It's a hard truth for politicians and voters to swallow.
As the income gap continues to rise, there seems to be no way around having to subsidize health coverage for lower income people. Most likely, for over half of the population, healthcare either has to be subsidized or rationed. Rationed could mean folks dying do to lack of care, or (in some cases) living longer do to avoiding risky procedures.
Subsidized means some kind of tax that higher income people must pay. Call it a tax, or hide it among premiums and other medical charges, it has to be done. Obamacare tries to hide the tax so it can be swallowed politically. This creates kind of a Rube Goldberg contraption of complexity, but when so many folks say it will fail, it still prevails.
There is no way around either a subsidy or rationing for at least the lower half of the population while income discrepancy is so wide in USA.
Aside from the subsidy issue, lots can be done to lower overall health plan costs. Promoting better diets and lifestyles; bicycling. Reducing bloated salaries toward the top of the medical and insurance sectors. The list goes on. Lots can be done, but there is no way around subsidy; given the current state of society.