NCPA - National Center for Policy Analysis


September 9, 2009

President Obama continues to portray the debate over health care reform as a choice between his plan for a massive government-takeover of the U.S. health care system and "doing nothing."  Those who oppose his plan are said to be "obstructionist" or in favor of the status quo.  Recently, the President again said, "I've got a question for all those folks [who oppose his plan]: What are you going to do?  What's your answer?  What's your solution?"

The Cato Institute has a long record of supporting health care reform based on free-markets and competition.  If the President wanted to know more he might have read Michael Tanner's recent op-ed in the Los Angeles Times or Michael Cannon's piece in Investors Business Daily (IBD).  He could have read Cato's book, "Healthy Competition."  Or he might have just gone to and read their plan:

  • Let individuals control their health care dollars and free them to choose from a wide variety of health plans and providers.
  • Move away from a health care system dominated by employer-provided health insurance; health insurance should be personal and portable, controlled by individuals themselves rather than government or an employer.
  • Changing from employer to individual insurance requires changing the tax treatment of health insurance; workers should receive a standard deduction, a tax credit, or, better still, large Health Savings Accounts (HSAs) for the purchase of health insurance, regardless of whether they receive it through their job or purchase it on their own.
  • Increase competition among both insurers and health providers; people should be allowed to purchase health insurance across state lines (one study estimated that that adjustment alone could cover 17 million uninsured Americans without costing taxpayers a dime).


  • Rethink medical licensing laws to encourage greater competition among providers; nurse practitioners, physician assistants, midwives and other non-physician practitioners should have far greater ability to treat patients.
  • Give Medicare enrollees a voucher, let them choose any health plan on the market, and let them keep the savings if they choose an economical plan; Medicare could even give larger vouchers to the poor and sick to ensure they could afford coverage.
  • Expand "health status insurance" which would protect many of those with preexisting conditions; states may also wish to experiment with high risk pools to ensure coverage for those with high cost medical conditions.

Source: Michael Tanner, "Mr. President, Here is our Answer," Cato Institute, September 8, 2009.

For text: 

For Los Angeles Times text: 

For IBD text: 


Browse more articles on Health Issues