Without a mandate for everyone to carry insurance, we have one industry footing the bill for what should really be paid by the government.

Instead, the indigent have insurance (in theory), and they can get healthcare other than at the emergency room, hopefully at lower cost.

The alternative is to end the mandate for hospitals to treat everyone.

As an aside, I agree that Medicare expansion would have been a better policy. Good luck getting that through congress, though.

It is being talked about but there is significant opposition from those that don't want to raises taxes to the level that would be required to finance such a proposal.

Many doctors don't take Medicare. Over a situation where say there are 3 doctors for a specialty in a town... the two better ones do not take it, and the new less good one will take it. So if that flat answer is let everyone take medicare, I think there are some serious quality of care problems.

(I have no better solution though, every angle seems bad).