Each year, millions of Americans log into the Health Insurance Marketplace and see the same message: “Your financial help may be different next year. Select the marketplace plan that best meets your needs.”
That single sentence reveals everything broken about the American health care system - its inefficiency, its bias, its inequality, and its dependence on corporate profit. And after years of navigating this maze myself, falling into its cracks, and watching others do the same, I’ve come to a simple conclusion: Free government health care for every American citizen is the only solution. Not subsidized. Not discounted. Not affordable. Free.
A System Built to Exclude
To get health care coverage, you must have an email or access to a phone or a computer. That sounds small, until you realize it’s a barrier for millions. Why should anyone have to apply for health care? Why is access locked behind digital paperwork and annual enrollment deadlines?
Then comes the slogan, “Choose the plan that best meets your needs for the following year.”
How am I supposed to predict what medical care I’ll need next year? Accidents don’t schedule themselves. Illness doesn’t arrive with a warning. This isn’t health care. It’s gambling with our lives.
It gets worse.
Your plan is not the same as your neighbor’s. We don’t get equal coverage, even though we are supposed to be equal under the Constitution. How is a citizen in one income bracket worth more protection than someone in another? If health care is a human right, it shouldn’t be a marketplace at all.
The “Gap States”: A Built-In Trap
Some states expanded Medicaid; others didn’t. If you live in one of these gap states, you can make too little to qualify for help, and too much to afford insurance on your own. Yes - too little. You’re told to “earn more” to qualify - not too much, otherwise you’ll lose eligibility for assistance again. People literally have to guess their income, often over-reporting it on taxes just to access a plan that costs $200–$300 instead of $1,500 a month. BTW - how is this a “federal” health care system when states can interfere with who gets covered?
My Story: The Crack I Fell Into
Before the Affordable Care Act, I paid for my own insurance as a self-employed entrepreneur. After it passed, my premium skyrocketed 300–400%. I made too much to qualify for assistance with AHC and too little to absorb $20,000 a year in premiums. I ended up having no insurance.
Then I broke my hip - broke the femur bone in half.
I paid $20,000 out of pocket for surgery.
Six months later, I pushed myself to return to work—on a cane. The following year, I was hit with a $10,000 tax bill as I had estimated my taxes based on the months I had been unable to work.
The following year, I made too little to qualify for Affordable Care. Again. This is the vicious loop millions of Americans silently endure.
The Root Cause: Follow the Money
The Affordable Care Act was never designed to be free health care. It was designed to be a marketplace - a profitable one for insurance companies and hospital networks. Before the law was even signed, some involved in drafting it openly acknowledged they would make millions or billions because of it. If a law is designed to provide free health care, no private company should be guaranteed profit when it passes.
Why did this happen? Campaign finance, insurance companies, health care lobbyists, and pharmaceutical giants pour massive sums into political campaigns. They aren’t donating out of generosity. They’re buying influence and protecting profit. That’s why the promise of free health care quietly collapsed.
Why Free Health Care Is the Only Ethical Option
Every system short of free health care creates victims: people denied procedures; people capped out on benefits; people who die because coverage ends; people who are forced into poverty just to qualify for help; people taxed into oblivion for trying to get back on their feet.
We agreed as a nation that assisted suicide is immoral and illegal. Yet every day, insurance companies make decisions that effectively end a persons life by refusing care. If ending a life is illegal, denying the care that would save one should be illegal too.
When America truly believes something matters, we find the money. War. Bailouts. National emergencies. When it’s “the right thing to do,” the funding appears. Why not for health?
The Real First Step: Campaign Finance Reform
We cannot pass free health care until we eliminate the conflicts of interest blocking it.
Step 1: Pass campaign finance reform. This bill has sat on the shelf for decades because the people who vote on it personally benefit from leaving it untouched.
I propose an addition: No political commercials. No TV ads. No radio spots. If politicians want your vote, let it be based on their record – not on fear-based, corporate-funded ads designed to manipulate your opinion. Remove corporate influence, and free health care becomes possible.
The Vision: A Simple, Logical, American Solution
Here's what universal health care should look like:
- No enrollment period.
- No marketplace.
- No applications.
- No guessing your future health.
- No coverage caps.
If you’re sick or injured, you walk into a hospital, show proof of citizenship, and get treated. That’s it. Simple. Equal. American. Anything less is a conflict of interest disguised as policy.
Final Thoughts
We need free health care for every American citizen because anything short of that leaves people behind. Free health care isn’t radical. It’s rational. It’s moral. It’s necessary. The moment we stop letting profit shape policy, it becomes achievable.
After posting my solo videos and audio versions of this topic on my podcast, I received comments from listeners. Comments included : Nothing is actually free. We end up paying somehow; I don’t believe in giving government more power; countries that have universal healthcare have long wait times to see a doctor; the motivation to innovate better treatments is reduced as doctors are paid less and told how to treat disease; some abuse the system, going to a doctor every time they have a sniffle.
Listeners - Thank you for taking the time to share your thoughts!
Let me respond to each of these points, not to win, rather to clarify my position.
1. “Nothing is free.” – True.
You’re right—nothing is free. What I’m advocating for is not “free” in the literal sense, rather publicly funded health care, the same way we fund fire departments, police, highways, and public schools, Social Security, and Medicare (a form of universal health care for seniors, one that also needs improvement.)
We accept that certain essential services work better for society when they’re publicly funded. Health care fits that category because everyone needs it, prices are unpredictable, and life-or-death decisions shouldn’t be tied to insurance companies.
Right now we are paying - we are paying more because we’re funding insurance company profits, CEO bonuses, and hospital administrative salaries.
2. “I don’t believe in giving government more power.”
Valid concern. We currently give insurance companies more power than government. It’s the insurance companies that decide what is covered what is denied, hoe much doctors get paid, and they ration care based on profit, not need.
I witnessed this when I was a nursing assistant. The media likes to say there is a “shortage of nurses.” Yes - nurses and caregivers can find jobs that pay better with better working environments elsewhere. If doctors and nurses were paid what they deserve there would be no shortage. Hospitals and administrators are paid bonuses to cut cost to the bare bones and then some.
Replacing private companies with public systems isn’t gibing them “more power”—it redistributes the power away from corporations whose legal obligation is to maximize profit.
3. “Universal healthcare means long wait times.”
This is a common talking point. It’s based on theory, not fact - the United States has never had a free healthcare system. Therefore, this is speculative. We can create a new system the way we want it. Countries with universal health care have longer waits for elective procedures—things such as knee replacements—not emergency care.
Americans already experience long wait times, and in many cases cannot get care. They may have to wait 4–6 months to see a specialists or be denied coverage completely. There are months-long delays for mental health appointments; weeks to months to get imaging; millions avoiding treatments due to cost. You can’t compare universal care everywhere else to a perfect U.S. system as our current system already creates delays through money, deductibles, networks, and approvals.
4. “Innovation suffers because doctors are paid less.”
Doctors are not the main drivers of medical innovation - research institutions are. Innovation comes from private research, universities, publicly funded NIH programs, pharmaceutical companies, and manufacturers.
5. “People will abuse the system.”
Some will. Guaranteed. The U.S. already leads the world in unnecessary tests, over billing, upcoding (as done with CoVid - use the code that gets you the most money!), and fraudulent claims. Every system has abuse.
6. “The system worked better before Obamacare.”
I agree. The biggest failure of Obamacare was it kept private insurance companies in charge. Had it gone all the way to universal care, premiums wouldn’t have exploded. The pre-ACA system also denied pre-existing conditions, allowed lifetime caps, and allowed insurers to drop sick people. ACA is flawed. Going backward isn’t the solution.
7. The Free-Market Argument
A strong point is made that free markets can push prices down. Health care violates this basic assumptions of free markets. You can’t shop around for the lowest price when you’re having a heart attack. You don’t know what the final price of a treatment until after a procedure. (I know this one well having paid for my own hip surgery and discovering I was charged for services I never received). You can’t choose to avoid illness. Insurance companies artificially manipulate prices.
Free markets work for TVs, phones, and cars. They don’t work for medicine. With the Affordable Health Care Act, the U.S tried “free market” health system. It led to the highest prices for health care in the world. (Many go to Mexico or Canada for treatment), medical bankruptcies, consolidation into hospital monopolies, and pharmaceutical price-gouging. Health care behaves differently from other goods and services.
8. “Government makes things more expensive.”
Sometimes. In health care, private middlemen are the reason health care costs exploded. Universal countries spend half what we spend per person and get better outcomes.
Where We Agree
Most of us dislike bloated government bureaucracy, corporate influence in politics, waste, corruption, symptom-based medicine, power being misused, and high costs. I see universal health care as removing corporate power. Some see it as expanding government power. I respect the opinions of others. This is a complex issue.
After falling into the cracks myself, and seeing people needlessly suffer, I am convinced the simplest, fairest, most efficient solution is public funding for health care.
This article helps you think clearly in a noisy world, cut through misinformation, and discover solution as applied to universal, government assisted, and market place health care.