The United States faces a significant health care crisis, with pressing needs for reform that extend beyond political rhetoric. Experts advocate for comprehensive solutions to ensure universal health insurance coverage while addressing rising costs associated with existing entitlement programs such as Medicare, Medicaid, and the Affordable Care Act (ACA). Currently, these programs are major contributors to the national debt, endangering the nation’s economic stability.
The ACA, which took effect in January 2014, succeeded in reducing the uninsured population by 24 million, lowering the rate from 16% to 8% of the total population. Despite this achievement, the program has struggled to control costs, resulting in substantial profits for health insurance companies. Over the past eleven years, these companies have benefited from government subsidies amounting to $138 billion in 2025 alone, while stock prices for major players like UnitedHealth Group and Anthem have more than quadrupled.
A recent report from the Commonwealth Fund highlights the stark realities of America’s health outcomes compared to other developed nations. The U.S. ranks poorly in terms of life expectancy, chronic disease burden, and maternal and infant mortality rates. Healthcare expenditures account for 18% of the nation’s GDP, amounting to $5.1 trillion. This figure is nearly double the percentage spent by other countries, with experts estimating at least 20% of this spending is waste due to unnecessary tests, procedures, and administrative inefficiencies.
Currently, health care programs consume 28% of the annual federal budget, translating to $1.9 trillion. These programs collectively cover nearly half of the U.S. population, which stands at 343 million. The remaining 170 million individuals either lack insurance or rely on private plans obtained through employers.
One potential solution to the complexities and financial burdens of the ACA would be to dissolve the program and offer its beneficiaries the option to enroll in Medicare at the current premium rate of $203 per month. Medicare has demonstrated lower administrative costs compared to private plans, along with built-in cost controls that cap service charges. This structure has historically resulted in slower cost growth per capita for Medicare enrollees, making it a more sustainable option.
The conversation around healthcare reform has been fragmented, with various proposals circulating within Congress regarding ACA subsidies, Medicaid funding cuts, and rising healthcare costs. Dr. Ezekiel Emanuel has recently suggested key cost control measures in his column for The Washington Post, emphasizing the need for a bipartisan commission to devise comprehensive reforms. The commission’s primary goal would be to establish a system of universal coverage that is both effective and cost-efficient.
Further considerations in this reform process should include initiatives for price transparency and drug price controls. Such measures would empower consumers to make informed decisions, potentially mitigating wasteful spending. While fraud is estimated to represent only 5% of Medicaid and Medicare costs, enhancing accountability remains crucial.
The urgency for a robust solution to America’s healthcare challenges cannot be overstated. Dr. Bob Newman, a family physician with over 40 years of experience, emphasizes the need for decisive action. His book, “Patient’s Compass,” provides insights into navigating the complexities of the health care system. As the dialogue progresses, it is imperative that Congress prioritizes this issue and works collaboratively to develop a sustainable healthcare framework that benefits all citizens.
