Obamacare is still private healthcare, with premiums mandator with penalties for non compliance.
Most of the young invincibles rather pay the penalty than pay for insurance.
Yet those cohorts are  what normally pays for higher costs at the older ages.

This is the great flaw of Obamacare and why premiums are rising, and why it is not sustainable.
The old system was far better......and medicaid took care of those who could not afford insurance....and most of these were non whites.

If you look at US lifespan data, lifespans of  these non whites are  lower than for whites, which skews the interpretation of life table statistics.

The canadian system is in between medicaid and the former US private insurance system.
....better coverage, but longer wait times and poorer outcomes.

We need to recognize that Medicare is no longer working according to its prescripts , is not sustainable, and urgently  needs to be changed.