Competition across state lines is just one aspect of things that must be fixed.
Notice with many health insurance programs, they force you to go to certain doctors. The HMOs have negotiated deals with doctors and hospitals. One can't go to a specialist before seeing a primary care physician. It's these types of arbitrary rules that need to be eliminated.
With car insurance, if someone crashes into me, I can get my car fixed at the shop of MY choice. I don't have to go to a 'preferred provider' or a list of shops that are members of a 'car maintenance organization.' It's ridiculous to force people to only go to certain hospitals or doctors. Open things up with competition! I think I've said that word a few times. 🙂
Expand health insurance coverage so that every American has access to reasonably priced health insurance, using private plans. Let the PATIENT choose the plan, let the companies compete for the business. Don't tie to employment. Let the individual deduct the cost of insurance from income tax. Force the insurance companies to compete on price and service. Prevent them from picking only low risk patients.
People should be able to make good decisions BEFOREHAND, based on good information, not find out what they are getting afterwards. No one would buy a camera not knowing what features it has until after it arrives!
Have rules to protect patients against abuses. Tort reform to reduce malpractice premiums for doctors.
Provide incentives for those that need help to purchase health insurance. This reduces the number of people that only show up at the emergency room which is the most costly form of health care.