First understand that there has been no free market health care system in the United States in over a century.

Free market healthcare ended  when doctors were first required to be licensed. That did not completely eliminate free market influences. Restricting entry into a field doesn’t destroy all competition. It does artificially elevate the incomes of those who are required to be licensed. For decades government also served as a sales force for the healthcare industry.  Government began paying the bills of certain citizens and eventually all of the healthcare bills of citizens over 65.  By 2000 health insurance companies learned how to extract money out of the system by calling payment management systems health insurance. Eventually having health insurance became synonymous with healthcare. With laws like Obamacare, insurance companies had figured out how to  to use government to extract a part of every dollar spent on healthcare. That has not worked to their satisfaction.

There is no doubt in my mind that returning to a free market system would be the best option the country could take. That won’t happen. Americans don’t trust free markets so it is politically impossible.

Here is a plan that will work. Certainly it is not my idea. It is so simple that certainly someone somewhere has thought this through.

First allow registered nurses to practice medicine. They already do but a doctor who never sees the patient has to sign the prescription. The doctor is dead weight and really gets paid to do nothing. If necessary, registered nurses could team up with pharmacists.

Citizens are going to insist that poor people don’t have to pay. There is not a society in the world that will let people die in the street because they can’t afford a doctor.

Issue everyone in the country a plastic health insurance card. It will work like a credit card.  The card is good for any healthcare expense including drugs. Doctors, hospitals, pharmacists  and others accept the card and are guaranteed payment by the government. Everyone who has a card gets a bill. Payment is on a sliding scale where some with no income pay zero. The very rich above a certain income level pay the entire bill.

Doctors will not know the income status of cardholders and since most pay something, there will always an element of price competition.

There is no way to provide free healthcare. One thing I am sure of, is that it would be hard for anyone to pay more for healthcare in a year than what insurance premiums plus drugs and copays cost now.

Having government pay for healthcare is not complicated. The more simple and direct the system is, the less it costs taxpayers. The system I describe is far more effective than any single payer system that is being offered.