The end product may very well exlude insurance companies.If everyone does not pay in, you are left with 2 bad options:
1. Ins. companies are free to reject sick people who apply for coverage after they are sick and drop people who become sick if they hurt your profit margin too bad and make your stock price go down (a guaranteed profit plan for the ins. companies and NOT a national healthcare plan). That's the way it is today, and it is terrible for people who lose a job and then have a serious illness.
2. The ins. companies must insure anyone who walks up and retain them if they get sick, in which case nobody who is well would buy insurance until they got sick. Then the rates would be sky high, as the insurance company is in essence just paying the bills for the sick people and adding a markup for the insurance company's profit. That doesn't make sense at all.
We are never going to get a program where people are forced to buy something and we are never going to just allow people to die. The only way we can do it is with a program similiar to medicaid.A way to "encourage" people to buy insurance (at least a catastrophic coverage plan) would be to let people die if they are in a bad accident and don't have insurance or the money to pay for the ER care. Right now there is little incentive for many who can afford health care to purchase insurance, since the law says if you are brought to an emergency room and are in life threatening danger, they must treat you. If you've been healthy all your life, you can take a chance and freeload on the taxpayers dime. You stay healthy, you don't pay; you get in a severe accident, your neighbor pays for you. Sweet deal.