, if they want, and unused funds are allowed to accumulate tax free. The fund is tax free when used for medical expenses. Something along these lines might allow for a gradual transition to individual insurance.
I do think a gradual transition to avoid chaos would be necessary. I read that Indiana(I think) saved a lot of money with an HSA, and most of the employees wound up liking the plan.