Imagine if all our roads and highways were owned by a few oligarchic insurance companies. For those of us with cars and bicycles, we must purchase an insurance plan to gain access to the roadway system. With one insurance company, you can use only certain roads within the network. (You will be denied permission -- or pay a hefty toll -- when using the other company's roadway system.)
This is how our healthcare insurance system is set up. With a comprehensive policy covering routine care, you are limited to the doctors within the network, and denied access (or pay out of pocket) to those outside of the network.
We have a horrible debt crisis. So if Paul Ryan were President, maybe he'd be calling for the privatization of the U.S. Department of Transportation. Then the federal government will hold a public auction. The Interstate Highway System would be sold off to the highest bidder. The remaining roads would be given as block grants to the states, for them to auction off.
Then for those of us with cars and bicycles, we will need to purchase a road insurance plan. But not to worry, Paul Ryan will provide us with taxpayer-funded vouchers (in the form of premium supports) to help pay for the expensive insurance.