I heard, and am putting aside, your 90%
"Give INDIVIDUALS the tax benefit on purchasing health insurance. There's no good reason why anyone should have to work for a large corporation to get insurance via a pre-tax benefit."
Eh, kinda sorta. I've already agreed with you a hundred times that the playing field should be level so that all health insurance costs are deductible, or not; I would propose that they are NOT deductible. Currently, people think that employers pay for healthcare, and they think that their wages are stagnant. In fact, employers have a certain amount of money to compensate you and overall wages have not been that stagnant, they're just being consumed by increasing healthcare costs, from which people are insulated. If people actually had skin in the game, and felt the pain of their monies headed off for various services, then it would be easier to motivate change in behavior. Right now people behave as if more is the only option, more healthcare, more expensive drugs, newer this, bigger that, mri my eyeball. That is because they think we're at one of those large birthday dinners where we all split the bill and trying to reduce costs by ordering less makes hardly any difference to your personal costs.
Anyway, your idea about deducting healthcare insurance at the individual level solves a tiny problem and does nothing about the larger issues.
"Allow for the creation of purchasing cooperatives. Look no farther than Germany
to see the concept in play. (I've been there on business, as my former company had the entire country of Germany as a customer for a product I helped upgrade.) That way the concept of pooled risk becomes a reality for individuals and small companies."
Germany, eh? From Wiki:
Main article: Health care in Germany
"Germany has the world's oldest universal health care system,
with origins dating back to Otto von Bismarck's Health Insurance Act of 1883. As mandatory health insurance,
it originally applied only to low-income workers and certain government employees, but has gradually expanded to cover the great majority of the population.
 The system is decentralized
with private practice physicians providing ambulatory care, and independent, mostly non-profit hospitals providing the majority of inpatient care. Approximately 92% of the population is covered by a 'Statutory Health Insurance' plan, which provides a standardized level of coverage through any one of approximately 1100 public or private sickness funds
. Standard insurance is funded by a combination of employee contributions, employer contributions and government subsidies on a scale determined by income level. Higher income workers sometimes choose to pay a tax and opt out
of the standard plan, in favor of 'private' insurance. The latter's premiums are not linked to income level but instead to health status.
Historically, the level of provider reimbursement for specific services is determined through negotiations between regional physician's associations and sickness funds. Since 1976 the government has convened an annual commission, composed of representatives of business, labor, physicians, hospitals, and insurance and pharmaceutical industries. The commission takes into account government policies and makes recommendations to regional associations with respect to overall expenditure targets. In 1986 expenditure caps were implemented and were tied to the age of the local population as well as the overall wage increases. Although reimbursement of providers is on a fee-for-service basis the amount to be reimbursed for each service is determined retrospectively to ensure that spending targets are not exceeded. Capitated care, such as that provided by U.S. health maintenance organizations, has been considered as a cost containment mechanism but would require consent of regional medical associations, and has not materialized. Copayments were introduced in the 1980s in an attempt to prevent overutilization and control costs. The average length of hospital stay in Germany has decreased in recent years from 14 days to 9 days, still considerably longer than average stays in the U.S. (5 to 6 days). The difference is partly driven by the fact that hospital reimbursement is chiefly a function of the number of hospital days as opposed to procedures or the patient's diagnosis. Drug costs have increased substantially, rising nearly 60% from 1991 through 2005. Despite attempts to contain costs, overall health care expenditures rose to 10.7% of GDP in 2005, comparable to other western European nations, but substantially less than that spent in the U.S. (nearly 16% of GDP).
Well, at least it's decentralized. But otherwise it fits pretty well into your disaster model, with opting out by paying a tax, mandatory insurance for most, and public options. Hey, even though you cleverly (didn't!!!) say that Obamacare was like having Pol Pot and Stalin in charge, here you get to have Nazis!
"Let there be a two-tier system. Philosophically we've always been a land of opportunity and not a land of entitlement. If you buy coverage, you get deluxe. If you don't, then you get deluxe at a deluxe price OR you get economy."
I'm sorry--wait, come again? If you don't buy coverage, you get economy. If I am reading this right, and maybe this is another mine laid to be misread because it seems way out of character for you, if you don't buy insurance you get economy. You get the lower tiered insurance. You get FREE HEALTHCARE INSURANCE AND MEDICAL CARE. Which is like Obamacare except you didn't have to pay that tax to exempt.
Are you serious?? I mean, I know functionally that everyone supports this in practice as we don't think it's right for hospitals to kick leukemia patients to the curb regardless of ability to pay, but in principle, this is what happened during the Reagan years: tax cuts, without service cuts = exploding deficits. This is California, voting for prop 13, reduction in property taxes without service reductions = insolvent state. And in contrast to your simul-claim, that's quite an "entitlement."
I actually agree though. I think there should be some basic level of care that's guaranteed and we simply aren't going to be able to deny care as a country to people to poor to pay for healthcare, which is a great many. Have a heart attack? That's crushingly expensive to treat these days. Cancer? Hugely expensive drugs and hospitalizations. There is not an "economy" option that's sufficient, sadly; there is only deluxe and ultra-deuxe. If you want to save money on economy class insurance you just increase copays for visits and meds, and people don't consume them anymore. They're too pricey. Or you can reduce reimbursement and doctors stop taking that insurance. UCSD will not self refer new patients with Medi-Cal to our own clinics anymore for these reasons.
Anyway, if we're going to provide an insurance guarantee to individuals, they should also get to pay for it (=Massachusetts, = Obamacare). If we're going to insure AIG against crises, which apparently we are, there should also be quid pro quo there, too. Regulations or payment. Or we can make an upfront promise that AIG will die, or the patient will die, if they don't take precautions early enough. As I've said many times, we seem not to be able to let that happen in our culture.
Incidentally, let's dispense with that silliness about how the growing economies don't provide universal healthcare. Of course they don't. They're still poor as heck. They're growing because they have basically unlimited labor at low cost, and they're industrializing. How can a fully industrialized nation match the growth of a country going through that change?
China has crazy growth because it's industrializing. China has crazy growth because it's obliterating it's environment. China has crazy growth because it's stealing copyrighted materials and producing poisoned heparin, poisoned toys, and poisoned dog and infant food. And they crush dissidents. If you want to imply there's something to their not having universal healthcare, coolio, but then you open yourself to others who point out they have a more state controlled economy and a single party system (no gridlock--if they want to flood a valley to make a dam, they just do it), as well as inevitable confusion as to why you just advocated guaranteed economy healthcare (provided by whom, if not the government?).