If you want some bandaids that help patients 1. Make all deductible phase brand drug purchases be priced at net, after rebate and fees. Not just for ACA, for everyone in every plan. This will save patients 10s of billions 2. Require inter company transfers from owned providers be at Medicare rates. Ends gaming MLRs 3. Rather than giving money to everyone for their HSA, work with providers to guarantee payments for all deductibles, if they charge Medicare rates for ACA plans. This reduces provider bad debt, ends medical debt for patients under the ACA , and makes ACA plans pay more because patients don’t avoid care because of they can’t afford deductibles. If the numbers work , expand this for all care provided to the uninsured. Means test repayments with a reinsurance cap This changes the game for insurance 4. Mandate Nationally, that any cash purchases have to be applied to deductibles. This allows for competitive price shopping. 5. Create a national rebate GPO that all states participate in by default that negotiates rebates for brand and specialty drugs. These aren’t perfect and are generalized. But you get the direction it can go(Mark Cuban)