I believe that if we are not going to go with single payer/universal coverage that we need to do more to strengthen the individual mandate. If people received a stipend from their employers for health insurance, but still purchased on the exchanges/individual market place, it would strengthen the individual market tremendously, lowering costs overall and allowing employers to set limits on how much they spend and how much of cost increases they are willing to absorb and eliminate a lot of uncertainty. Meanwhile, individuals can shop for the plan that best suits their needs. Young healthy people who don't expensive plans may choose to take a high deductible HSA plan. Employers could even mandate that the balance of the stipend be placed into an HSA if it doesn't get used for premiums. This idea weakens the individual market place which gives individuals LESS choice. They become stuck in jobs because they worry about losing coverage, they are often times over insured, etc.