Yes, we are officially in fantasyland.
That said, if you remember when GEICO was only for actual government employees, and when the Slovenian Community Credit Union required appropriate ancestry, you will perhaps be amused by a single provider plan which could, I think, result from executive vigor (if only we had a vigorous executive...) with no tiresome legislative hoorah-ing.
The VA medical system (now very well thought of, believe it or not...) announces that it will sell access, at the underwriting cost plus 10% (the profit to be used to reduce premium cost to actual veterans) to anyone who is a family member of a veteran, or a friend of one (as shown by the ability to provide the name of a veteran, dead or alive).
I bet this would put the parasitic health insurers (you give them your dollar, they pay your doctor 80 cents and require several full time office assistants just to fill out their forms--creating value how, exactly?) in the ground in a quick hurry. I think they call it competition, or the free market, or something.
Plus, as the number of actual veterans dwindles, facilities are closing imposing real hardships and reducing the economies of scale which would be restored by opening up the system to "Friends and Family"
Kind of like GM used to do when they offered employee discounts to any fool with the jones for a hummer...