People have to pay a healthcare tax instead of paying their money to private insurance companies. If Americans put the money they are now paying to health insurance companies into a public plan we would all be covered. A large part of the reason insurance costs are so high is because people who are buying insurance are being billed for people who need care and cannot afford to pay for it. Hospitals and doctors have to make up the difference somewhere and insurance purchasers get the bill. Insurance companies are behind the staggering premiums doctor's pay for malpractice - not the patients.
I'm a good example of the problem engineer. For my husband and I to have insurance (we are self employed, small business owners) it would cost us about $12,000 a year for basic coverage. In addition, we would have to purchase a special disability insurance that covers our premium bills in case we get sick and cannot run our business. A common problem of small business owners is that if they are sick and can't work they might miss a premium payment and thus lose their health insurance. Insurance companies love this excuse to get out of paying for serious illness treatments. That disability insurance is another $4,000. So our cost to have insurance is $16,000 per year. In France, the average small business individual pays $3,600 a year in taxes for guaranteed coverage. My husband and I could each manage to pay another $3,600 in taxes to have health insurance. There are many small business people like us who could be paying into a public system, but we don't even have the option. I would at least like the option.