Healthcare for All

Summary:

I. Introduction

II. Eliminate Bad Incentives

III. Eliminate Pharmacy Benefit Managers (PBM)

IV. Support The public Option

    A. What It Is/How It Works

    B. Mental Healthcare For All

    C. Pet Care For All

V. Greatly Increase the Number of Wellness Longevity Clinics

VI. Encourage Scientific Exploration and the Use of Plant-Based, Natural, and Holistic Treatments

VII. Focus on Prevention

VIII. Eliminate Medical Debt 

The U.S. spends $1.7 trillion annually on Medicare and Medicaid, accounting for 25% of the federal budget—our single largest expense. Meanwhile, with a national debt of $36.22 trillion, we’re paying $1.13 trillion in annual interest, a number that will only keep climbing unless we start balancing the budget. This is truly existential.

Yet, healthcare is a human right, and I am committed to expanding it to all Americans.  But not only can this be done without increasing government spending—it can be done while actually reducing it. And here’s how:

• Eliminate bad incentives: Right now we have a sick care system. Insurance companies have actually officially changed their terminology from “healthcare” to “managed care” because they actually make more money when you’re sick. 
• Eliminate Pharmacy Benefit Managers through transparency and competition.
• Establish a public health insurance option that guarantees coverage for all Americans and is designed to outcompete private insurers by prioritizing prevention, transparency, and the elimination of waste and corruption.
• Encourage scientific exploration and the use of plant-based, natural, and holistic treatments.
• Greatly increase the number of wellness longevity clinics. These should be supported and subsidized by the government. 
• Focus more on prevention.

II. Eliminate bad incentives:

Insurance companies often benefit financially from an increase in claims for several reasons. First, they raise premiums, co-pays, and other costs to offset the payouts from those claims, which leads to higher revenue even as their costs increase. This creates a cycle where claims become a justification for cost increases. Second, an uptick in claims can attract new customers and prompt existing customers to upgrade their coverage, as people often seek more comprehensive insurance after experiencing a claim.

Additionally, insurance companies profit through Pharmacy Benefit Managers (PBMs), which they own, by inflating the sticker price of prescription medications and taking a cut by charging higher co-pays. 

Lastly, insurance companies are aware that many people stay at jobs for just one to two years, so they deny claims and pass the financial burden onto the next employer or policyholder. 

The public option would prioritize preventive care far more than traditional insurance models, focusing on early intervention and wellness to reduce the need for expensive treatments. The best way to to this is to encourage healthier living and healthier diets, but due to this being a longer term strategy, something we can do as early as tomorrow that is very effective is increase the availability of, and invest in, blood and biometric labs. These labs are highly effective in detecting the big four killers: Heart disease, cancer, chronic respiratory diseases, and diabetes.

By identifying early biomarkers, tracking key health metrics, and enabling proactive interventions that can prevent or mitigate the progression of these conditions. Together, these diseases account for approximately 90% of all healthcare costs in the United States, highlighting the substantial financial burden they place on the healthcare system. For instance, comprehensive blood work—often not covered by insurance—can identify if you’re pre-diabetic and headed towards developing diabetes. If caught early, interventions can prevent the condition from progressing. Without early intervention, however, your lifetime medical expenses increase seven fold! 

We also must encourage positive incentives for the medical providers, similar to how countries like Canada and Germany do:

Blended capitation models: In some provinces, doctors receive a set payment per patient (rather than per visit), which encourages them to focus on preventive care and long-term health outcomes rather than just seeing as many patients as possible.

Pay-for-performance (P4P): Some regions provide financial bonuses to doctors who achieve specific health targets, such as improving chronic disease management (e.g., diabetes or heart disease), reducing hospital readmissions, or ensuring patients receive preventive screenings.

Team-based care incentives: Some provinces fund Family Health Teams, where physicians, nurses, and specialists work together, and doctors are rewarded for coordinating care effectively rather than just performing more procedures.

III. Eliminate Pharmacy Benefit Managers (PBM) through transparency and competition:

Prescription drugs could be much cheaper, but they aren’t due to convoluted and deceptive practices. Take, for example, a drug that Grandma, who has insurance, pays $10 for at the counter. The deception lies in how the transaction is framed and the fact that PBMs, which once served the public interest by helping lower drug prices, are now owned by the insurance companies. The PBMs make it appear as though the total cost of the drug is $50, with insurance “covering the rest” after Grandma’s $10 copay. But in reality, the true cost of the drug is only $4, and insurance doesn’t actually pay anything—they pocket the extra $6!

Here’s how they make it seem like they’re covering something:

1. The receipt might show:

• “Retail Price: $50”

• “Insurance Discount: -$40”

• “Your Copay: $10”

Making it seem like insurance helped reduce a big cost.

2. In reality:

• The pharmacy only needed $4 to cover the medication.

• Grandma overpaid by $6.

• That extra $6 is taken by the PBM, not the pharmacy.

• Insurance didn’t actually contribute anything, despite making it seem like they did.

So Grandma thinks, “Good thing I have insurance, or this would have cost $50!” when in reality, if she had just paid cash, she could’ve gotten it for $4—but no one is allowed to tell her that.

A public option would fix this by requiring transparency in drug pricing and out-competing PBMs, ensuring consumers see the true cost of medications without hidden markups or deceptive practices.

IV. Support The public option:

A. What It Is/How It Works:

A public option is a government-backed health insurance plan that operates alongside private insurance (including the Affordable Care Act), giving individuals and small businesses the freedom to choose a more affordable, transparent alternative. Unlike Medicare-for-All, it doesn’t replace private insurance, it simply introduces real competition into a market dominated by profit-driven companies. By leveraging the government’s negotiating power, a public option can lower premiums, deductibles, and out-of-pocket costs while offering comprehensive coverage that emphasizes preventive care. It also provides small businesses with a more cost-effective way to offer benefits, helping to stabilize and strengthen the workforce. Ultimately, a public option pressures private insurers to compete on value, transparency, and results—not just profit.

 
It would increase transparency by making pricing clearer and requiring insurers to disclose key data like costs, claims, and outcomes. This would empower consumers to make better-informed decisions, avoid surprise medical bills, and hold insurers accountable.

(See here for how we would roll-out the public option)

B. Mental Healthcare For All:

As our society grapples with economic stresses and the overwhelming impact of technology, mental health challenges are on the rise. These pressures affect everyone—not just those with diagnosed conditions. Mental health is a force multiplier: it makes us better learners, coworkers, parents, neighbors, and leaders. Supporting mental well-being fosters a more engaged, compassionate, and productive society. That’s why we must expand access to care for all, not just those in crisis, and incentivize more providers to meet growing demand. This is an investment that will pay for itself and then some by reducing healthcare costs, strengthening our workforce, and building a more resilient, connected community. (There is so much potential here that I've included it in my New New Deal). 

C. Pet Care For All:

Every family deserves the joy and companionship that pets bring—not just the wealthy. To make pet ownership more accessible, we should offer discounted pet insurance for up to two pets per household. This coverage would include routine care like checkups, vaccinations, and emergency services, allowing families to provide for their pets without financial strain. In late January, one of our cats got a UTI that cost us $3.5K, and it broke us financially—many families face this kind of burden. We shouldn’t have to choose between saving our pet's life or going broke.

V. Greatly Increase the Number of Wellness Longevity Clinics

A wellness longevity clinic is a healthcare facility focused on promoting long-term health and well-being through a combination of preventative care, personalized treatment plans, and advanced therapies aimed at slowing aging and enhancing quality of life. These clinics typically go beyond conventional medical care by offering services designed to optimize the physical, mental, and emotional aspects of health over the course of a person’s life.

Increasing the number of wellness and longevity clinics can offer a significant societal benefit, addressing both immediate and long-term health challenges. Here’s why:

1. Prevention over Treatment: Wellness clinics emphasize preventative care, which can reduce the burden on traditional healthcare systems. By focusing on maintaining health, addressing issues before they become chronic, and offering personalized health advice, these clinics can lower the incidence of diseases like diabetes, heart disease, and even cancer. This shift towards prevention can save society billions in healthcare costs and improve quality of life.

2. Empowering Individuals: Wellness clinics can empower individuals to take control of their health. By offering personalized plans for nutrition, exercise, and mental well-being, they provide the tools for people to make informed decisions about their lifestyle. This empowerment fosters a culture of proactive health, encouraging people to be more engaged in their wellness journey.

4. Advancements in Science: With growing research into the science of longevity, there are increasingly effective ways to enhance human lifespan and quality of life. Wellness clinics can serve as hubs for these innovations, offering cutting-edge treatments, like stem cell therapy and regenerative medicine or personalized genetic counseling, that could slow aging and improve health outcomes. Widespread access to these advances will ensure equitable distribution of life-extending technologies.

5. Economic Benefits: Investing in wellness and longevity clinics is not just an investment in health, but also in the economy. Healthier individuals are more productive and incur fewer medical expenses. Additionally, the creation of these clinics can provide jobs, boost local economies, and drive innovation in health-related industries.

6. Mental Health and Well-Being: Longevity is not just about physical health but also mental and emotional well-being. Wellness clinics often focus on holistic approaches to health, including mental health support, stress management, and mindfulness practices. Addressing mental health proactively can reduce the strain on psychiatric and emergency services, improving overall societal well-being.

By greatly expanding wellness and longevity clinics, we have the opportunity to shift from a reactive healthcare system to one that promotes sustained health, longevity, and quality of life for all.

VI. Encourage Scientific Exploration and the Use of Plant-Based, Natural, and Holistic Treatments:

For far too long, potentially groundbreaking therapies have been suppressed by Big Pharma and the failed war on drugs. For decades, research into substances such as psilocybin, marijuana, MDMA, ibogaine, ketamine, and even stem cells have been ignored or restricted, not due to their lack of efficacy, but because they are natural and can’t be patented. This has hindered the development and widespread use of these therapies, as the pharmaceutical industry profits from synthetic treatments that are patented and can be sold at high prices.

Psilocybin, the active compound in certain mushrooms, has shown remarkable potential in treating mental health conditions such as addiction, depression, anxiety, and PTSD. In addition to these benefits, mushrooms have been shown to attack cancer cells, with emerging studies suggesting their potential as a complementary cancer treatment. Paul Stemmons, a leader in this field, has highlighted the potential of psilocybin in cancer treatment, including his mother’s personal experience with the compound in her fight against cancer. Furthermore, psilocybin has been demonstrated to promote neurogenesis, aiding recovery from brain injuries such as strokes, concussions, and other traumatic brain injuries, where it could support cognitive rehabilitation and healing. With my lifelong best friend suffering from one of these, I actually have a dog in this fight! However, research in these areas has been stymied for decades, resulting in a significant loss of about 50 years of potential scientific progress.

Marijuana is another example. For many years, its medicinal benefits—such as pain relief, loss of appetite, reduction in inflammation, and alleviation of symptoms related to cancer treatments, have been dismissed or obscured, largely due to the stigma imposed by the war on drugs and its classification as a Schedule I drug. Yet, numerous studies now show that cannabis can play a role in managing chronic pain, mental health disorders, and even neurodegenerative diseases like Alzheimer’s.

MDMA, once vilified due to its use in recreational settings, is now gaining recognition for its therapeutic potential in the treatment of PTSD and trauma. Controlled studies have demonstrated its efficacy in helping patients confront and process deep psychological wounds, yet the therapeutic use of MDMA was delayed by decades of political and social stigma, perpetuated by the war on drugs and the interests of pharmaceutical companies invested in conventional psychiatric treatments.

Similarly, ibogaine, a powerful compound derived from a West African shrub, has been shown to not just reduce withdrawal symptoms but actually eliminate addiction. Anecdotal reports reveal that individuals who undergo ibogaine treatment experience a profound loss of the urge to use substances, offering a reset for the brain and breaking the cycles of addiction. This could potentially provide a long-term solution, contrasting with the need for ongoing, conventional treatments.

Ketamine, now increasingly being recognized for its role in treating severe depression, was initially dismissed for years as a “party drug.” Its recent revival in medical settings highlights the disconnect between public health needs and the constraints imposed by drug policies, influenced heavily by industries that benefit from more conventional treatments.

Stem cells are perhaps one of the most exciting frontiers in medicine, offering potential cures for conditions ranging from spinal cord injuries to degenerative diseases. However, progress in stem cell research has also been hindered by both political and economic pressures. The pharmaceutical industry, invested in long-term treatment regimens, has historically pushed for regulations that limit access to stem cell therapies, despite their potential to revolutionize medicine and significantly reduce long-term healthcare costs. As a result, people often travel abroad for “medical tourism,” seeking stem cell treatments in countries like Mexico and Panama, where these therapies are more accessible.

These natural and holistic treatments have been suppressed or ignored for far too long. The war on drugs and the pharmaceutical industry’s financial influence have actively impeded scientific progress, resulting in the loss of decades of valuable research! that could have provided more effective, holistic, and affordable treatment options. By encouraging scientific exploration and embracing the therapeutic potential of these plant-based and natural treatments, we have the opportunity to heal not just individuals, but society as a whole, fostering a more sustainable, compassionate, and innovative approach to health.

VII. Focus on prevention:

• Incentivizing Healthy Lifestyles: The public option could also incentivize individuals to make healthier choices by offering discounts, rewards, or other benefits for participating in wellness programs, getting regular checkups, or maintaining healthy habits. This could encourage more people to take responsibility for their health and lower long-term healthcare costs.
• Increase the availability of, and invest in, blood and biometric labs. These labs are highly effective in detecting the big four killers.
• WE MUST START EATING HEALTHIER! We need real food, not these poisoned 'food-like-substances'. See my Chronic Disease Epidemic for more on this. 

VIII. Eliminate Medical Debt 

Buying up medical debt is a practical and compassionate solution to help alleviate the financial burden faced by millions of Americans. Medical debt is one of the leading causes of bankruptcy and financial distress, especially among low-income individuals who struggle to pay off bills for necessary care. By purchasing medical debt at a significant discount—sometimes up to 90%—states and organizations can provide substantial relief to residents. The process works by buying debt portfolios from hospitals or providers at a fraction of their original value and forgiving the debt for individuals who are unable to pay. States like California, with the non-profit RIP Medical Debt, have effectively used this approach to forgive millions of dollars in medical debt for residents. Massachusetts has explored similar efforts, purchasing debt at a steep discount to help its low-income population, while North Carolina and Oregon have also seen success with debt-forgiveness programs. By partnering with third-party organizations or directly investing state resources into buying medical debt, governments can improve public health outcomes, reduce financial hardship, and restore dignity to those who are struggling with overwhelming medical costs.