I've got an idea.
Insurance companies are in the business to make money. I offer an overall view of how they make a profit, then I'll give a possible to solution to the crisis we face.
Many have no insurance, basically due to the cost of premiums and some carriers refusing to allow already sick people to be part of their "plan". The elderly populous is growing because men came home from WW2 and did their wives and girlfriends (mm mm that must have been a fine time). Those babies are now elderly and with advancements in healthcare, they are going to live a great many years. As they dwindle, care of the elderly is going to be quite in demand.
That said, yes we have Medicare. It is limited to 80%, still costing geezers for a supplement. To make that worse, insurance companies try to replace Medicare with hidden pitfalls like little to no hospitalization coverage but the pills are cheaper and the premiums lower. It's a trap. Stick with Medicare.
Basically, insurance works like this. Everyone young and old put cash premiums into the "pot". When one of the contributors gets sick, the insurance company pays the bill by using the "pot" cash. Their game is to get healthy people to pay premiums so the healthy people(and a little from the patient), can indirectly pay for the bypass surgeries, dialysis or transplant of the sickos. The fewer claims, the more profit the insurance company makes. Then they demand pre-certification, and regular updates by the care provider looking for a reason not to pay any longer. This is called Utilization Review.
They thrive on carefully choosing who is in the group of premium payers. That is where pre-existing conditions came from. "We'll cover you, but not for this or that because it will be an issue again."
Here's my solution. Everyone is covered 100%. If you are an American citizen you will be charged your premium at tax time. If you are not an American you will be shipped back to your country for care immediately if possible, otherwise when your well enough.
This includes wellness check-ups, pediatricians, ER visits for incidentals all hospitalizations and mental illness.
The premiums will be based on age, younger people paying a bit more actually. Grandma can't make the money you do so shut up, you'll be old someday too.
Insurance companies will be reimbursed throughout the year. They will apply to Congress for participation.
Insurance companies will leave Utilization Review up to neutral advisers as to prevent abuse of the system. These Reviewers will consider for the people assistance in affording prescribed medication as well.
Insurance companies may compete with the governments' plan, this is a free country.
Healthcare providers will take reasonable cost fees so that their doors can remain open and the equipment, Physicians and staff are excellent.
The problem to overcome: Insurance companies have for too long played the game well, producing millions of dollars, maybe billions in profit. They stuff the pockets of lobbyists. ROAD BLOCK.
Maybe part of the solution is to make being a lobbyist illegal. They have a huge hand in the pharmaceutical industry as well.