Eliminating Third-Party Payment Is the Cure for America's Healthcare Cost and Fiscal Crisis
Source: https://www.facebook.com/americanspectator/. "Is America’s Healthcare Crisis a Sleeper Issue for the Midterms? | The American Spectator | USA News and Politics." October 26, 2026. spectator.org
The Gist
The author says healthcare costs are out of control and may sway the midterms, and that neither party has a real fix. He argues the problem is that someone other than the patient pays the bills, so nobody has a reason to hold prices down. His answer is to put the money directly in patients' hands so that they, and not insurers or the government, control spending.
Conclusion
Healthcare costs will be a decisive issue in the midterms, and the only real solution is to eliminate third-party payment and return healthcare to a two-party buyer-seller market in which patients control their own healthcare dollars. Voters should therefore reject candidates who promise more third-party-managed federal spending.
Premises
- Health costs are rising sharply (a projected 30% consumer increase, after employer cost increases of 7.2% in 2025 and 8.8% in 2026), and families spend about $37,824 on healthcare against a median household income of about $87,460.
- Healthcare spending, at about $6 trillion in 2026, together with Social Security, Medicare, and Medicaid, consumes a huge share of the federal budget and drives deficits and debt, creating an unsustainable fiscal condition.
- Neither party offers a workable solution: Democrats' Medicare-for-All would cost about $40 trillion and lengthen wait times, and Trump has promised a health plan but has not delivered one.
- In normal markets, prices are restrained by buyers who economize and sellers who compete for buyers' dollars. In healthcare, a third party (government or insurers following government rules) pays, so patients have no incentive to seek low prices and providers compete for contracts instead of patients.
- Therefore third-party payment is the root cause of unaffordability, and solving the problem requires removing the root cause rather than adding regulation or expanding government coverage.
- Returning money control to individuals (as in the Empower Patients Initiative) would eliminate roughly half of healthcare spending now wasted on bureaucracy and compliance, cut prices, shorten waits, balance the budget, and end medical fraud.
Assumptions
- Healthcare behaves enough like an ordinary market that consumer price-sensitivity and seller competition would reduce prices.
- Patients can evaluate prices and quality well enough to shop effectively, including in emergencies and for complex care.
- Roughly half of healthcare spending is nonclinical waste that can be eliminated by removing third-party payment.
- The Empower Patients Initiative would work at scale and be politically and practically feasible.
- Voters will respond to healthcare affordability as a decisive electoral issue and reward a credible reform plan.
- Third-party payment is the single root cause, rather than one of several contributing factors such as consolidation, drug pricing, aging, and technology costs.