“I’ll put out this fire for you if you pay me $5000”

"I don't want to be forced to pay for insurance, but will move to a state with subsidized insurance the second I need it."

The fact that the hospital doesn't know what a procedure costs (they make it up based on deals with medicare, medicaid, and individual insurance companies) should give you a hint.

Yes, the patient needs skin in the game. People need to take care of their own health. Most procedures are given to grossly unhealthy people.

Yes, completely privatize it. Make people pay for their care so their daily decisions are weighed against what affect it will have on their overall health.