Still have work to do on the numbers, and this is off the top of my head. But I would allow patients to pick whatever cash pay provider that honors their published price . Have the patient commit to what they can afford to pay , (with documentation ) , and have taxpayers finance what they can't. With repayment being deducted from their paychecks, but limited to no more than 10pct of their check and all unpaid debt written off without penalty after 15 years. There would be zero premiums to insurance companies. But you would pay 400 to 500 per month, for your family, for re-insurance, capped at 50k. So you never incur more than that in annual medical expenses No PBMs. No health care from employers. You could buy private insurance if you wanted to. Medicare and Medicaid would go net pricing on meds. And fee for service for needed services like claims processing and other required services. Again. Off the top of my head. Numbers are guesses based on my companies