We are moving towards some sort of single payer system in the US. Personally, I favor a NHS, but your milage may vary.

The reason that we are seeing personal mandates right now is because ERISA, passed in 1974, pretty much prohibits most other sorts of action.

The best short term solution is to remove the preemption clause of that law, because in addition to preventing meaningful healthcare reform, it provides a ‘get out of jail free’ card to the worst actors in the insurance business.