Yeah that's what SRO means & yes I think FINRA and it's precursor, the NASD have historically been very good at oversight. In addition to the approval of marketing materials & enforcement of requirements & standards, they're the ones that administer securities and principal licenses. You may have heard reference to a series 6, series 7 or series 63 licenses. Anyone who sells securities must be properly licensed to do so & this also involves a bonding, a background check, credit check and a requirement to keep your records (address, disclosure of outside income, legal info) up to date. Anyway, it's not perfect - bad eggs certainly get in - but serious violations will mean losing your license which means you can't be hired.
If that is the case, then are you suggesting that a similar setup might be wise for selling health insurance on a nationwide level - some self-policing for most matters, with a fairly strong governmental organization available to step in when things get severely out of hand?
Not health insurance - all insurance. And almost exclusively self-policing, federal regulators just outline the major framework for things. For example, the SEC sets some of the general guidelines about what a mutual fund is. FINRA then has rules about things such as requiring a prospectus to be given prior to a sale - and of course there are requirements about what must be in the prospectus - for example full disclosure of returns and expenses (and how those numbers are to be calculated).
Were this applied to healthcare, guidelines would be set up for levels/categories of insurance. To market and sell your plan as say Plan A, you must cover X, Y and Z. Take down the state barriers and instead of the few companies you might have been able to choose from, you can now choose the hundreds of companies and price shop comparing each one's Plan A, knowing all of them meet the same requirements. Some may add optional coverage to try to differentiate, but if you've determined that Plan A fits you, then it's a matter of which additional options and/or price (ie premiums) you like best. Competition comes in because of the market is now national. Also, it's much easier for new companies to enter & existing companies to expand into the health market because the framework is there. A new company can be smaller & more efficient or just that they're happy with lower margins & can price their plans lower.
This brings me to the last major element. Health insurance needs to be just that - insurance. Insurance involves a shared risk - actuaries decide what premiums to charge based on the likelihood of something to happen. For the most part, these are fairly unlikely things - but if they did happen could be...well catastrophic financially. But our health insurance right now, covers everything from a heart bypass things to routine things like physicals, a flu shots, antibiotic for a stubbed toe, etc. These sorts of things make the actuarial tables impossible. We need to separate health insurance - coverage for the major, catastrophic problems - from minor problems & maintenance. Yes, the minor things are going to require us to either pay out of pocket or come up with some addition support systems. But by separating the two, we divide & conquer. That sort of insurance - coverage for major/catastrophic things - is something the free market can do very very well. Look at life insurance - almost anyone you can go online, price shop & select the best choice from a ton of options. It's something the math geeks...uh actuaries can calculate and know what their payouts will be and what their premiums need to be to make a reasonable profit. But by muddying it all together you get...well the big mess we have now.