I would say that it's a good idea to have a means-tested social safety net for those with reasonably unexpected catastrophic medical expenses. Other than that, I would leave things the way they were before ACA.

There's a medicaid waiver (I think it's state level but I'm not sure) for those with chronic illness so that they aren't bankrupted from the expenses that are on top of their health insurance.

I grew up with "free" education (think limited seats at the university, no general education, no second chances, have to know what you want to "be when you grow up" at about 15 years, so that you take all the right requirements in year 11 & 12 to gain a place in the exact right program). It's waaaaaay better here. Having the market provide pressure is a good thing.

For example, DS is very good at math and programming. He's going to the less expensive, local 4 year university and it will do him just fine.

Universal health was implemented when I was a teen. It was originally supposed to be covered by a 1% increase in taxes. Well, of course soon that wasn't enough. And now, the health care is awful. No Aussies want to be a doctor, because they dont' get paid enough. The doctors barely speak English, because they are from Eastern Europe and other countries.

A lot of care is clinic care, because the nice, red carpet office visits that we are used to are more expensive. So my sister, with gestational diabetes, gets to sit for hours, waiting her turn to be seen in clinic.

People with any money buy private insurance on top of the public care. They get better care. They don't have to go on wait lists for normal care. My dad had aggressive cancer but had to go on a wait list for surgery, because he just had public health care and there were no hospital beds available.

I don't think there are any perfectly pretty solutions to health care. The reality is that our technology advances, and it's expensive, and we are an ageing population. But I do think the best of the solutions is to leave the market in charge as much as possible but with the social safety net for those with the greatest need, since the poor and disabled are simply not an efficient market.

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