Toolkit: How to Talk with Your Neighbor About Free Market Health Care

Americans love the free market, even if they don’t realize it. From our coffee to our cars to our work environments, we demand choice and the ability to personalize. Give them options and they will choose; more is always better.

When individuals are empowered to prefer a specific beverage, mode of transportation, or quality of life, it not only makes products better but it makes us happier.

We are watching this principle come to life in the health care debate—members of Congress who are fighting to preserve ObamaCare do so in the name of choice, while members who are fighting to “repeal and replace” are also doing so in the name of choice. The difference lies in who chooses—the government or you.

This is the heart of the argument, not only for politicians on Capitol Hill but for all of us as we talk to coworkers, neighbors, family, friends. Health care matters to everyone, and the decisions made in D.C. affect us for better or worse. If you believe the best health care policy is created by the free market, now’s the time to talk about it.

You may be hesitant given the accusations and myths on repeat in the news cycle, but we have the opportunity to make positive changes to bad policy. Let’s seize the moment and set the record straight.

To make the case for free market health care, show how the free market delivers more choice, lower costs, and better care.

The Free Market Produces More Choice

Both sides of the health care debate lean on choice. The train comes off the tracks when we talk about who chooses, especially when we defend our position with fancy words and phrases like “capitalism” and the “free market.” Both lead to good reform, but it’s best to use less controversial words for the sake of persuasion. Instead, support your argument with a simple word: “choice.”

The common ground you’ll establish at the beginning of the conversation is that we want everyone to have access to quality, affordable health care. You might think this goes without saying, but you’d be wrong. Say it, and say it first. Doing so makes you seem reasonable and not radical.

Once you establish common ground, continue the discussion by acknowledging the choice problem created by Obamacare.

Problem: For the past seven years, the government has been given the power to choose, and it’s safe to say they’ve chosen poorly. The American people have:

  • Lost their doctors. Insurers have responded to the cost pressures created by Obamacare’s insurance regulations by negotiating lower reimbursement rates with providers. Some doctors have refused to accept those lower rates, which forces their patients in those plans to find a new doctor.
  • Lost their insurance. According to an Associated Press tally across 30 states, there were 4.7 million cancelled policies in 2014, the first year Obamacare was fully implemented.
  • Lost their options. Heritage Foundation analysts Aylene Senger and Edmund Haislemaier have found that 70 percent of U.S. counties will have only one or two insurers in 2017. That figure is up from just 36 percent last year.

Merely stating the problem isn’t enough, though. People crave solutions. Once you highlight the problem that most resonates with the person you’re talking to, give them hope via a solution or two.

Solution: Here’s how the free market can do it better!

For example, a one-size-fits-all model doesn’t work. Asking someone to pay for something they don’t want or need is unfair, so let’s get rid of mandates that force services on patients. Men shouldn’t pay for OBGYN coverage, young people should be able to choose catastrophic rather than comprehensive plans, and those who disagree with abortion and/or gender reassignment procedures shouldn’t have to purchase a plan that includes either.

If you want to put “care” back into “health care,” spread the message that doing so begins with you—every person, regardless of income level or pre-existing conditions, should be empowered to choose a plan that works for him or her.

The Free Market Lowers Costs

Once you establish why and how the free market allows for more choice, now’s your chance to prove that more choice inevitably leads to lower costs. Thank you, competition.

Again, start with common ground—we want all people to have access to quality, affordable health care. Then move to talk about the cost problem created by Obamacare.

Problem: For the past seven years, Obamacare has removed choice from the equation and we’ve watched prices skyrocket. According to a report by the Department of Health and Human Services, premiums will increase by a shocking average of 25 percent in 2017.


  • Because government oversight often means government intervention in the form of restrictive policies, taxes, and regulations. As a result, insurance companies dropped out of the market because they don’t want to (or can’t) comply.
  • Because Obamacare funneled more and more people—many able-bodied who could buy insurance on their own—into an unsustainable entitlement system (Medicaid), and taxpayers were asked to pick up the tab.
  • Because the government banked on more people paying into the system. Young, healthy people have chosen to pay the cheaper penalty rather than enroll in an expensive Obamacare plan, which means the exchanges are covering more older, sicker patients who cost more money.

It’s ironic the Democrats named their government takeover of health care the Affordable Care Act.

Take your pick of examples that show why costs have soared and then talk about solutions.

Solution: Increased choice, not a one-size-fits-all model, leads to lower costs. It’s a win-win! Here’s an example to illustrate:

We’ve already established that the patient knows best what coverage he/she needs, so he/she should be given the power to choose. And choice drives down costs because of competition.

When price-competition is allowed among providers in different states, it enables insurance companies to promote coverage for the best service at the lowest possible price. If provider A knows that provider B offers better coverage at a lower rate for one segment of the population, provider A is forced to do the same or risk losing business.

Competition is a good thing, and works in the best interest of the consumer. If we appreciate competition between car dealerships when shopping for a new car, or competition between car insurance providers when shopping for car insurance, let’s apply this principle to health care—one of the most personal decisions we’ll ever make.

The Free Market Provides Better Care

Now for a challenge: At this point the conversation will inevitably turn to those with pre-existing conditions or low-income individuals.

These are reasonable concerns, but remember the common ground: All people should have access to quality, affordable health care.

Unfortunately, Obamacare made a bad situation worse. The health care system we had prior to 2010 was in need of free-market reform, but the reform we got didn’t address (in a sustainable way) people with pre-existing conditions and the albatross that is Medicaid.

In this conversation, you have two areas of common ground to use: All people should have access to quality, affordable health care and the need for reform prior to 2010. Then move to address the current problem.

Problem: Coverage is not care.

Government programs are invariably designed to get people “covered”—and thus secure their votes—at the lowest cost to the government. But as Medicaid roles expanded, care decreased.

As able-bodied adults were added to the roles (think: 27-year-old adult who can work but struggles to afford health care), the number of patients per doctor increased resulting in longer wait times and more tax payer funds. The people Medicaid is supposed to help aren’t being helped and are actually being hurt.

Solution: Free-market solutions lead to better care for all, especially the most vulnerable.

  • Don’t penalize people for changing/losing their job. Congress got it right when they put in protections for people with pre-existing conditions, but when they passed those reforms, they failed to extend them to the individual market. All it takes is for Congress to extend those same protections to people buying insurance on their own. So when people move jobs, they take their coverage with them. If someone with a pre-existing condition has been paying for insurance since day one, they shouldn’t be penalized if they decide to switch jobs.
  • Keep Medicaid for those who truly need it. A federal safety net should exist, but it should be only for those who truly need it. For others who are struggling to afford health care (remember, it’s more affordable when competition is present) let’s invite states to set up premium support programs as well which results in more choice at a lower cost.
  • Innovation saves lives. Better care also looks a lot like innovation, because innovation leads to treatment and prevention. When government gets involved, costs go up and innovation goes down.

Take the Human Genome Project for example. As science was trying to find a way to sequence DNA and map human genes in the 1980s, the government tasked the National Institute of Health with the project in 1984. Thirteen years and almost $3 billion later, they were finished.

Around the same time, a private company, Celera Genomics, tackled DNA sequencing on its own. The result? They finished three years before the government did and for a fraction of the cost—10 times less to be exact ($300 million vs. $3 billion).

The free market can provide faster breakthroughs in science that can lead to better care for everyone.

This is just one of many examples where the free market can provide faster breakthroughs in science that can lead to better care for everyone.

The one positive result of Obamacare? Its failure is making the best case for a free market approach. Obamacare removed choice and increased cost; the free market allows us to choose what we want when we want it in order to increase our options and lower costs. Sign me up!

If my coffee order isn’t one-size-fits-all, I don’t want my health care coverage to be either.

Ms. Hallberg is a visiting fellow at The Heritage Foundation and President of District Media Group.