The Health Care Cost Crisis

In the insurance industry, this is called "adverse selection". People who really need the insurance (older people, you know, like everyone on this forum) will buy it at almost any cost. People who don't think they need insurance(but they probably do need some) will not pay for it, no matter how affordable it might be.

Why this model works in the business-centric US model is that the younger folks sign up because the company offers it, and they've been told it's a great "benefits package". Why it doesn't work for everyone else is that when you're tasked to do it on your own, you have to put some effort into it.

As PJ said, that is why the mandate had to be in the legislation. Who didn't understand that or wanted to kill it no matter what? Yep, first Republicans, then MAGA.

Tax breaks and HSA accounts will not accomplish that. 

IT IS A BASIC PRINCIPLE OF THE ENTIRE INSURANCE INDUSTRY: EDUCATE YOUSELF, OR STFU.

Now go cancel your auto insurance because you haven't had a claim in 20 years. 

You're kind of getting lost in the details. There doesn't have to be a "special" tax. Here's the simple way, as done in Europe, Canada, et al:

Free medical care for all.

Paid for out of general government revenues. Incomes taxed sufficiently to avoid a deficit. Yearly budget includes allocations for all medical care provided.

Simple!

AND! An overall 20% savings due to much lower administrative costs (single payer).

Health insurance, offered in a free marketplace and not mandatory, carries the seeds of its own destruction; I believe the industry term is "death spiral." The pool of policyholders shrinks and gets sicker and sicker, while prices go upwards. 

Which is why it has to be offered by the government. That isn't unique. There are lots of things that government does that would be terrible in the hands of private enterprise (post office, military, etc.).

That's also why enrollment has to be mandatory. Not that anyone would object if the government simply paid for it. Jawohl, taxes would be higher. But the total outlay would be lower, in the absence of premiums.