Neither the Affordable Care Act, aka Obamacare, nor its much-ballyhooed replacement, the American Healthcare Act, are truly insurance but parts of an inefficient, expensive reimbursement program. Insurance should be for rare, catastrophic and severe illnesses. Most medical care is routine, essential services such as preventative health, minor diseases and the like.

Just like you don’t insure your home for light bulbs burning out, we shouldn’t ensure for basic care we need throughout our lives. My friend, Carolyn McClanahan, who in addition to being a Certified Financial Planner is also a medical doctor, proposed in Forbes (March 10, 2017) a dramatic proposal to improve medical care delivery.

McClanahan’s idea starts with free healthcare delivered by community health centers for basic services. Currently, we can provide basic dental care, mental health and primary care for an average of $1,000 annually per person. Her community center proposal would be much cheaper ($150 billion annually) than we currently spend. Couple this with catastrophic insurance for rare events like trauma or serious illnesses, we could go back to $100 per month premiums, easily affordable.

While people with more financial resources could work with direct providers if they choose, steps should be taken to make sure community center health does not bring inferior care. Spain, for example, already has a community healthcare system in place and they spend much less on healthcare while getting better results than we do.

Easy access to primary care lowers costs, improves productivity and primary care, regularly delivered, mitigates and prevents serious illnesses. Employer insurance costs would drop since they only need to provide catastrophic coverage. A national network of adequately funded community health centers would be a much-improved defense against pandemics and bioterrorism. Think about how much better community health centers would be in the opioid epidemic sweeping the country.

Free sounds bad, but lots of things are free, municipal bond interest and Roth IRA distributions to name a couple. When someone has untreated diabetes, you pay for their treatment through higher insurance premiums. Property taxes often increase to pay for indigent care. McClanahan points out spending $150 billion annually in basic healthcare needs in community healthcare centers would be the proverbial “drop in the bucket” compared with current costs.

We spend more money on healthcare than any other nation, but many of our healthcare scores are far from great. If you have a traumatic accident or a grave illness, the American system is world-class. Currently, we spend healthcare dollars inefficiently. Growing up I saw the interstate highway system expand and I watched when we beat the Russians to the moon. We need leaders who are not afraid to take bold steps like President Eisenhower and President Kennedy did. It is easy and simple to point fingers and blame politicians, but we elect them.

You can’t always get what you want but Buz Livingston, CFP can help you find what you need. For specific recommendations visit us online at or come by our office in Redfish Village, 2050 Scenic 30A, M-1 Suite 230.