Throughout my timeline. Here is the “short”, off the top of my head. Cure all would be, to make the big carriers divest all non insurance assets. Smaller stuff: 1. Make all cash purchases that are lower than current out of pocket, deductible 2. Require all contracts with any company or agency or org that gets taxpayer funds to be publicly posted, with prices. 3. If a HC entity gets fined by a state or federal agency more than once in 5 yrs, they can’t do business with the feds, or states, for 5 yrs 4. All non profit hospitals must publish their detailed general ledgers, prices paid to vendors, and any fees charged. Also require them to show yield (actual net revenue earned ) by plan 5. End Anti kickback waivers, require sales from brand manufacturers to distributor to be net of any rebates or fees. (Effectively cost plus) 6. End in network PAs/Denials. Your plan picked the doctors. If you don’t trust their judgement, don’t put them in your network Then, Require a denial list provided daily to CEOs of self insured employers so they can see how their carrier is hurting or killing their members. 7. Create nationally standardized PBM, ASO/TPA, and other HC contracts employers sign, only the numbers and length can change 8. End all provider networks. End chargemaster pricing. Require direct contract cash prices to be inclusive of deductible so no patient OOP, but the cost is still less to the employer. 9. 10. Allow the fed or state government to negotiate the pricing of all accessories, like implants, screws, glues, etc , and it be made available to all providers. 10. Have the fed gov (taxpayers) guarantee the cost of any medical care that is priced at Medicare or less, for anyone not on Medicare or caid. Paid up front. Repaid by the patient, on a means tested basis that starts at 3 pct of take home pay , but never exceeds 10 pct. With a maximum term of 20 years. After which it is written off. Think of it as a guaranteed student or SBA loan. The key here is, because of the price caps, providers will find Ways to meet the price and push down pricing across the board. (They say they don’t make money at Medicare rates, but they make contribution margin and they know it. ) Since there is no insurance premium required , the pay back amount would be less than what you would pay in ACA premiums. The fed would have the option of buying stop loss insurance or taking the risk for high $ care. Insurance carriers would have to innovate. To each according to their healthcare needs, from each according to their ability to pay ✔️ @SenWarren @BillCassidy @RogerMarshallMD @AbdulElSayed @AOC @HawleyMO @BernieSanders @1klomp(Mark Cuban)