You're focused on the Extortion whereas requiring financial responsibility for medical treatment is simply that. I'm simply proposing to fund it through a payroll tax, and keeping public care cheap through tort reform. But you're avoiding my question. "What do we do with the 25 million uninsurable people skewing the actuarial tables? ". No one will insure them, they don't qualify for Medicaid unless they become wards of the state anyway. Is that your idea of how it should work?