Solving The Healthcare Affordability Crisis

Originally published with Dr. Deane Waldman at American Thinker. 

​The constant headlines touting this quick fix or that instant solution to our healthcare affordability crisis call to mind a football metaphor, given the Super Bowl this coming weekend.

It’s the fourth quarter. Your team is losing by one touchdown and inside the red zone. There are no timeouts remaining. The quarterback steps back to pass. Today, he has thrown ten consecutive incomplete passes and two interceptions. Nonetheless, the fans scream for him, expecting that this time will be different—he will complete the pass for a game-winning touchdown.

Healthcare’s the game. The losing team is the USA, and the quarterback who is supposed to save us is...Washington? With its record?!

Congress has been playing at fixing healthcare for more than six decades. The score: in 2025, the U.S. spent more on its healthcare system --$5.6 trillion — than the entire GDP of Germany. Yet, Americans die waiting in line for promised care that never comes, what we call death-by-queue.

​Trump has his Great Health Plan. Democrats push subsidies as the answer. The progressive group called the Center for American Progress, just like most of the other Washington-based think-tanks, has its detailed proposal for coverage and access. They all start with federal control of both healthcare, the system, and health care, the service.

Fortunately, Americans for Tax Reform (ATR) is choosing a different route.

The ATR proposal, Empower Patients Initiative, begins with a reminder from George Santayana: “Those who cannot remember the past are condemned to repeat it.” ATR remembers Washington’s track record with healthcare fixes and chooses not to repeat their mistakes.

​Medicare (1965) was going to guarantee medical care after retirement. It will go bankrupt in less than ten years. Medicaid (1965), intended for the small number of medically vulnerable Americans, now covers nearly a quarter of the U.S. population. The crowd-out effect has caused medically needy enrollees to die waiting for care. The first name of the ACA — Affordable — is unintentionally ironic. ACA insurance is so unaffordable that it generated the 2025 government shutdown.

The current unaffordable, inaccessible healthcare system is the direct result of both action and inaction by Washington. The action was thousands of acts that massively expanded the regulatory state.

​Between 1970 and 2020, when the number of doctors doubled, the number of healthcare bureaucrats increased by more than 4,400 percent! Somebody has to pay their salaries. You, the taxpayer, do. But in one sense, American patients are paying the price with death-by-queue. Funds that should be spent on patient care, $2.8 trillion (!) “healthcare” dollars in 2025, were wasted on healthcare bureaucracy.

Washington’s inaction dates back to WWII. After wage freezes were enacted in 1942, Congress passed an accommodation that allowed employers to increase employee compensation without raising wages. Employers could offer employer-sponsored (health) insurance (ESI) in lieu of wages earned, paid to insurers, tax-free for employers. All wage and price freezes were repealed after the war, except one — the ESI. For more than 80 years, American workers have been denied their full wages.

ATR recognized both the unfairness and the great opportunity presented by the ESI. They also understood that federal regulation is the cancer in healthcare, never the cure. The Empower Patients Initiative (EPI) was based on combining those two ideas.

To address the affordability crisis, simply repeal the ESI. Last year, the average ESI payment to insurance for American workers was $26,993. Repealing the ESI would follow President Trump’s suggestion, “give the money to the people...instead of insurance companies.”

​When tens of millions of American households have an extra $27,000 to spend on health care as well as insurance, they constitute a true free market in healthcare with more than one trillion dollars to spend.

The healthcare affordability crisis is suddenly gone!
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Make the “bonus” (really restoration of full wages) tax-free if placed in an HSA. This will require the creation of a new no-limit HSA, as current accounts have family contribution limits well below $10,000.

Insurers will have to compete for consumer dollars thereby helping to drive down prices and offering policies that consumers want, including short-term (“junk” per Biden) as well as high-deductible catastrophic policies.

Both doctors and care facilities will have to compete for consumer dollars, driving prices down while simultaneously increasing payments to providers. Care providers will have to publish their prices and results and offer prompt service, or no patients.

Employers benefit by having stable, predictable budgets, no longer at the whim of ever-increasing insurance premium rates.

​Washington bureaucrats will be the big losers as many will be out of jobs. However, that means taxpayers benefit greatly as they will spend fewer “healthcare” dollars on unnecessary bureaucracy.

The affordability crisis, at least in healthcare, is readily fixable. Americans just need to regain control of the money they earned. Then they can afford more, including enjoying the Super Bowl with family and friends.