Yes, have a federal law that requires everyone to have and contribute something to a personal, portable tax free healthcare saving account as well as carry a high deductible plan. An employer could decide to match contributions as a benefit if they desired to do that, but everyone would then have their own accounts and be covered for catastrophic care. Make sure that left over amounts when a person dies could be inherited or gifted to a needy person. Most healthcare needs could be met from the savings accounts and the government would not need to be involved so much. We could continue SSI and Medicare and other government assistantance programs for several years until needs decrease and people have savings sufficient to meet most needs built up. It really should only be a few years since most high deductible plans are not that expensive and if people with certain income levels are required to contribute amounts scaled to their income levels, such as requiring a person making $50,000 per year to contribute a minimum say of $200 per month, savings should accumulate quickly for most healthy people and the unhealthy people should benefit as some accounts are inherited or given as gifts and of course welfare would continue as needed.