J. F. Wharam and Others
N Engl J Med 369:1481, October 17, 2013
The authors point out the real and predictable failings of a market-based health care system: it costs too much (duh). And they suggest more market-based reforms to fix the problems of unaffordably high deductibles and co-pays in the Obamacare health insurance exchanges (premiums could be lower too). California is perfectly poised to leverage the situation by taking the obvious next step towards a single payer system (a goal for 2017): authorize the elected Insurance Commissioner to set the prices of the health insurance plans. The legislation's been introduced and almost passed several times. The Exchanges have already whittled down the insurance plans to only a few left standing, and set compulsory enrollment, and standardized benefits. Chopping their rates and profits gets pretty close to the role health insurance plans already now play in Medicare, as third party administrators.