These goals can be achieved simultaneously! The answer is that those who choose the public option, which is anyone who feels they need it, regardless of what other health insurance they may or may not have, regardless of their income, to get approval from a randomly selected jury for each health care procedure. That jury would have the full power to vote that the heart attack victim be left to die on the side of the gutter. They have full power to say the motocycle rider without a helmet does not get care and full power to deny care to those who drive drunk. That jury would have the full power to say go ahead and have that care and the government will pay for it. But we will have full control over your income until it is paid off. And if there is a controlled study running that is relevant to their condition, the jury would have power to say to the person they must enroll to get their care. The jury would have full power to make the person's medical records avaialable or even public, or keep them fully private if that is just. And the jury would have full power to mandate a specific care option, e. g. prostate removal when the person might prefer some other treatment choice. And the jury would have access to the person's financial and income history so they could decide whether the person presenting for case could have saved/contributed to the public option/bought private care and chose not to for foolish reasons, or they truly could not afford to do so. I made a more general post on a four part plan on how to apply participatory democracy to health care. However, now the main question is public plan, to be or not to be, so on that I blog now.
A government could not, it is simply not politically feasible to let a person die. The juries won't often vote to exercise this power, nor should they! But the power would be there--
(Victor Broadcasting versus Federal Communications Commission. WABZ was the incumbent broadcasting system and Victor Broadcasting wanted the frequency. They claimed that WABZ was simply not contributing to the community and frequently duplicated care. The case itself, of course, is not relevant to health care. But I remembered one dissenter's comment in the opinion for decades, when they observed that from 1961 to 1983, the FCC always let the incumbent license holder keep their license with one exeption. and he said the following.
One is reminded of the remark attributed to Theodore Roosevelt: "If the President of the United STates were obligated, irrespective of cause and at his own free choice, to put to death one man every year, the powers of the Presidency would be vastly enhanced." "If the Commmission would screw up its courage to a height never before reached by that agency, and firmly resolve to deny just one incumbent out of thousands of license renewals each year, the quality of television and radio programming ni America would be remarkably enhanced." Victor Broadcasting inc. versus Federal Communications Commission, 722 F.2d 756, 779, (1983, United States Court of Appeals for the District of Columbia Circuit)
Everyone would get the opportunity to serve on such juries. Everyone would have the power to say, "you screwed up; you shall be left to die." Maybe once per year, this option will get a majority vote of a health care jury. But with that option, the public option and the private plans would be immeasurably enhanced.
(I searched for this quote. It appears to be apocryphal.)