Privatization of publicly funded Medicare and Medicaid, managed care, and “value-based payment”1 have failed to reduce cost or improve population health despite over 30 years of trying, and a new paradigm for health policy is needed. Public funding is appropriate for essential public services necessary for everyone—funded by taxes and paid for with budgets based on cost of operations, with no opportunity for profit or loss. Examples include police and fire departments, public schools, the military, roads and bridges, and government services. Health care should be added to this list. Other industrialized countries with far more cost-effective universal systems treat health care as a public good, not a commodity.

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