This paper analyzes the structural consequences of health insurance consolidation in the United States, focusing on its effects on medical innovation, clinical autonomy, and private sector care capacity. It proposes a decentralized solution architecture that separates innovation approval from centralized risk pooling, introducing parallel approval lanes, bounded risk corridors, opt in micro premiums, outcomes-based reimbursement, and restored provider autonomy. The framework is designed to preserve insurer profitability while expanding patient access and enabling sustainable innovation.
Kearon Allen (Sun,) studied this question.