Under the ACA, there were already different levels of plans available - Bronze, Silver, Gold, and Platinum - that offered varying degrees of coverage and cost-sharing. The challenge lies in balancing affordability with comprehensive coverage.

As for increasing transparency around pricing agreements, it's indeed a complex issue. For instance, in 2019, an executive order was signed to increase price and quality transparency in healthcare. But it faced resistance from hospitals and insurance companies due to concerns about revealing negotiated rates, which they argue could lead to increased prices if all providers demand the highest rates paid by insurers.

Regarding the tiered approach for small businesses, it's a great idea in theory. However, it may risk creating loopholes that companies could exploit to avoid providing coverage. For example, some large employers might split into smaller entities to avoid the requirement.

Looking to successful healthcare models in other countries is an excellent idea. However, what works in one country may not necessarily work in another due to cultural, economic, and political differences.

It seems there’s no easy solution to these issues. Perhaps one way forward is to pursue a combination of approaches. For example, could a tiered approach for businesses be combined with stricter regulations to prevent exploitation? I'd love to hear your thoughts on this.