HTownND made a solid point years ago.

He said that the employer based model removes the incentive for insurance companies to care about their patients over the long-term because people will roll off of their plan at some point (and onto Mcare).

The hesitancy to pay for weight-loss drugs highlights this issue. Why pay a lot now to limit future medical problems?

I will say that I have been on the other side of this. At my old job, we used to treat a lot of Hep-C patients. The treatments were very expensive, but effective. The issue was that these guys would go back out and use needles to inject drugs and catch Hep-C again. Then, we would pay to treat them again. So I can kind of relate on some level with both parties here.

I will say that breaking the employer based model should be a political goal for both parties. I'm on the ACA exchange and it is pretty easy to use. The plans are expensive, but that is because I pay full boat. It would be different under a different design.