>>I have yet to see a more ideal solution than removing government involvement in the transactions of health care. Government has an important role in establishing and enforcing the rules, but needs to be completely removed from payments.

I wonder whether the Swiss system is closer to what you mean. The model does include choice, competition and a private option, though the model is expensive compared to everybody else except the US. Perhaps it's better to contrast the prevalent public and private "pay as you go" Ponzi schemes with the well-known principles of underwriting that could make any sort of system self-funding if not for entrenched positions and the resulting deficits. For the record, the present value of predictable unfunded Medicare obligations is over $40 trillion which will have to come from "somewhere" or Medicare will collapse. Having watched politicians posturing and arguing about borrowing another lousy few trillion ;-) you can imagine the fun when those Medicare liabilities start coming home to roost.