A number of interesting questions have been brought up. Before I get into my comments, I want to point out that I am neither a financial consultant or an insurance specialist, so what I do is what I do, but it’s not meant as a recommendation. Also, my comments on based on Medicare coverage, rather than commercial.

1) What percentage of those 26m people without coverage are not legal residents of the USA and thus would also not qualify for a universal healthcare insurance plan?

In the absence of seeing the wording of a potential plan, the answer is "who knows?". That said, in its current configuration (at least in NY State), I believe Medicare would cover many of these and the rest head to hospital emergency rooms for free care. That's one reason that I'm guessing, despite their denials, the Powers that Be are going to slice up Medicare to help hit their $1T in cost cutting.

2) Sufficiently wealthy that they would just as soon pay out of pocket, rather than purchase a plan? I'd be happy to pay out of pocket if I could get the same rates the insurance companies pay.

Being "sufficiently wealthy" and taking a chance on catastrophic costs are two different things. My sister (WendyBG who I think sometime shows up on this board) recently weent through some work on her ticker which, after the Medicare discounts, still came in in the mid-six figures. While she has a high-deductible "medigap" plan (G, I think), her out of pocket expense was less than three grand. Like her, after doing back-of-envelope scribbling, I have elected to carry the cheaper between type F and type G high-deductible versions. As far as getting the same price as Medicare? Dream on. My wife's doctor ordered a battery of blood tests to track here high-cholesterol and the same battery for me as part of an annual physical. Hers were free and mine cost a few hundred bucks. Different coding, different pricing - mine ended up at retail as they were not covered.

... sufficiently wealthy that they would just as soon pay out of pocket, rather than purchase a plan?

Well, I travel a lot (sometimes six months at a clip) and do some of this with travel insurance. The big-ticket items on this sort of insurance are "trip cancellation" and "trip interruption" insurance. The policies also cover sundry other stuff including luggage insurance, rental car insurance, etc., etc. Most importantly, it includes medical insurance. What I do is, regardless of the cost of a trip, I cover $500-$1000 recoverable cancelation/interruption costs and some pretty high levels of medical insurance come along for the ride. (Sometimes, paying with appropriate credit cards can augment this somewhat). We tend to purchase this from Allianz and in NYS it tends to cost less than a couple hundred bucks. We also take out annual air-ambulance contracts, as we travel to some pretty out-of-the-way places and that phrase "nearest adequate medical facility" is a bit too fuzzy for me.

So, while the medical aspects of our trip are well covered, if we had to cancel the trip, other than a pittance, we'd likely eat a major portion of the cost. I figure we've already paid for the trip, so obviously we can afford the loss. The insurance cost, if we covered the whole trip would run about 10% of the cost. We have probably taken about 30 trips without a loss, so if we ever did get a major ding (which probably gets more likely as we age), I can always console myself by saying we still beat the system.

So, context determinate rather than a consistent answer.

Jeff