If you want to fix our broken ass healthcare system, I recommend the following for starters:
1. Eliminate state lines - not for the same reasons you are use to hearing. Consolidate insurance companies and turn them into national companies instead of regional/state companies. This would make it easier from an administrative standpoint for hospital networks. We don't need 15 different BCBS and it ultimately increases administrative costs trying to maintain contracts with so many different payers.
2. Contractual Obligations - require all insurance companies to have one set of standards and all hospitals are required to be contracted with it. All claims must be settled between hospital/insurance company within 120 days. Place a fine every day for each claim not resolved on both the hospital network and insurance company. Would eliminate out-of-network plans and would save massive amounts of administrative costs trying to settle claims with insurance companies.
3. Incorporate Deductibles/Co-Pays into Premiums - would eliminate bad debt collection activities from hospitals and patients don't pay them anyways. Patients in this country obviously don't care about taking their healthcare seriously, not like a deductible would reduce risky behavior.
4. Consolidate billing - it's stupid you get 10 bills from 10 different doctors after a visit. Your explanation of benefits doesn't make sense anyways.
5. Taxes - implement a tax based system onto hospital networks and insurance companies based off the quality/value of healthcare services and key population health metrics.
6. Maternity care - implement a true maternity care system. Jesus christ I can't believe we don't have this.
7. Fraud - increase fraud investigations on government funding. Medicare/Medicaid wouldn't be so difficult if it weren't for the massive amounts of fraud we see each year.
8. Fix Patent System - would save a ridiculous amount of money on prescriptions and other medical technology
Single payer isn't happening any time soon and I wouldn't support paying into a system that rewards our unhealthy country anyways.