Taxes go down and the deficit decreases. Those from Texas can legally buy insurance from companies in Florida or Vermont or wherever they choose. No health care is tax advantaged or disadvantaged - it just is. People can order insurance custom to their needs; a pick and choose model that serves their situation. Healthcare lobbyists flood the street seeking alternative employment. Insurance is bought and sold like cell phone or cable service. Startups become highly tuned to the needs of the market and excel in matching people up with insurance companies and health plans in innovative ways. The market is allowed to operate like it should.
Or, taxes don't change enough to move the needle on health insurance affordability.
We further deregulate the insurance market, and the private insurers of last resort in several locales move to more profitable markets.
Meanwhile, the insurers in the states with the greatest consumer protections move to the venues with the least consumer protections, producing a net decline in health care quality for the entire country. With barriers to interstate insurance removed, the industry is also free to concentrate itself through M&A.
While that's happening, the adverse selection problem with health insurance continues to fester, as our "free market", in enabling "the pursuit of happiness" for everyone, especially 20-something bachelors, cons the whole consumer market into believing they can free-ride into their 40s (or their first child) and then get reasonable insurance, while draining the entire risk pool of all the low-risk patients.
Those same 20-something bachelors show up in emergency rooms, bankrupting themselves over broken bones --- but no problem, by the time they're old enough to care about their credit rating, the only people who will care about this health event are the hospitals and doctors, who will raise rates on everyone else to cover.
At the same time, nothing is done to address the fundamental problem that even in the most consumer-friendly venues, tens of thousands of totally normal families are unable to obtain private insurance coverage at any rate because of preexisting condition coverage.
I think you'd have tons of undesirable side-effects. For instance, anyone with a prior history of an illness could never ever get affordable health care. With car insurance, I can understand the principle (bad drivers pay more), but I just don't think it's ethical to let sick people pay (significantly) more than healthy people.
