Opinion: Restoring Health Insurance to Its Core Purpose Will Improve Healthcare
The Make America Healthy Again movement challenges us to rethink how we approach health insurance, health care, and health itself. Past health reforms have focused heavily on expanding health insurance coverage, but they have failed to improve health care or the overall health of Americans. To make meaningful progress, we need to return health insurance to its original role: protecting individuals from unexpected financial risks.
At its core, insurance exists to shield beneficiaries from large, unpredictable costs. It’s not designed to cover routine, predictable, or elective events, as that would make premiums unaffordable for most people. Think of it like car insurance—if your policy covered routine oil changes or home insurance covered faucet repairs, premiums would skyrocket.
Yet, in the current health system, regulations force insurers to cover expenses that are, by definition, not insurable. Many politicians seek to expand health insurance coverage to virtually all health-related expenses—sometimes including things like air conditioning—while minimizing out-of-pocket costs for patients. This approach not only drives up costs but also erodes the decision-making power of patients and the autonomy of healthcare providers.
The result is a system that benefits big industries while leaving patients without true agency over their own care. Prices soar, premiums climb, innovation stalls, and health outcomes suffer. Industry lobbyists often shape the policies that impact their profits, while regulations tend to favor established players who can afford the compliance costs, leading to more market consolidation, higher prices, fewer choices, and diminished access.
A Return to Insurance’s Original Purpose
Health insurance should return to its traditional role: protecting against significant, unpredictable financial risks—like motor vehicle accidents, strokes, and heart attacks. For the majority of health care expenses—primary care, generic drugs, routine visits, and elective procedures—patients should pay directly with cash, using tax-advantaged Health Savings Accounts (HSAs) to ease the burden.
This reform would drastically lower premiums and alleviate much of the financial stress that many Americans face. Access to HSAs should be universal, allowing individuals and private entities to contribute with tax benefits. For low-income individuals or those with high health risks, taxpayers should fund reinsurance programs to help stabilize premiums and directly subsidize their HSAs.
Transforming the Healthcare System
By shifting to a model where insurance covers only major risks and most care is paid for out-of-pocket via HSAs, several transformative changes would follow:
Greater Patient Control: With more control over their healthcare dollars, patients would have the freedom to choose providers without insurance restrictions. They could access care at transparent, non-discriminatory prices, and make informed decisions that reflect their personal health goals and financial priorities. As patients take on more responsibility for their care, they would also be more motivated to engage in preventive measures that could improve their long-term health.
Increased Competition and Innovation: When health care becomes as simple and straightforward as buying a coffee, the barriers to entry for new providers would collapse. With fewer regulations, competition would intensify, and the healthcare market would see an explosion of innovation as providers respond to patient demand for more personalized, accessible care. A dynamic, patient-centered ecosystem would emerge, offering diverse options tailored to individual needs.
Relief for Providers: Health providers would be freed from the bureaucratic red tape of pre-authorizations, denials, and insurance claims. The current system has led to burnout and financial strain for many physicians, and it restricts their ability to deliver optimal care. Under this new model, more doctors would opt back into the system, offering broader access to care for all patients, regardless of their insurance status.
Economic Benefits and Worker Mobility: When workers control their healthcare dollars and purchase insurance locally, the burden on employers to provide health insurance would decrease. This shift would enhance worker mobility, simplify hiring processes, and encourage entrepreneurship by freeing workers from the traditional employer-based health insurance model.
The Growing Movement
Models like flat-rate direct primary care, cash-pay surgical services, concierge practices, and telehealth are already thriving. These alternatives use transparent, competitive pricing that appeals to both uninsured patients and those who prefer to bypass traditional insurance. Despite regulatory efforts to control these innovations, demand for direct transactions between patients and providers continues to grow.
The Make America Healthy Again movement presents an opportunity to revolutionize the U.S. healthcare system. We can either maintain the current status quo—where patients are constrained by insurance restrictions, providers are stifled by regulations, and costs continue to rise—or we can embrace a new paradigm that restores health insurance to its true function: offering protection from major financial risks while allowing patients and providers the freedom to engage directly in the care process.
Restoring insurance to its core purpose could unleash an era of greater choice, innovation, and efficiency in the healthcare system, ultimately improving both the quality and affordability of care for all Americans.
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