It's a frustrating situation for employees (and their dependents) but the ability for self-funded employers to shop around and switch health plans is one of the only things that is preventing healthcare prices from rising even faster than they already are. Most of those "insurers" no longer really do insurance, they largely construct provider networks and administer claims on behalf of self-insured group buyers. Some payers drive harder bargains with providers and you can see significant price differences in the price transparency files.

Sure, the employer is doing what is best for them in the current system. Everyone is. But the results can be rough for real people to actually live with.

One of the big scary talking points when politicians start talking about changing our insurance system is that people like their current plans and doctors and are scared to change things.

I just think this is silly since my plan has changed roughly annually since I've been in the workforce due to a combination of employers shopping plans, employers changing ownership and moving to the new company's plans, and switching jobs.

An in-between step to single payer would be to let me pick a marketplace plan and then let my employer reimburse it directly, provider a voucher, or something like that. At least that way I have the freedom to switch jobs without entering a whole new health insurance world, and which health plan I pick is none of my employer's business.

That is essentially how ICHRA plans work.

https://thatch.ai/resources/ichra-for-startups

Nice, I hadn't heard of that but yeah I think that's a much better system than employer group plans. If more of the market went that way, insurers would have to actually compete at a consumer level and not just offer "go away" pricing when you try to get insurance outside of a group plan.