It depends on what your purpose is. It is at least debatable that one of the major problems with our current system rarely addressed by anyone on any side is that it conflates a health care plan with a health insurance plan. The two things may with some justification be the same thing inside of your head, but in monetary terms, they have radically different statistical distributions of monetary payouts required, one being a fairly reliable steady drip of relatively small amounts of funds, one being a highly irregular payout of large amounts of funds. Only the latter is something that "insurance" is a solution to; if you're getting a steady drip of low-payout events the only thing insurance can do for you is add a middleman and raise net prices as a result. (Some individuals may win and some may lose, but it has to come out net more expensive for the system.) Trying to bind the two together into one thing may be part of, though probably not the entire, problem.