Free Markets. Real Healthcare.
A Real Free-Market Cure for America’s Broken Healthcare System
Written by, Ryan Binkley
America spends nearly $13,500 per person on healthcare—more than double what Germany, Switzerland, or Japan pay—yet we rank near the bottom among wealthy nations in life expectancy and preventable deaths.
The reason is simple: we don’t have a healthcare market. We have a cartel of insurers, hospital chains, pharmacy benefit managers, and government middlemen who profit by obscuring prices, restricting choice, and keeping patients and doctors at arm’s length.
Obamacare didn’t fix this. It poured gasoline on the fire by subsidizing the very intermediaries who were already driving costs through the roof. Premiums doubled for many families, deductibles soared past $8,000, and narrow networks left millions unable to see the doctors they wanted—even when they were paying thousands in premiums.
President Trump’s first-term executive orders began to crack this cartel open. He expanded Association Health Plans, forced hospitals to post their real prices, and tried to let Medicare pay no more for drugs than other developed countries pay. Much of that progress was stalled or reversed by courts and the Biden administration.
A second Trump administration can unleash genuine competition and consumer power with a handful of bold but straightforward executive actions and reconciliation measures.
HERE’S HOW
First, bring back and supercharge Association Health Plans and short-term plans. Let small businesses, the self-employed, and even community groups band together across state lines to buy coverage that isn’t strangled by ACA mandates. These plans were working—premiums fell up to 30% in states that embraced them—until the courts and Democrats killed them.
Second, let Americans redirect a modest portion of their own healthcare dollars—say $100 a month for individuals, $200 for families—toward the primary-care arrangement of their choice.
Want a $90-a-month direct primary-care doctor who answers your texts at 10 p.m.?
A functional-medicine practice that actually prevents diabetes instead of just treating it?
A concierge telemedicine service?
You should be able to use your own money (private or taxpayer-subsidized) without begging an insurance company for permission.
That single change would cover 80% of routine care needs, collapse demand for bloated insurance products, and finally reward doctors who keep people healthy instead of just processing sickness.
“What we’re dismantling is the bureaucracy that makes that coverage unaffordable.”
Third, turn price transparency from a publicity stunt into a weapon. Hospitals now post some prices, but insurers still hide what they pay brokers and middlemen. Force full disclosure of every dollar flowing through the system, especially the kickbacks on the ACA exchanges.
Sunlight will do more to lower costs than a thousand Washington “cost-control” commissions ever could.
Fourth, stop forcing religious and ethical communities into the ACA straitjacket. Health-sharing ministries have been sharing medical expenses successfully for decades. Remove the regulatory barriers so they can operate freely alongside other options.
Your Healthcare Dollars
You should be able to use your own healthcare dollars without begging insurance. Most routine care gets handled, insurance demand collapses, and doctors finally get rewarded for keeping people healthy.
Fifth, redirect ACA subsidies from padding insurance-company margins to empowering patients directly. Put the money into expanded Health Savings Accounts, direct primary-care payments, or community-based plans. Tie a portion of subsidies to outcomes—lower blood-pressure readings, smoking cessation, weight loss, instead of just premium size. Reward health, not paperwork.
Finally, tear down the state licensing walls that keep a doctor licensed in Texas from treating a patient in Ohio via telemedicine. Expand the Interstate Medical Licensure Compact to nurses, PAs, and therapists.
“Let competition—not bureaucracy—decide where doctors and patients connect.”
Critics will scream that this is “dismantling Obamacare” or “leaving people with pre-existing conditions unprotected.” Nonsense.
Every serious free-market proposal, including those from the Trump administration—has explicitly preserved coverage guarantees for pre-existing conditions. What we’re dismantling is the bureaucracy that makes that coverage unaffordable.
America doesn’t need another 2,000-page healthcare bill. We need to get government and corporate gatekeepers out of the examination room and put patients and doctors back in charge.
President Trump has promised to Make America Healthy Again. The fastest, surest way is to make American healthcare a market again.
The tools are already on his desk: executive orders, budget reconciliation, and four years of momentum. All that’s missing is the political will to use them.
Our health, and our wallets, can’t afford another decade of the status quo.
“Our health, and our wallets, can’t afford another decade of the status quo.”
Let’s not waste another term. Let’s give Americans the transparent prices, genuine choices, and direct relationships with their doctors that the rest of the developed world takes for granted.
