Washington, D.C. — The U.S. health care system is at a breaking point. With rising costs, unequal access, administrative complexity, and growing dissatisfaction among both patients and medical professionals, many experts argue that patchwork reforms are no longer enough. Instead, they say the entire system must be torn down and rebuilt from the ground up.
This isn’t a call for minor tweaks or temporary solutions. It’s a bold declaration that the American health care model is fundamentally flawed—and only a complete overhaul can save it.
The U.S. spends more on health care than any other developed country—over $4.5 trillion a year, according to data from the Centers for Medicare & Medicaid Services. That’s nearly 20% of the nation’s GDP. Yet, millions remain uninsured, and even more are underinsured. Medical debt is the number one cause of personal bankruptcy in the United States.
“The system is fragmented, profit-driven, and inefficient,” says Dr. Angela Richards, a public health policy researcher. “It wasn’t designed to provide universal care—it was built to generate profit.”
In comparison, countries with universal health care systems such as Canada, the UK, and Germany spend significantly less per capita while achieving better outcomes in areas like life expectancy, infant mortality, and chronic disease management.
Patients aren’t the only ones affected. Doctors and nurses are burning out at record rates, largely due to administrative burdens, insurance paperwork, and time constraints. A recent survey by the American Medical Association found that over 60% of doctors are experiencing burnout.
“We spend more time checking boxes and arguing with insurance companies than treating patients,” says Dr. Michael Chen, a primary care physician in California. “That’s not why we went into medicine.”
If the current system continues without major changes, experts warn of worsening public health outcomes, rising insurance premiums, hospital closures, and further inequity in care access.
A report from the Commonwealth Fund estimates that without reform, the number of Americans uninsured or underinsured could rise to over 100 million by 2030. That would push the country into a deeper health and economic crisis, particularly as the population ages.
So what does “tearing down and rebuilding” actually mean?
Health policy experts propose various models, but several common elements include:
Ensuring every American has access to affordable health care, regardless of income or employment status, is a top priority. This could come in the form of Medicare for All, a public option, or a multi-payer universal system like those in France or Switzerland.
The U.S. pays some of the highest prices for medications. Reforms could allow the government to negotiate prices directly with pharmaceutical companies, similar to practices in other countries.
The U.S. health care system is bloated with billing departments, coding teams, and insurance negotiations. A rebuilt system could streamline these processes, saving billions annually and allowing doctors to focus on care.
Reinvestment in community health, preventative care, and primary care would help catch health issues early, improve outcomes, and reduce long-term costs.
Not everyone agrees that a complete teardown is the answer. Critics argue that such an approach would be expensive, disruptive, and politically risky. They believe incremental changes—like expanding Medicaid, capping out-of-pocket expenses, and improving the Affordable Care Act—are safer and more realistic.
“We can’t afford to destroy what we’ve built,” says Richard Thompson, a senior fellow at the Heritage Foundation. “We should improve the system, not replace it.”
Still, public opinion is shifting. According to a 2024 Pew Research Center survey, 58% of Americans support a universal government-run health care system, up from 45% just a decade ago.
One of the biggest barriers to real reform is political and corporate resistance. The health care industry—including insurance companies, pharmaceutical firms, and hospital chains—spends billions lobbying Congress to maintain the status quo.
“The current system works for corporations, but not for people,” says progressive Senator Rachel Lopez. “As long as money drives policy, we won’t see real change.”
Lopez and others in Congress are calling for legislation that would create a national health care task force with the goal of drafting a new, simplified, and equitable health care framework.
The COVID-19 pandemic exposed deep flaws in the U.S. health care system. From overwhelmed hospitals to uneven vaccine distribution, the cracks became impossible to ignore.
Now, with public awareness at an all-time high, experts believe we have a unique opportunity to take bold action.
“We can’t just put more duct tape on a broken engine,” says Dr. Richards. “It’s time to build something better—from scratch.”
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