I wouldn't mind paying for mandated insurance if it were structured like this...

First, in order to control costs, the Federal Government will pick ONE insurance company from each state to cover people within those states. This is the ONLY company you will buy your insurance from, and the government will subsidize those at poverty level.

The reason this will be a way to control costs is because of risk pools, the larger the risk pool, the lower the premiums for each individual who pays into the system, in addition, with such a large risk pool, coverage is expanded to everyone within a state.

Health Insurance isn't like most "markets" if you can even properly call it that, the more competition there is in health insurance, the higher the cost for each insurance company in the system, because their potential and actual risk pools of healthy people shrink accordingly.

So a monopoly would be the most practical way to control those costs, in addition to being able to cover all necessary medical procedures. So you would have Federally mandated State Insurance companies, of course, these companies, being monopolies within the state will have to be heavily regulated so they don't take advantage of their position as the only available medical insurance company for medically necessary procedures.

I would imagine the best way for them to be regulated is for the individual State Governments to buy them out, and run them directly, as State Owned Corporations. Of course, this would be optional, something for each State to decide on its own.

Premiums in the states where this insurance company publicly owned may opt to replace them with simple payroll taxation, others with monthly fees, etc.

Hmm...I wonder where I've heard of a system like this before.

I am sure there will be no lobbying, corruption, and kickbacks on that idea.

Hell if I spend $1B lobbying congress to get a state like CA then make $100B a year for next 10 years thats a nice ROI.

Larger risk pool = better but you quickly reach a point of diminishing returns.

That is why many major companies (20,000+ employees) simply manage their own healthcare.

Risk pools are important going from a policy with 100 people to one with 1000 or one with 100 to one with 10K or even one with 10K to one with 100K.

However at each steps the gains are less and less.

No need to make a statewide (millions or tens of millions) of person risk pool.

Simply allowing for example all small businesses in a state to organize and join same policy (thus 1000 small businesses with combined employees of 250,000) could negotiate costs down would be sufficient.

Just a hint, but look up how Canada manages its healthcare system on the Provincial level.

who gladly spend money we don't have (national debt) while doing the bidding of major corporations at the expense of American taxpayer.

Given the Congress we have, the utter lack of any sense of care for the middle class giving that much power to Congress would be in effect a giant trillion dollar free for all for companies to lobby their way into at taxpayers expense.

Who better from which to borrow some ideas for streamlining the processes and procedures by means of which they do business, in order to best leverage the increased pool of customers. Economy of scale optimization contractors or something like that...