Obamacare/ACA has this too. The "Medical Loss Ratio" or "80/20" rule says that 80% of premiums have to be paid as claims. There's no downward pressure on claims payments because they raise rates and take 20% of a bigger number.
UNH can’t charge too much more than Elevance/CVS/Cigna/Humama/Centene/Molina/etc.
That cannot happen with a utility like electricity.
I found that in practice the non-default options do not wind up being any cheaper so after trying it for a few years I switched back to the default option, where the price is not regulated but is set through a prescribed auction process.
I suppose the deregulation might still put downward pressure on prices in theory.
Electricity transmission at the minimum should be owned wholly by the public to remove profit incentive.
There’s your downward pressure—no incentive to jack up costs.
Until then, providing electricity to people will be a profit generating activity.
My provider is a coop and my rates are lower than the publicly held providers in this region. So you seem to be correct.
You can tell your employer you don’t want to pay for the employer subsidized plan, but then you lose access to the employer subsidy and ability to pay premiums with pre tax income.
A silver plan an employer subsidizes is similar to a silver plan from healthcare.gov (expect plan to pay 70% and insured to pay 30%).
They are better than nothing if you qualify for a subsidy, but if you don't and you live in a HCOL area (which the subsidies are not adjusted for) you are pretty much screwed.
The MCOs are not carving out different networks for specific employers. You buy a bronze PPO from United Health directly, or your employer does, it’s going to be all the same providers. If you get gold, then the deductibles/copay will be less.
The networks used to be different when HMOs were in vogue, but if your employer is only giving you an HMO option, you need to find a different employer. PPOs are the only sensible option (except maybe Kaiser on the west coast, but even they sell PPOs, just costs more to see a non Kaiser provider).
Everyone else gets stuck with the awful mess of their employer choosing their insurer, switching not more than once a year.
Whereas multiple utilities are disincentivized due to the cost of moving earth and labor to get you the utility.
Also, I like how the trope is managed care organizations wield unlimited power and make enormous sums of money and have laws that help them benefit over everyone else, but their profit margins and stock returns are abysmal.