Avik Roy: We can have universal health care without Obamacare

Exam room
A procedure room at the University of Minnesota's Nurse Practitioners Clinic in Minneapolis, Minn.
Jeffrey Thompson | MPR News File

Avik Roy is a prominent national conservative who has a proposal to replace Obamacare with a system that provides universal coverage and is fiscally sustainable over the long haul.

Roy says other countries that rank high in "economic freedom" do have universal health care coverage, and we can too. But he says the longer we wait to solve this problem, the harder it will be.

There's a way to achieve universal coverage that doesn't conflict with the conservative idea of economic freedom, Roy said. In fact, our current system is actually the worst of both worlds. Roy concludes that "we can spend less and cover more people."

Roy presented data to show that medical care in the United States is more expensive than elsewhere because the price of procedures, medications, doctors and hospitalizations are, in many instances, five times higher.

People who worry that increased access to health care, and universal coverage, will increase costs are missing the point. "It's not utilization, it's that the prices we charge for services are higher ... and it's not just drugs, it's everything," he adds.

Roy points to Singapore and Switzerland as possible models for what a market-oriented system can look like, and wonders why America set up a system where "all of us are subsidizing health care for Warren Buffet."

He offers specific proposals to reform the health insurance exchanges, reform Medicare and reform Medicaid. "My twin goal," Roy said, "is to cover everybody, but do so in a way that makes the system fiscally sustainable permanently."

Roy is president of the Foundation for Research on Equal Opportunity based in Austin, Texas, and he's written up his ideas in two white papers called "The Competition Prescription" and "Transcending Obamacare." He's the author of the 2013 book, "How Medicaid Fails the Poor."

Roy has been a health care adviser to Republicans Marco Rubio, Rick Perry and Mitt Romney, and he outlined his proposals in a May 31, 2018, appearance at the University of Minnesota Humphrey School. After his speech, he answered questions from political science professor Larry Jacobs.

To listen to his speech, click the audio player above.

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