How to Fix America’s Health Care System Without Embracing Socialism

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The United States is at an important crossroads. Democrats, at the urging of the party’s left-wing base, insist that America should adopt a European-style single-payer health care system—or, at the very least, a “public option” that would undoubtedly lead to single-payer health care.

Republicans argue a government-funded universal health care model, regardless of how it’s structured, would create massive problems, including a loss of liberty, rationing of services, and long wait times for patients, which would lead to premature deaths and unnecessary suffering. However, those on the right have continuously failed to present a clear and concise plan to the public for reforming our broken health care model.

The purpose of the paper linked below is to provide Americans with a pro-liberty, conservative proposal to fix the U.S. health insurance system, lower health care costs, and create universal or near-universal access to health care services.


This Policy Study begins by briefly outlining the failures of the Affordable Care Act and the shortcomings of our current health care system. It then offers to lawmakers and the public a commonsense plan to create a free-market, pro-liberty health care system that would make health coverage available to all Americans, without compromising quality or putting individual liberty at risk.

The plan is laid out in two distinct parts. The first (Section 2, beginning on page 4) describes a proposal to reduce health care costs and establish a new “Health Freedom Accounts” program, which would completely alter America’s existing and irrevocably broken employer-sponsored model.

The second part of the proposal (Section 3, beginning on page 12) provides substantial improvements and reforms to Medicaid, giving lower-income and poor families greater access to higher-quality health care services.

For those of you who don’t have time to read through the entire paper, here’s a brief outline of my proposal:

  1. The Obamacare exchanges should be terminated, and many of the most burdensome Obamacare regulations should be repealed at the federal level.
  2. Association health plans and health savings accounts should be expanded dramatically. These reforms alone would greatly reduce costs and catalyze innovation.
  3. Direct primary care agreements should be legalized everywhere, and consumers should be incentivized to enroll in these plans rather than use their health insurance for primary care services.
  4. The current employer-sponsored health insurance model should be substantially reformed, empowering workers to make their own health insurance choices, encouraging wise financial decision-making, and making it much less likely an employee will lose his or her health insurance when employment ends—a major contributor to America’s past pre-existing conditions problem. All of this can be achieved by transitioning to an employer-funded health savings account model (which we call Health Freedom Accounts), rather than continue forward with the current employer-provided health insurance system.
  5. Medicaid should be transformed into a health-savings-account-based model, and policies should be enacted that would require able-bodied, non-pregnant people enrolled in Medicaid to work, volunteer, or participate in an educational program. Medicaid should be reformed so that it’s easier for people to work their way out of Medicaid and other welfare programs, helping to end the cycle of poverty so many American families remain trapped in.
  6. Every able-bodied American who can’t afford health insurance should be given access to a Health Freedom Account that would allow him or her to receive the aid needed to purchase an insurance plan, but only if he or she fulfills work requirements and uses those funds to purchase a low-cost health insurance plan. (Those who suffer from a disability or are pregnant would not be subject to work requirements.)
  7. Most of this plan can be paid for using existing health care funds and by cutting waste, fraud, and abuse. Whatever costs remain could be covered by a modest national value-added tax.

As this paper shows, those who make the assertion that the only possibility of providing all people with access to health care coverage is to give to the federal government total control over health care are completely wrong. There is no denying that the current health insurance model in the United States is severely flawed, but giving more power to the very same government that contributed to creating the current, failing model would not solve the present crisis, and would likely make things much worse. There is a better way forward.