The issue with US health insurance in general is that (a) it's not understood by the public as insurance, but rather as access to group rates, & (b) it's utilit

The issue with US health insurance in general is that (a) it's not understood by the public as insurance, but rather as access to group rates, & (b) it's utility is proportional to the number of counterparties it covers (more doctors, more useful), which opens it up to a huge amount of abuse (doctor you've only done 3 transactions with over the past 5 years is vastly inflating fees on all). What should probably happen is something akin to the housing market: backstop consumer insurance companies with re-insurers (semi-supported by the government) who buy and back compliant policies and providers. Allowing consumer insurance companies to bound their risk and offer more reasonable rates. I think ACA has a provision in there for catastrophic cases falling off the insurers' books onto someone else's, but it's been awhile since I read through it.