Happy open enrollment season everyone! Isn’t it the most wonderful time of the year to choose between the limited plans our employers offer us or lose their contribution and go out and buy on our own?

I haven’t heard this from anyone in government (maybe I’m not listening to the right people) but it seems obvious what needs to happen to fix health insurance in the US if we’re not going to a single payer system:

Allow employees to take their employer premium contribution in a tax free account (similar to HSA, but with a higher limit and allow it to be spent on health insurance premiums).

Let families (spouse and dependents) combine their employer contributions to be spent on a shared plan.

Allow employers to continue to offer their plans, but also allow employees to shop on the market should they be able to find a plan that fits their needs better (healthcare.gov exchange or other qualified plan).

Allow employees to contribute and keep any excess beyond their premium to fund future premiums or pay for medical care.

Use this framework to also provide healthcare to the military, medicare or medicaid should people in those groups chose to take a voucher to spend on the open market.

This would:

Allow the free market to work like it does in auto or homeowners insurance, where people go to companies with competitive rates and better service. You’re not happy? You don’t have to quit your job, just switch providers.

Allow people to continue coverage on career transitions.

Allow people to continue coverage into retirement should they choose.

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Prevent married couples from losing the employer benefit from one employer should they choose to go with the other spouse’s insurance. That employer contribution should be able to be captured.

Level the playing field for small employers who aren’t able to negotiate or self insure like the mega corporations that have huge leverage when obtaining insurance.

Take your choice for your healthcare in your own hands instead of leaving it up to corporate HR/Benefits administrators.

This isn’t intended to be a political post but a nuts and bolts conversation about our health insurance framework.

Why wouldn’t a system like this be better?