It seems like you're focused on the Extortion of taxation whereas requiring financial responsibility for medical treatment is simply that. I'm proposing to fund it through a payroll tax, and keeping public care cheap through tort reform. But I think you're avoiding the main question. "What do we do with the 25 million uninsurable people skewing the  private market actuarial tables? ". No one will insure them, they don't qualify for Medicaid unless they become wards of the state anyway. Is that your idea of how it should work?