When you only offer "catastrophic" plans, and particularly with no rules,
I believe I stated “reestablish” catastrophic plans as it relates to ACA putting an age 30 limit on them. That age limit affected millions to include me for no apparent reason than to force people to buy full coverage that was not wanted.
And never said “no rules” or “unregulated” either. But requiring the same insurance provider to abide by different rules for the same policy in each state is not cost effective either. A single group of rules and regulations at the federal level seems to work for just about every other similar situation except private medical insurance. Which will also substantially reduce the current “huge administrative and time costs” you mentioned.
While I don’t follow your “medical bankruptcy” comment, if that is a concern you can apply an asset requirement/review to each plan as needed. They do this with Medicaid and other similar programs.
It fundamentally comes to that you can never fairly assume that the consumer of medical services or purchaser of medical insurance is a well informed consumer, so a "free market" assumption is always going to be a poor starting point to assume.
So you’re saying someone should make that decision for them? Should we also decide/force people to save for their retirements as well given over 75% of people age 50 have less than $100K in retirement? Regardless what medical system is used there will always be the 25% who expect someone else to make their decisions and take care of them. I understand that but to tweak the remaining 75% to accomplish that I don’t agree with.
For example, at one time my state had a robust charity hospital system that consolidated the Medicaid money and provided care to those who couldn’t afford care, fell through the cracks, or couldn't figure things out that you refer to. This system was managed and operated through the state medical schools and it worked. Granted there wasn’t a clinic in ever town and you may have to travel from one end of the state to the other to get certain services, but you got the care needed. And on average, care equal to or better than the private hospital system. Our charity system started it’s downfall with the original signing of ACA in 2010 and completely went away in 2014 because it didn’t fit into the “narrative”, i.e., insurance companies couldn’t make money.
So why not have each state form a charity system? They could manage it to handle the demographics and issues unique to their state and use the existing Medicaid monies. However, I don’t think there will be a simple solution to the core mess caused by ACA. It changed things to the point where you can’t get rid of it. Regardless, I have been having this same discussion for the past 7 years with a variety of people who tend to follow what I’ve posted earlier than a single payer system. Hopefully one day soon we can at least move in some sort of direction than the one we are on now.