The health insurance situation in the US can be vastly improved with one simple change:
Make it ILLEGAL for any group (usually employers) to get preferential pricing from health insurance companies. Insurance should cost the same for any two people in the same situation, including taxes. I have my own business so I have to pay a lot more for health insurance. I know companies pay part of employees premiums, but the total of employer contribution plus employee contribution plus taxes is a lot less than it is for people who are self employed or work for a small business.
This one simple change:
1. makes health insurance companies compete - people will shop around instead of just getting a provider chosen for you by your employer.
2. makes everyone realize what they are really paying for heath care. When things come out of a paycheck like taxes, people seem to accept it more than if they had to write out a check for it each month. If people realized how expensive it is they would be outraged and more likely to shop around or get involved politically. Most people don't need the low deductible, cover-everything plans some of employers offer at low costs - they would probably lower their coverage if paying for it out of pocket. Anytime people aren't paying with their own money costs skyrocket (just ask politicians). "Oh look, he has good insurance, let's run this test and this treatment too, your insurance will cover it"
The issues of pre-existing conditions and people who can't afford any form of health insurance are different. If you let anyone get medical treatment without paying, and cover pre-existing conditions, then you are no longer talking about INSURANCE which is a hedge against unforeseen problems. Then you are talking about government-run health CARE, which would likely be the end of the private health insurance industry as we know it. Whether or not that a good thing is an a different argument, but with all of their lobbyists I don't see it happening anytime soon, so let's start by fixing health insurance, and go from there.