[11thEarlOfMar]

For completeness, a couple of other health related actions by the current administration:

- 'Most Favored Nation' drug pricing. Also as of 1/1, big pharma has to charge US payers the same price as the lowest price they charge to other countries. One example cited is insulin. Apparently, the price of Insulin from the same pharma is 10% the price in Canada as it is in the US. Now that this law is enacted, that pharma has to charge the same in the US as they charge in Canada.

- 'Right to Try'. Greatly reduces restrictions on terminally ill patients' access to experimental treatments.

- Removed the mandate on the affordable care act. People who do not have any health insurance were liable to pay a fine. That fine was removed.

- eHealth across state lines. Doctors were not permitted to see patients via video calls across state lines. During the pandemic, that restriction was removed.

[aksss]

We should not ignore the attempt to relax restrictions on Association Health Plans in 2019, which would have made it easier for small businesses to band together to negotiate insurance terms using combined group numbers on par with that of larger corporations. This was struck down by a federal court[0], but would have moderately improved one of the biggest barriers to small business ownership/employment - unobtanium health insurance. This was a huge loss of something almost great.

[0]https://www.shrm.org/resourcesandtools/hr-topics/benefits/pa...

[lotsofpulp]

The better, and simpler option is to remove employers from the equation entirely. Either go with taxpayer funded healthcare, or force everyone to buy from healthcare.gov where they can choose whichever insurance company they want.

[aksss]

In terms of moderate tweaks to an enormous problem, AHP reform for small businesses is comparatively low-hanging fruit that could help businesses today meet the minimum requirements for attracting talent - health insurance. Your proposal may be better in the long term, but the journey there is not simple by any means.

[lotsofpulp]

My proposal could be done immediately. All the infrastructure already exists. Remove the tax deduction for employers, give it to individuals on healthcare.gov, job done. Or ban employer sponsored health insurance and don’t offer anyone a tax deduction.

Either way, it’s all just a matter of changing regulation. The real problem is big business will lobby against it because it gives them an advantage over small business, and a leash on employees.

[aksss]

> immediately

Theoretically only, perhaps. I feel like you're overestimating the ability of our regulatory bureaucracy to implement change, or assuming that if you (or I) were dictator the proposal could be done immediately. But imagine flushing out that proposal nationally, getting it through the Legislature (with all the conflicting interests of the medical field, employers, etc), President and then implementation. Comp structures nationally would radically change, so such an overhaul would have to be phased in even if you did get through the gauntlet of bill approval.

[lotsofpulp]

Getting it through legislation is the only problem is what I mean. People can already purchase insurance on healthcare.gov. The infrastructure, the sellers, the pricing is all ready to go with no work. The insurance companies already do the same work so it’s not even like they need to hire people. It’s just cutting out a middleman.

Only politics is in the way, and current entrenched interests not wanting to lose their advantages.

[avrionov]

'Most Favored Nation' drug pricing is currently blocked in court. We don't know how this will play, if it works.