Common sense and good politics have always made awkward bedfellows--that is, at those times when they can even get into the same bed together.
In a perfect, non-political world, the best way to pay for health care insurance would be to tax the hell out of the things we consume that harm our health. We could pay for our own upkeep with our vices. As the social engineering took hold, and we began to consume less of these things, the revenue from them would, of course, drop.
But, by then, we'd be correspondingly healthier as a nation, and would have less overall need for medical services. Our race of super-healthy ubermenschen could march happily off into the future.
Well, that isn't the American way. Only a politician getting ready to retire anyway would be nuts enough to suggest something so sensible. Besides, this isn't Scandinavia. Rugged American individualism requires that we be free to eat, drink and smoke ourselves to death if we want to. It is our right, and if it isn't somewhere in the Constitution, then, by God, it should be.