a) I didn't say "universal health care is the only way to solve these problems".

b) just divorce 'insurance' from being something which people expect to be tied to employment. whatever falls from that would likely be better.

Employer-tied health insurance is also my main irritation with the current system. How you feel about the health insurance situation in America is directly tied to how large / well off your employer is.

I think that would be the most painful change to healthcare in America, but I don't think anything can improve until it happens.

Universal healthcare is a goal and a problem to be solved, not a plan in and of itself. There are many ways to achieve it that have been successfully practiced in many other countries. If you genuinely want an explanation instead of playing the tired old "just asking a question" rhetorical dodge, then I suggest you research how all the other countries are managing to cover most or all of their citizens for a nominal cost. Participate in the solution.

Do you have an alternative that addresses all those points and is cheaper than the current American system?

Yeah, price controls? AFAIK most affluent countries have some form of price controls in place.

And they also don't tie (through culture and regulations) access to health insurance (and therefore care) to employment situations.

Really... break ties between "employment" and "health insurance". It's a massive distortion of the 'free market', which is typically a conservative crowing point.