> some reasons it should continue, but they are not really good reasons.

Many of those reasons are legislature that allows insurance companies to do/demand things that they really shouldn't be able to. Even if the goal isn't public healthcare, America still needs a major healthcare insurance restructuring.

I think that should look like this: HMO style access for all - automatically. Rebate if you decide to up it with PPO style insurance (or beyond). So you get 200 per month off taxes to pay towards your own insurance.

Also, get it out of the employers hands - as in make it illegal to offer any benefits and let the employee get paid 100% of their salary instead. Also make it so that employers can't legally collect taxes without consent.

You'll then create two systems – PPOs for the healthy that can afford it, underfunded HMO for those who can't.

Just drop the rebates, and make any secondary insurance be primary. That would make sure the insured group for the public system includes the healthy rich (which makes the pool for those that actually need and can't afford their health).

> It continued to be an okay way to do group insurance without facing major problems with adverse selection.

This is sort of a hot take, but there are plenty of examples of things like this in the US that have the unstated parenthetical "(because poor and minority populations were ignored by the system completely)"

Well yes, it was functioning as a health care plan featuring actual bona fide insurance, which means you paid for yourself, and you paid an amount commensurate with the risk that your health care needs might prove to be expensive. It was not designed as a wealth transfer to the needy any more than the auto insurance market.

We may need more wealth transfers to the needy so that they can pay for healthcare! You will note, however, that the recent approach to reforms, which tried to turn the vehicle of “insurance” itself into such a wealth transfer, has not exactly solved the problem!! Nor has it achieved its stated goal of making healthcare and health insurance more affordable to the general population, a mission always contradictory to its goal of being a wealth transfer!

>"Given the mandates on insurance there are some reasons it should continue, but they are not really good reasons."

Besides the fact that there doesn't seem to be any better or viable alternative available in the marketplace what are the other reasons?