I had the impression that Obamacare extended coverage to the high-risk guys as well, and that's good. But it is true that insurers will "move" the burden of payment to the healthy guys, who will see premiums rise. The way I see it, Obamacare is trying to put a band-aid on a system that is inherently flawed.

I would propose something even more daring (and I know it sounds positively communist to Americans): universal healthcare, or at least universally-subsidized healthcare.

(1) Private healthcare gives incentives to providers to milk patients for money. For example, in many cases you do not need to buy any medicines you might get prescribed expensive medicines. Another case: instead of using cheap and effective generics, medical practitioners provide "branded" pharmaceuticals because of their close relationships with pharma companies and patients pay through their nose for them.

(2) Healthcare (AND VACCINATIONS!!) have strongly positive "externalities": these are impacts outside of the direct payment from patient to doctor. For example, vaccination reduces the spread of diseases, so they have impacts beyond the two parties involved in the exchange (doctor and patient). Vaccinations should be free. Wait, vaccinations should be mandatory and maybe accompanied with a cash prize or tax break. You really don't want your people to avoid getting healthcare on account of the cost, because the benefits accrue to the whole of society and not just their own health.

(3) Birth control and abortions are one of the most effective means of reducing unwanted births, and unwanted births have a strong correlation with criminality and unemployment of the child in question. These should be provided for free, no questions asked, no shaming inflicted on the woman. Of course if the majority of Americans have a religious issue with that, then that's up to Americans to decide if their religious morals outweigh the societal benefits.

Addressing the counterpoints to universal healthcare:

(4) There will be no competition driving costs down. Not true, you can have multiple private companies which compete purely on cost reduction but not on pricing of medicine and treatment. They will be paid a top-up by the government to cover the subsidized pricing. They can still compete on how well they can cut costs.

(5) There will be an incentive for people to seek free healthcare for frivolous things. Disagree with this, because in the first place nobody likes going to the hospital. But if that's really a concern, maybe subsidize healthcare by 90%. That will make it very cheap and at the same time still retain some economic incentive for patients.

(6) There will be an incentive for people to get fat and eat crap. Again, disagree because people don't like being fat and unhealthy if they had the willpower to help it. I would actually suggest that everyone is free to take a fitness test every year, and if they pass it they get a cash prize. So this gives a bit of an incentive for people to do some exercise.