As I wrote last week, one of the nation's biggest employers — Boeing — is pioneering a concept in providing health care benefits to its employees that eliminates insurance companies as middlemen. What Boeing is doing represents a seismic shift in health care financing and delivery that potentially will have more far-reaching effects than Obamacare, primarily because it is coming from the private sector, not the government. It is a shift that the big health insurers have been anticipating and preparing for since long before the Affordable Care Act was enacted.