Several people in this thread have mentioned that there is no way to make health insurance affordable to all Americans as long as healthcare costs are so high. I think this is wrong. There IS a way to give everyone affordable insurance without controlling costs at all. Insurers and hospitals/doctors can continue to get rich, and everyone can have access to affordable care. I think I've cracked the nut.
What secret sauce have I invented? The key is in the definition of "affordable". Just pay 100% of everyone's private health insurance premium with tax dollars.
Think about this. Taxes are already designed to be "affordable" to everyone. They are progressive (for income tax, so the rich pay more) and they are also a flat tax (for OASDI, which everyone pays the same percentage regardless of income). No one ever goes broke because of taxes. If you have no income, you pay no taxes. If you have lots of money, you pay lots of taxes but you still have lots of money. In both cases, taxes are "affordable" to you. Why can't health insurance work the same way?
The 100% covered premiums would have to be for basic services, of course, not cadillac plans. Maybe make them similar to current subsidized silver plans, say 100% coverage for routine preventative care, $25 copays for other stuff, and $1k per person deductibles so everyone pays for their first basic care out of pocket. People who want more than basic coverage could still buy it, if they can afford it. Exclude cosmetic procedures. Revoke HSAs. Your doctor would bill your insurance company just like it does now, and your insurance company would bill Uncle Sam instead of you. The private insurance industry would become just like the post office, a quasi-government for-profit corporation subject to federal oversight and regulation, that provides a uniformly available service for the common good and receives periodic bailouts when necessary and makes good money the rest of the time.
If you have employer-sponsored insurance, nothing would need to change. The money your employer currently pays towards your insurance would get paid to Uncle Sam as taxes. If you run a small business, you don't need to worry about providing healthcare to your employees if you don't want to. If you are unemployed or retired, your health insurance is now covered just like your unemployment insurance and disability insurance are already covered under current law.
So this solutions obviously isn't a 100% free ride for everyone. If Uncle Sam is paying all of this extra money for health insurance premiums, where is the money coming from? Your taxes, of course. You can either raise tax rates (either the progressive income tax brackets or the flat OASDI taxes or both, or other taxes) or you can cut spending. Doesn't really matter. The key is that taxes are always "affordable" by design, so we're piggy-backing on that system. Theoretically, your savings from not buying your current insurance should cover your costs from higher taxes.
In either case, the government basically becomes the only end-consumer of health insurance. They can negotiate rates with the private insurance companies, who can negotiate with providers, to bring long term costs under control. Medicare already pays a fixed amount for MRIs, and that amount should be the MRI price for EVERYONE, not just old people. Similar arguments apply for any other billable procedure. They also get to ration care, for example by denying cosmetic surgery for old ladies who are vain or providing palliative care instead of invasive surgery for 90 year-olds with aggressive cancer. If you are a billionaire 90 year-old with brain cancer, you can buy additional insurance or pay out of pocket, but even if you don't your basic care is covered just like it is for everyone else.
Everyone gets affordable health care! You are covered, your rates are affordable to you, and no one will ever go medically bankrupt again!
There is no individual mandate! You're not forced to buy anything. The government is buying it for you, just like it buys national defense for you, because we all need it.
There is no denial for pre-existing conditions! Everyone gets (reasonable) care regardless of health history. And you can always buy more if you can afford it.
Health outcomes will improve! Preventative care is free for everyone! Here's your "how to quit smoking" pamphlet and free nicorette gum.
Emergency care is still available to everyone, but won't be the only care available to poor people! There is no need to repeal EMTALA.
It's not single payer! The insurance industry isn't nationalized, and they continue to exist as profitable private corporations.
I'm open to suggestions and criticisms of this plan. There are clearly a thousand details to complicate the implementation, but the overarching idea of just raising taxes to pay for universally available private insurance seems like the only way to give everyone what they want.