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Let's say for a second we were to take a public option off the table. Then I believe the following reform would be needed.
1) Health insurance companies would have to put at minimum a fixed % of premiums into coverage. At the end of the year any amount over the required % would be refunded proportionally back to all policy holders.
2) All policy holders are placed into the same risk pool, that is everyone pays the same rate for said coverage. Essentially make it as if every person in the US were in the same group plan.
3) Everyone qualifies for every plan and no one can rescinded or denied coverage.
Insurance agencies could still complete with each other and could offer plans that meet peoples needs. Essentially each plan offered would carry its own risk and the insurance company would set premiums accordingly but everyone would have the same rates.
Right now greedy insurance companies are fleecing the sick and laughing about it all the way to the bank. They had their chance to play fair and they abused it and now they need regulation.
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