Perhaps a membership subscription service, with real benefits included besides just emergency and preventive healthcare to entice the young and healthy to join, such as the use of gyms and pools, and included or reduced price health food restaurants/shops. You would be a member of your community hospital instead of paying into health insurance. Hospitals could have sharing agreements for member care when the are not near their home hospital. It might be similar to current insurance in network and out of network costs to the patient.