Health insurance like any insurance such as home, or auto insurance should be a personal policy not job related. Insurance by traditional definition is a sharing of risk. Uninsured Americans should be grouped as to insurable but uninsured , higher risk, and poor. The uninsured would be offered a pool by all insurance companies offering health insurance in the designated area as a last resort with premiums averaging those of offered by insurance companies in the state or bi state region. Higher risk would be pool insured also at a 10% higher premium. Poor or unemployed would be insured in a pool of the same insurance companies at heavily discounted premiums say 10% depending on assets. All premiums would rise some but this program would provide an American infrastructure to keep Americans healthy and functioning, spread the risk among insurance companies, and eliminate the need for tribal clinics, va hospitals and clinics, and state and local government clinics . Eventually medicaid and medicare might be replaced or privatized by this sharing of risk including disabled. Insurance companies would be regulated to assure that expense to premium ratios were maintained at designated levels like 80% and that costs were not inflated of executives, company employees, contractors, and providers of medical services. Charges by providers exceeding state or regional comps would be reported to state and federal compliance officers. Providers repeatedly violating and abusing charges would be de licensed, nationalized and imprisoned under due process. This would likewise eliminate age discrimination and age related genocidal policies and programs in government and employment. reply to mbrcatz17 its called the law of large numbers. Your reference is to a minority of experiences as opposed to the majority of Americans who have integrity and don't want to abuse the system. Pooling of large losses to 50 insurance firms gives each 1/50 th of the loss not the whole loss. My proposal is simple and will work. If you were in the high risk category due to genetics or environmentql exposure or preimmunization ages you would want some help too. I have used pooling in insuring other types of risk and it works and insurance companies recommended it and profited from it. Making every American a profit center is anti American and it isn't insurance. I have managed workmans comp programs, health programs, and retirement programs for corporations and corporate greed and executive bonuses are the only thing standing in the way of equitable pro American programs besides political contributions to both parties.