How to fix healthcare with the single stroke of a pen

Dear Mr. President,

With one bold action, you have the power to save millions of lives and trillions of dollars: ban network restrictions and suspend harmful incentives in healthcare. These systemic barriers are fueling a crisis in access to care for patients and doctors. They're also driving up costs for everyone, including employers. 

Right now, millions of Americans can't find a doctor and the problem is growing. Physicians are being driven out of private practice, retiring early, unionizing, or selling their practices to private equity or hospital corporations. These consolidations inevitably lead to higher prices and reduced access to care.

The root cause? Insurers and employers, with government support, have created artificial barriers that prevent patients from seeing doctors — even those nearby. Network restrictions mean that patients face financial penalties, out-of-pocket costs and surprise bills simply for seeking care from the "wrong" doctor or hospital. This is restraint of trade — and it's devastating healthcare.

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Imagine if coffee shops were banned from selling a cup of Joe within five miles of a Starbucks or Dunkin' Donuts. Medicine is the only profession wherein this level of restriction is allowed. Rural hospitals are closing at alarming rates because of consolidation and unfair practices that cut off their payments. It's as if firefighters were prohibited from putting out a fire in the next town. It's wrong — and it must stop.

Burden on doctors

Doctors are overwhelmed by administrative burdens, regulatory compliance and cuts to Medicare. These pressures are driving up healthcare costs – not because doctors are being paid more, but because the system itself has become more expensive for them to navigate. Incentive programs push doctors to "upcode" and meet arbitrary metrics that are misrepresented as evidence-based care, further complicating their work.

Even more concerning, hospitals and networks are financially rewarded for providing less care to Medicare patients. These incentives prioritize cost-cutting over patient well-being, leaving many patients underserved. Instead of benefiting networks and administrators, these funds should be redirected to patients – enabling them to pay their doctors directly and receive the care they need and deserve.

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This flawed system siphons off 80% of the healthcare dollar, leaving only 20 cents for actual patient care. The majority of tax-subsidized spend is consumed by middlemen, consultants and systems designed to "manage" care in ways that no longer align with modern healthcare delivery, which increasingly occurs in offices, homes and outpatient settings. Healthcare is the obvious example where applying the principles of efficiency, as outlined by Elon Musk, would have an immediate positive impact.

We don't need a massive overhaul or more bureaucracy. With two simple steps, we can fix healthcare:

1. Ban network restrictions. Patients should have the freedom to see any doctor they choose. The very idea that a Blue Cross doctor can't see a Blue Cross patient is unconscionable.
2. Suspend all incentives. Incentive programs distort care, inflate costs and prioritize profits over patients. Eliminating these programs would lower costs across the board.
   

Healthcare should be simple: a transparent, fee-for-service model that allows patients to know their cost upfront — like comparing hotels in Europe after the Euro was introduced. No more token exchanges or complex billing systems. Just one transparent price for everyone.

The stakes are too high to wait

The healthcare crisis is hurting every American and every business that is struggling to contain their group health plan costs. Workers see their wages garnished for health benefits they can't even use. Patients are denied care or stuck paying outrageous bills. Doctors are forced to retire early, sell their practices or leave the profession altogether.

This isn't just a healthcare issue; it's an economic one. The rising cost of healthcare is driving manufacturing jobs overseas. Fixing healthcare will bring those jobs back, as companies will no longer be burdened by the unsustainable cost of health benefits. And with tens of millions of migrants entering the U.S. without health benefits, the strain on the system is only growing.

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Now is the time to act. The system is bloated, inefficient and unfair — but it can be fixed. By banning network restrictions and removing harmful incentives, we can restore fairness, lower costs and ensure that every American has access to the care they need. Patients, doctors and nurses alike are ready to support bold, common-sense reform.

The stroke of a pen can fix healthcare. Let's do it now!