There’s no reason why we can’t have a fiscally conservative universal healthcare system in the US

Currently, around $800 billion to $1 trillion is spent per year by employers to private insurance companies to provide private health insurance coverage, and the ability for big companies to be able to pool up funds as well as promise insurers that they can bring large collective contributions from monthly employee premium payments is what gives them leverage to negotiate better coverage with insurers than buying insurance as an individual.

What should be done instead is all 50 states should form a compact together and require all employer contributions to go to the intrastate compact, which, combined with Medicaid proceeds from the federal government, can provide a barebones public option for all Americans that can cover emergency medical costs.

To supplement that, individuals should be allowed to form voluntary intrastate organizations similar to unions that can collectively pool funds together to negotiate for decent private health insurance coverage, and healthcare providers and pharmacies should be required to publicly list cash prices for their goods and services to ensure market transparency and competition.

A combination of public and private healthcare would be fiscally conservative and also provide a reasonable safety net to finally bring affordability to healthcare for the American people.