1. People who are well often don't see the value of health insurance.
3. Opt-in programs will never achieve 100% coverage because a % of people don't see the value.
4. A % just don't want to help others even if it helps themselves

5. A program that covers sick people and not the well will always be unstable and more costly.

My proposal is to fix the ACA, restoring it to the original design with a robust Medicare-like public option on the exchange.

Then automatically enroll every child born in Medicare. From birth to 18, that child's covered by a Bernie Sanders proposed level of coverage.

On a person's 18th birthday, they can choose to: opt out and pay a pandemic preparedness tax each year, get a job with private insurance, or do nothing and pay for their Medicare coverage through taxes.

What's the net result? Very few people opt out. They've had medicare for 18 years, it's reliable and worth paying for it.

When given the choice to accept private insurance that costs more and covers less, most will stay with Medicare.