The only way to achieve an medically and cost effective health care plan is to immediately change the method of payment to health care providers. The first step would be to stop using the term "health insurance" and start referring to it as "Health Care." The insurance Industry must be removed from participation or it will never work. It was Hillary's attempt to control the insurance industry that doomed her maiden effort.
I have over 10 years of experience exploring how to change the US health care delivery system. I have watched everything that my Union employer tried to alert the health care professions and the public during the 1970s and 80s about HMOs and other provider group forms and the effect it would have on the quality and scope of health care. It was so difficult to try to make everyone recognize what was happening, much less prepare to do anything about it to avoid the disaster we are now in.
The only thing that will work is a not-for-profit single-payer health care system that does not include the insurance industry. It will be difficult enough to control the profit motives of the hospital industry.
Until we get the for-profit parties out of the health care system, the conditions we now face will only get worse. The insurance industry will fight to the death to prevent this from happening because they earn huge amounts of money by controlling health care through employer and private health insurance plans. They always cry "poor mouth" about their costs, but its a scam on the public.
If we get the insurance companies out of the picture and convert to a single payer system, it will help small employers as well as large, and everyone will have access to health care services.
I could go on and on, but this is getting too long and I'm getting riled up in frustration over the greed that has caused this situation.