Yes. Enact single-payer coverage only for catastrophic expenses. It would cover medical costs over something like $4,000-5,000 per adult, and maybe $500 per child. This would replace all other health insurance for medical costs of this magnitude. This doesn't have to be a huge, national bureaucracy. I'd prefer a regional arrangement. Groups of 7 or 8 contiguous states would establish a catastrophic health insurance fund. Everyone in the region would pay a premium--or you can call it a tax--into the fund. Medical risk is not a factor. Employers would also pay through a FICA like payroll tax. The fund is responsible for covering medical costs over the deductible. Then, private insurers can sell optional supplemental plans that could cover the deductible, or experimental treatments, or any benefits someone is willing to pay for. This arrangement is actually a hybrid single-payer system. It's based on the Medicare model, which is already well accepted and very popular.
There are several advantages to this kind of single payer coverage:
1) It's non-profit. No premiums must pay for a profit margin, or exorbitant CEO salaries.
2) Having as many individuals, and businesses as possible in each region pay into the fund spreads the risk as widely as possible. A large risk pool lowers each payer's cost as much as possible. That's a basic actuarial principle. And that's also why it must be mandatory. Imagine if 20 million or so working people, and businesses are contributing to the same insurance fund. There will definitely be a cost saving compared to the premiums people and employers in smaller risk pools must pay. And it allows people which chronic, pre-existing conditions to have coverage at the same price as everyone else.
3) It has a potential to lower medical fees. A single payer can negotiate prices with providers much more effectively than can many small insurers. One of the biggest misunderstandings is that single-payer insurance is anti-competitive. It's wrong because insurance companies are not really sellers of a product. Fundamentally, they are buyers. Their business is paying for health care. When you have dozens of payers for a product--especially one like medical care with a high, inelastic demand--there is no pressure on the sellers of that product--who are hospitals, providers, drug and medical equipment manufacturers, etc-- to keep prices low. But when there is only one buyer, then there is real price competition among hospitals and doctors and drug companies. The buying power of a monopsony lowers prices. You can't go overboard with this. If you stiff providers, you'll lose them. (Which is a problem with some states' Medicaid programs.) But a sensible one-payer system, that pays fair and reasonable fees, has the best chance to keep medical costs in check.
4) Insurance for catastrophic illness or injury is the only kind of coverage everyone really needs. I do think people should be responsible for their own initial health care. If they want coverage for that too, then they can buy that themselves. Limiting publicly funded coverage to high cost illness reinforces the idea that health care is not free, and social welfare programs are just a safety net.
This is just an overview. Good health care will never be cheap. But I think this a rational and sensible approach that has the ability to keep costs reasonable and maintain quality.
Sorry for the long post.
