My solution, and it’s not perfect, is: Rather than the government/taxpayers taking on the obligation of payment for almost all medical care as M4A proposes, we take on the risk of non-payment at Medicare or Medicare Reference Pricing, for the same care, by guaranteeing all patient debt and seeking means tested repayment plans. No HC insurance beyond supplemental plans. The taxpayer acts as the insurance company. Rather than premiums, taxpayers pay for what they use, based on what they can afford.(Mark Cuban)