Healthcare
Universal catastrophic coverage as a floor, market choice above it, federal negotiating authority on prices. No American bankrupted by illness. No one priced out of care.
The United States spends roughly eighteen percent of GDP on healthcare — nearly double the OECD average — and produces worse outcomes than most peer nations. The cause is not insufficient spending. It is the fragmentation of the buyer side. Medicare, Medicaid, employer insurance, marketplace plans, and the uninsured pay wildly different prices for the same care, and no single buyer has leverage against hospitals, device makers, or pharmaceutical companies. The result is the highest administrative overhead, the highest prices, and the widest outcome disparities in the developed world.
Read more
We propose universal catastrophic coverage as a legal floor, funded federally, that eliminates medical bankruptcy. Above that floor, private insurance and HSAs continue to exist for additional coverage. Hospital and drug prices become subject to federal negotiation on the Medicare model, applied across all payers. Employer-linked health insurance remains legal but is no longer tax-advantaged in the way it is today, decoupling healthcare access from employment over a fifteen-year transition.
This is not single-payer. It is a floor with market choice above it, which we believe is politically durable in American political culture in a way that full single-payer has never been. It is also not the status quo, which is collapsing under its own cost and complexity.
Specific policies
- Universal catastrophic coverage — out-of-pocket maximum tied to household income
- Medicare-style price negotiation extended across all payers
- Mandatory price transparency at point of service
- Public option available in every marketplace
- Phase-out of employer-insurance tax preference over fifteen years
- Community health infrastructure expansion in rural and underserved areas
What we reject
The Republican position that market competition alone will reduce healthcare prices. Sixty years of evidence says otherwise. Also the reflexive Democratic assumption that single-payer is the only serious reform option. A floor-plus-market hybrid is both economically coherent and politically achievable in a way Medicare-for-All has never been.
Universal catastrophic coverage as a legal floor, market choice above it, Medicare-model price negotiation across all payers, decoupling of insurance from employment over fifteen years.
Expand the Affordable Care Act with a public option, modest drug-price negotiation, retention of employer-based insurance; Medicare for All framed as aspirational but politically deferred.
Reduce regulation, expand Health Savings Accounts, block-grant Medicaid to states; opposition to federal price negotiation; market competition as the primary cost-containment mechanism.