The issue with health insurance is, it does not work. It is against very basis of concept of insurance. Which is why universal health insurance is the only way forward.
You said such a system has flaws, but did not tell me which flaws. Mind you I am not asking universal healthcare.
If the current health insurance situation in the US does not work, an exaggeration at the least, or have flaws, it is because of government regulations and restrictions, one of them is one cannot buy health insurance from another company in another state. This absurd restriction was lobbied by the insurance companies to prevent state level competition and agreed upon by state level legislators. Then insurance companies locked in that monopoly, or having fewer competitors, by having multiple state licences. Companies that cannot afford to be so licensed remained small, local, and limited in their coverage issues.
Solution: Legislators simply have to refuse to be corrupted by the health insurance industry as a whole. Refusing to enact restrictions would force the marketplace to work out its own shortcomings. At best, state level legislators could mandate a minimum level of coverage in order to do business in their states and let the marketplace and the consumers chose. Competition always bring down costs and improve product quality. It will not happen overnight but it will happen. It always happened.
Now why health insurance does not work. A fundamental principle of insurance is, insured should not have any extra information that can jeopardize the amount of premium.
It works pretty well for life insurance, nobody is sure when dealth will come (insurer might ask about life threatening ilness as it needs that info to figure out risk).
It is actually 'life assurance'. Assurance is about certainty. Insurance is about uncertainty.
Everyone is going to die but not everyone is going to have cancer, a broken arm, or even a sprained ankle. Since everyone is going to definitely die, there is no reason to have life assurance or insurance, for the sake of familiarity. The reason people have life insurance is because the unpredictability of when a person is going to die, leaving the possibility of denying one's family of income, but because death is so final, you do not suffer and is no longer a burden or contributor to society, there is little compelling reason for anyone to have life insurance, least of all a single person like me. Life insurance policies are easier to provide than health insurance.
For health insurance, only those tend to take who have probability of falling ill. Which means if they pay 100 dollar as premium, there is high chance that they will take out the insured amount (say 1000 dollar).
As insurance is basically sharing of risk, it jacks up the premium, say to 150 dollar. That makes it unaffordable to some insurers and they exit the policy.
So basically it creates a vicious circle which pushes premium higher and higher. Insurers can reduce it by asking you to give all information about your health, but still they are unable to solve this puzzle.
First of all...There is no moral mandate to create health insurance. The insurance industry, not just health but auto, home, etc., is essentially a scheme to provide a service as well as making a profit. People saw the high cost of auto or human repairs and came up with the scheme where everyone who voluntarily got involved would share the cost of providing auto or human repairs for those in the circle who need that service. But there are no moral or religious mandates anywhere for society and government to create that scheme.
Second...Once that scheme is created and have members, it is perfectly reasonable to reduce outlays and this where excessive denials by the insurance companies have contributed to the sorry reputation they all share. An insurance scheme is basically the sharing of cost when a risk by a member was not or cannot be avoided. It is perfectly reasonable for a particular circle to query its members as to what they do that may raise their odds of having risks come true.
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I used to skydive, now I do not because of money, not of physical capability. I can get hurt to varying degrees or even die. I can have insurance for either potentiality. It is not immoral for any insurance provider to raise my rate due to my dangerous hobby. After all, who forced me to jump out of a perfectly good aircraft for fun? For war, yes. But for fun? I plan to try paragliding next and a rig is about $4-5k. Again, who forced me to enter this dangerous activity? If I get hurt, why should I pay the same rate as the man who drives below the speed limit, is a vegan, does not smoke, does not drink, does not take any kind of hallucinogenics, and live very plainly?
Health insurance issuers realize that nobody is going to be that boring so they are willing to provide that sharing of costs in the event of a risk coming true by any member, be it a broken leg from skydiving or got cancer due to bad genes, without being too intrusive in everyone's lives. But if we are willing to allow and participate in this kind of scheme, we have to allow those companies to make profits, especially when there are clearly no moral or religious compulsion for them to exist in the first place.
If the company is forced to insure me, a skydiver, a weekend amateur motorcycle racer, an open water diver, a skier, mixed martial arts fighter, smoker, drinker, drug user, prostitute user, and who knows what else, at the same rate as my religious neighbors, that company would be out of business quick. What are you going to do? Force the company to stay in business? And with whose money?
The current health insurance system in the US is flawed, but not broken, just like you are flawed but is still a functioning human being. There are many ways to fix those flaws without getting the government involved at the expense of personal liberties.
I did not say a millionair should pay more. Lets say millionair will pay as much as poor. Its not millionair vs poor, rather its healthy vs ill. Its spreading the risk so that predominantly healthy population can care for a few ill.
The case you said (high networth but with income poverty) are the people who are vulnerable to sudden homelessness and poverty if a disease hits hard. Due to issue I told you above, they cant afford to pay insurance premium.
Many of them are pensioners(build up asset over a period of time, asset value goes up and they look rich, but their income is low and ever decreasing), and an insurer will consider them high risk customer. (prohibitively expensive premium).
How is it different from universal healthcare? To start with, it does not tie you with a specific service provider. You can choose your doctor, hospital whatever you want.
It will allow private healthcare providers to compete so there is no beurocracy. The fund can even be managed by a trust(not govt).
The problem with your premise, as highlighted, is that the 'universal health care' scheme is essentially a monopoly. It does not matter if the fund is managed by the government or not. If there are competition, then it is not 'universal', is it? If you are forced to pay in, then what is the point of competition anyway? Do just like the commie say: government is responsible for your health care.
