Reihan acknowledges that we have a hybrid healthcare system, one with both public and private elements, and that "we will continue to have a hybrid system under any imaginable set of health system reforms":
Singapore is another hybrid system, in which the state aggressively regulates prices, mandates transparency, and has created a mandatory systems of savings accounts that residents draw on for routine health expenditures and universal catastrophic coverage. One can argue that Singapore’s system is more statist than the U.S. health system, yet the U.S., as a sprawling federal republic, has a large number of overlapping jurisdictions that impose their own regulations that add to the thicket.