Originally Posted by The_Jazz

Second problem first: in a capitalistic society, you have to allow companies to manage their own risks, including insurance companies. That means that you can't force companies to do things they don't want to do without some sort of trade-off. Ask Florida property owners how making that mistake has been working out for them. The biggest problem here is that individuals and smaller groups actually produce more risk for insurance companies than larger ones. It's a little counterintuitive until you realize that accuaries can predict health care costs for large groups much more accurately than small groups and not at all for individuals. Someone who works for a large company is going to get cheaper insurance than someone who is self-employed, almost regardless of any pre-existing conditions. The risk is going to be factored into the premium charged to the large company from the very outset. There are also a number of things that a company can do to lower their premiums, like taking on some of the risk themselves. It's actually much more complicated than this, so let me know if you want more details. I'm trying to paint with as broad a brush as I can.

Currently, there's no good fix, but I know of several that are being proposed right now. I have a client who is a large benefits agency (health insurance falls under the benefits umbrella). They are current lobbying their state legislature to be allowed to set up what's called a "risk purchasing group" for the self-employed. Their goal is to get several thousand individuals, along with their families, into this pool to allow them to enjoy the benefits of group buying power. This is current illegal in most states (for some very good reasons, actually), but if they can demonstrate the controls that they want to put in place, it could turn into something very interesting.