While I think it is important for people to understand the difference between health insurance and a health care plan, there's no actual problem with people banding together and creating health care plans that are no longer, strictly speaking, insurance.
I do think a nontrivial amount of the mess in the health care system is the confusion between the two. People want to create health care plans, but they are trying to make it out of insurance companies, which is going to be problematic at best. Further, people want health care plans but don't want to think about it from an actuarial perspective... because they don't like the answers that come out. That doesn't prevent the answer from coming out, but it does mean we end up trying to build glorious systems that seal themselves away from reality from the get go, and that also can only be problematic at best, total failures at worst.
I think that the more certainty people have about their future medical issues the less likely health care plan groups are to work. What incentive does a future-healthy person have to join with someone who is certain to have high expenses? And why would you trust someone to tell you that they haven't been tested and know what lies ahead?
That's what I'm getting at. The more knowledge all the participants have (and that's both insurance and users), the more the fundamental contradictions between "insurance" and "health care plans" emerge. But closing your eyes and just remaining ignorant is a terrible choice too, because in the medical domain, knowledge isn't just power, it's life.
I do think a nontrivial amount of the mess in the health care system is the confusion between the two. People want to create health care plans, but they are trying to make it out of insurance companies, which is going to be problematic at best. Further, people want health care plans but don't want to think about it from an actuarial perspective... because they don't like the answers that come out. That doesn't prevent the answer from coming out, but it does mean we end up trying to build glorious systems that seal themselves away from reality from the get go, and that also can only be problematic at best, total failures at worst.