Well, the most obvious is to have some sort of universal health care coverage that can be separated from your place of employment.

I agree with the second part (separate health insurance from employment), but I disagree that we need universal health care.

I think we should remove all incentives for employers to offer insurance and require employers to make the cash value of any benefits available to employees upon request (and make that option clear at hiring time). Basically, when your employer shows you a "total compensation" amount, you should be able to get that in your paycheck if you so choose.

I also think we should encourage (maybe require) insurance companies to offer long-term contracts at a fixed rate, adjusted only to account for inflation and changing costs (uniform across all customers). We can continue the subsidies for poorer people if we want. This would essentially be a market-driven "universal healthcare", but it's opt-in.

Maybe we need universal healthcare, but I feel like that's a bit overkill. I feel like we can ease into it by expanding on the ACA and getting more people to get insurance outside of their employment.

A lot of people just don’t pay for insurance given the facts.

A Family of 4 in their 40s are in for what, $1800 a month for health insurance? If your total income is $5000 a month you just don’t pay it.

You still go to the ER when you get real sick, but you just deal with it then.

No, the most obvious step is to stop giving them your business.