The mathematics of universal coverage is not going to work unless everyone is required to contribute.  What you are trying to do in this scenario is to pool everyone's funds together, but knowing that only a fraction of the contributors need medical care in any given time, hence you can socialize the cost.  Actually this is the easy part.

 

Now the harder parts:

 

1.  Under universal coverage, what would be the package of universal/basic coverage that is available to everyone?  Universal coverage does not imply that every cardiac patient is eliglble for bypass operations!  Must decide on what should be included in the universal/basic coverage.

 

2.  Risk analysis (a.k.a. 'death panel'):  American voters and taxpayers should stop playing dumb and realize that we are surrounded by results of risk analysis.  Obviously, signal lights are not installed on each and every intersections.  Likewise, if there are only a limited supply of flu vaccines available, priority goes to the highest-risk group which consist of mostly children and a few elderly.  Likewise, someone who is in his 50s and need a cardiac bypass is likely to get one, but someone who is over 90s is less likely.  The lesson:  Life can be quantified and we have been doing this for ages!

 

3.  Need to change our tort laws.  One of the major procedural criticism towards American healthcare system has been practitioners prone to running so many superfluous tests to avoid the risk of lawsuits.

 

4.  Privatization has not worked wonders for controlling the cost.  Most of privatization fad did not gain momentum until in the '90s.  (Until then, most of our hospitals have been 'community hospitals', not as for-profit companies.)  That was also when healthcare cost started going up faster.  There were even comparative hospital studies done:  A hospital in El Paso and another one a few hundred miles away.  The former depended a lot of its revenue on Medicare, while the latter much less so, however both shared similar patient demographics and psychographics.  It turned out that the the latter had much higher price tag on performing the same operation.

You are wrong on number 4, it was NOT privatization, it was a 1985 law authored by Ted Kennedy that established HMO's. Prior to the law, people basically paid 20% of thier cost and insurance which was much less expensive covered beyond that. This enabled individuals and hospitals to weigh proceedures on a personal basis and the patient could weigh the risk/cost. Once HMOs became the norm, everything became an accuary, thus driving up cost, the exact opposite of what the law intended. This forced many community hospitals to either close or privatize for mear survival.

 

Follow that with increased focus on Medicare and the fact that medicare cost soared to 9 1/2 times it's projected cost due to an aging population and health care became a mess. The fact is that ALL MEDICAL COST ARE BASED ON A PERCENTAGE OF MEDICARE.