In that respect, universal healthcare exists now, today, in this country. It’s just that it is a ridiculously ineffecient and incredibly expensive manner of delivering healthcare.

We really only have two choices, continue as we have been, with everyone eligible for care at the taxpayers expense, once they have exhausted their own resources (or simply don’t pay and forfeit their credit rating). Or, we can decide that we already have mandatory coverage as a result of the societal agreement not to deny care, and create a system that allows  this mandate to be as effecient as possible. Meaning essentially that everyone would be required by law to carry health insurance of some form or another. I would imagine in this scenario, young healthy people could potentially carry catastrophic insurance coverage, with a low premium and high deductible.

The only alternative is to repeal the social agreement and corresponding laws that say that no one can be denied necessary care. I don’t see this happening, do you?

That is a common problem which leads many libertarians and conservatives to take positions they wouldn’t otherwise take. The right wing noise machine is very good a framing issues as a debate between freedom and government when issues are far more complex than that.

The problem is the system that protects a free market is a construct, a fiction created to present the illusion of a free market, but because the system which protects must necessarily have the might to take anything by force,  rights exists at the pleasure of it’s source of protection.

The good news is that the markets would collapse if the source of protection overtly abuses it’s might, which would in turn eliminate the source of power of the system protectors. The bad news is that the system can be corrupted internally. This takes the form of regulatory capture, whereby monied interests buy favor with the system protectors, and gain advantages and protections that could never exist in the myth of a free market.

There are some actions that can be take to mitigate regulatory capture, but realistically, it is an inescapable element of any market.

This is where liberalism comes into play. Not liberalism to eliminate the freedom of the market, though that is the claim of conservatives, but liberalism to counteract the effects of regulatory capture.

There are examples of this tilt and counterbalance across our history, but I think one good example is the is the management/labor relationship of  the Industrial Revolution. Corporations gained the power to virtually own their labor force through various mechanisms such as company towns. The liberal counterbalance was the protection of unionization.

In the healthcare debate, the insurance industry controls nearly 1/5 of the nations GDP, this industry has used regulatory capture to great success, and is fighting the liberal counterbalance with everything they’ve got, and have been hugely successful for decades, and are on their way to victory in the current debate. The problem is that we like to frame the debate as freedom vs government, but in fact the debate is regulatory capture vs counterbalance. Unless the debate is understood for what it is, then regulatory capture has already won.