Make the government the insurer of last resort.

Take the elderly out of the equation--their medical care has already been nationalized.

Private companies will indeed resist insuring people with chronic conditions, but how many of those are there in the under-65 population? I'm talking real chronic conditions requiring expensive medical care, not having to take Lipitor for cholesterol. Ten percent?

Create a government-backed insurance system for those who are "uninsurable." Make them prove that they can't get insurance, or insurance at a reasonable price. Charge them premiums about equal to what a private insurance company would charge a person of reasonably good health to help keep people from ditching private alternatives for "free" care.

In fact, such things exist. There was a period of time when I bought health insurance on the open market. My wife, who has MS, could not get a reasonably priced policy, and we participated in a "state risk pool" insurance program. I paid as much for her as I did for myself, but at least she could get the insurance.

The government program will lose money hand over fist on expensive medical care, of course. The whole POINT of a government aid program is to pay out to those who can't pay it back.

But I bet the taxpayer cost of high-end medical care for a small portion of the population is going to be a lot less than covering those very same high-risk people PLUS all of the healthier people in America. I'd need to see numbers to figure out the actual savings.

Food stamps buy food for the poor. We didn't need to nationalize the grocery stores and farms.

The details aren't that important. Whether the government runs the high-risk program, or creates a heavily-regulated "private" company to do it, what minimal level of regulation might be needed for the real private insurance companies, increasing competition by allowing interstate insurance...all that can be worked out.

The idea is to have the goal of minimizing state power and increasing competition in the health care system. The government should always be the last port in a storm. Lately, it's becoming the first one.

My view is that this is less about providing Americans with medical care than it is about consolidating government control over a large portion of the economy. You can tell someone's motivations by their hostility to any solution other than total state control of the medical system.