What do YOU propose they do, when it comes to meaningfully addressing the same issues?
What? This problem has been discussed by great and not so great minds throughout government, academia, and health care for years. Now Jaw the layman is supposed to come up with the solution? That hardly seems prudent, but I'll give it a shot.
Form a national PCP/LPN union that negotiates a basic rate for every service offered by any member, as well as the costs to provide generic, medically necessary prescriptions for a range of medicines that cover non specialized needs. Adjust the rates for the value of the dollar locally so that rural Kentucky citizens aren't paying for San Francisco real estate. Allow every PCP and LPN to decide whether they will participate in the program voluntarily, but require anyone participating to accept only the negotiated rate for every service offered if it is being paid for by the government policy, minus some extremely low office visit co pay.
The goal behind all of that is to price services at a point that will encourage providers to participate in the plan and to eliminate cost uncertainty for the patients.
Allow citizens to opt in to the program during a pre-specified open enrollment period from February to April with premiums calculated to cover the government cost. Allow citizens to direct their tax refund to cover or contribute to their monthly premiums for the coming year. The goal here is to copy the car dealer tactic of getting people to use their tax return as a down payment. The best time to get people to pay is when they have cash on hand, and this is especially relevant to lower income earners.
Allow private insurance companies to offer whatever plans they like. That should guarantee that people who want everything to be covered can get it, people who want ER coverage can get it, people who want coverage only for what the government plan doesn't cover can get it.
So, those with faith in the federal government to provide cost effective health insurance should be confident that this plan will grant affordable access to basic health care for all. Those who think we should subsidize health care for low income earners should be pleased that those customers can use their existing tax break refunds to pay for their coverage, and those who want something beyond basic access to health care can still pay for that on their dime, without government interference. I'm sure there are plenty of holes, but I don't think this is bad for shooting from the hip.