If in a calendar year a person has in excess of $100,000 in medical expense they are transferred over to Medicare, regardless of age.
The remainder of the citizenry is able to choose from a competitive insurance market, which is essentially selling $100,000 “Term” health insurance policies.
That is from Kim Meyers of Northwestern. As she notes in an email to me, this can be combined with health savings accounts and various kinds of deregulation for the coverage of the lesser expenses. You also can raise the Medicare eligiblity age and I would say you could raise it to a very high level indeed.
I view this as the most plausible way of bringing a Singapore-like health care system to the United States.