At Atlanta’s Grady Memorial Hospital’s emergency department, where—as in many U.S. hospitals—patients are forced to wait for treatment in the hallways due to lack of space and overcrowding. (Photo by Jonathan Torgovnik/Getty Images)
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Washington’s political class keeps insisting that our healthcare problems can be solved with more regulations, more dictates and more bureaucratic tinkering. The results of this command-and-control mindset speak for themselves: exploding premiums, shrinking choices and a healthcare system that’s increasingly unresponsive, unaccountable and unaffordable.
We don’t need more government engineering; we need more freedom. When individuals, not bureaucrats, control healthcare dollars, innovation flourishes, costs come down and patients receive better care. This is the same formula that has made the U.S. the global leader in technology, finance and consumer products. There’s no reason healthcare should be any different.
Here’s a blueprint for reform grounded in common sense and economic reality.
• Empower Americans with True Universal Health Savings Accounts
Health Savings Accounts (HSAs) embody a basic truth: When people spend their own money, they demand better value. But today’s HSAs are hedged in by restrictions that undermine their potential.
There are ways to fix that:
1. Make HSAs universal, available to everyone
2. Raise or abolish contribution caps
3. Allow HSA dollars to be used for a wide array of services, from telemedicine to mental health to preventive and wellness care
4. Allow HSAs to be used to buy health insurance
Put consumers in control, and providers will have to compete, just like every other industry that delivers quality and innovation.
• Restore Reality to Health Insurance
One of the great absurdities in healthcare today is the attempt to pretend that everyone presents the same risks. That’s an economic fantasy and is driving premiums through the roof.
Reform must allow:
1. Wider age bands and sensible health ratings
2. Premium discounts or HSA bonuses for healthy behavior
Rewarding healthier choices lowers costs and improves outcomes. Only in Washington is that controversial.
• Make Catastrophic Coverage the Foundation of Health Insurance Again
Insurance was never meant to micromanage colds, routine checkups and basic prescriptions. No other form of insurance attempts this.
We need:
1. Affordable catastrophic plans that cover big, unexpected expenses
2. The ability for these plans to compete across state lines
3. The ability to use HSAs and direct payment for routine care
This simple structure would instantly eliminate mountains of waste and administrative bloat.
• Give Americans the flexibility they deserve, including access to the Federal Employee Health Benefits Plan
Consumers should be able to tailor coverage like they tailor their investment portfolios—a catastrophic plan here, a direct-primary-care membership there, plus telehealth and chronic-care add-ons.
One of the best reforms available is also one of the simplest: Open the Federal Employees Health Benefits (FEHB) program to everyone.
For decades federal workers have enjoyed an abundance of private insurance choices competing for their business. It works. The rest of Americans deserves the same. This reform alone would create a national, transparent and competitive marketplace that empowers families instead of bureaucracies.
• Demand Real Price Transparency
Healthcare invoices that read like ancient cuneiform tablets must become relics of the past. The only way to drive down prices is to shine a light on them.
We need:
1. Bundled, upfront prices that itemize costs, such as the anesthesiologist
2. Strict enforcement of transparency rules
3. Freedom for cash-based and subscription-based providers to compete openly
When prices are visible, competition follows. When competition follows, costs decline. Every time.
• A Safety Net That Elevates, Not Entraps
Those who need help should receive it—but in a form that maximizes dignity and choice. Vouchers would give low-income Americans the ability to buy the same innovative private plans as anyone else.
The bottom line is that our healthcare crisis is not the fault of markets; it’s the result of markets being strangled. Free up choice, empower consumers and unleash competition, and U.S. healthcare will become more affordable, more accessible and far more innovative.
Freedom works. It’s time we let it work in healthcare.
Source: https://www.forbes.com/sites/steveforbes/2025/11/25/free-markets-not-mandates-will-fix-our-broken-healthcare-system/
