At the time Obolacare was rammed through there were a great many alternatives to decrease health costs. Federally this included allowing Insurers to sell across state lines, allowing people to create tax sheltered HSA’s, and making medical treatment and devices tax free. At the state level it is all about tort reform.
The most difficult nut to crack is what to do about those who won’t get insurance and then can’t/won’t pay for treatment recieved. I have heard that even in the best cases hospitals still have at least a 20% no-pay rate, and in poorer areas the no pay rate can be well over 50%. That doesn’t even take into account underpayments from medicare/caide. Hospitals then must distribute the cost of treating these people to all those who do pay.
It may not be popular here on FR but if we as a society aren’t willing to tell those who can’t or won’t pay that their only option for treatment is private charity, then we invite the government into the health care business. Once that is accepted I believe the best thing to do is have clinics and hospitals run by local governments where those who can’t or won’t pay will get government standard treatmetn. Those who will pay will get to participate in the free market system. There is no way to give non-payers the same treatment as payers unless care for all goes down.
The original RomneyCare / Heritage bill had a caveat that the non insured post a $100,000 bond or some such number as their self insurance. Ya that didn't make it beyond the Mass Legislature which at time was prolly as left as Gorby's Politburo....