[arethuza]

For some reason none of that sounds particularly unreasonable to me - once you decide to opt out of the NHS then you have to accept that you are paying for all of the costs. Note that this view might be because I'm in the UK and have private health insurance - although everything major (accidents, childbirth) I've relied on the NHS.

While mixing and matching might seem sensible I suspect that the resulting administrative complexities might introduce the same kind of inefficiencies that the US system appears to suffer from.