Introduction
The Reality Check-Up explores the merits of market-based solutions versus government interventions in the U.S. health care system.
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The Daily Dish
Reality Check-Up
Even with a new president in the White House and a new administration in the executive branch, the left’s assault on the U.S. health care system continues unabated.
Insight
Single-payer Health Care Wait Times: A Feature, Not a Bug
Patients in single-payer systems typically have significantly longer wait times for services than patients here in the United States. Why? In short, long wait times are a feature, not a bug, of single-payer systems.
Insight
Quality Care in Perspective: Children’s Hospitals
Both private and single-payer systems prioritize kids' care, but their quality differs. The U.S. leads in top children's hospitals, a key metric of effectiveness.
Insight
The Dangers of Single-payer Systems for Cancer Patients
Cancer is one of the most ubiquitous health challenges facing people around the world. Cancer incidence rates are rising, with a projected 35.3 million cancer cases worldwide by 2050. The United States’ mix of public and private payers has typically ensured that Americans have much speedier access to innovative and specialized cancer treatment than those living under single-payer systems.
The Daily Dish
The Return of Senator Sanders
At the moment, the Washington, D.C. world is engaged in a fake debate over deficits and controlling spending, with Congress and the administration collectively pretending they will turn from the path of debt accumulation – without touching Social Security, Medicare,…
Insight
Cost Ineffective: Pricing a Single-payer System
Executive Summary Over the past decade, there have been various proposals to change the U.S. health system to “Medicare for All,” a type of single-payer system. Single-payer health care systems – those for which the government is the sole payer…
The Daily Dish
A Good News Change of Pace in Health Care
This Eakinomics is not about tariffs – just trying to swim against the media tide. Instead, it will flag two recent pieces of writing on U.S. health care that are in the spirit of AAF’s Reality Check-up. The first, by…
Insight
Quality-adjusted Life Years: A Single-payer Tool That Leads to Discrimination
Executive Summary Quality-adjusted Life Years (QALYs) are commonly computed as outcomes for health policy analysis and cost-effectiveness analysis to facilitate treatment and value comparisons across diseases and populations, attempting to balance treatment investment with quality of life. As employed by…
Insight
Single-payer Systems: Access to Rare Disease Treatments Is Not Guaranteed
Executive Summary Breakthrough therapies for rare diseases often face long delays in coverage by single-payer systems due to strict cost-effectiveness evaluations. The disparity in treatment of rare diseases between single-payer systems and the United States is pronounced; treatments for rare…
Insight
Cancer Care in the United States Is Unrivaled
Executive Summary In 2025, there is estimated to be more than 2 million new cases of cancer in the United States; the continued increase in cancer prevalence presents a complex care challenge for the health care industry. The United States…
Insight
The Inflation Reduction Act Is a Trojan Horse for Single-payer Care
Executive Summary The Inflation Reduction Act was meant to be a significant step in increasing affordable access to the United States’ top-tier health care system by decreasing the out-of-pocket expenditures and capping the price of highly utilized drugs in the…
Insight
Most Favored Nation Drug Pricing: Inviting Unnecessary Harm Upon American Patients
Executive Summary The president issued an executive order yesterday to align prescription drug prices in a most favored nation pricing scheme – which would require drug companies to charge U.S. patients the same price they charge in the country with…
Insight
Assessing State-level Single-payer Health Care Prospects
Executive Summary Colorado recently enacted legislation that commissioned a study to evaluate the coverage and cost implications of implementing a single-payer system in the state. A similar endeavor was attempted in Vermont in 2011, when the legislature passed a bill…
Insight
The Slow Creep Toward Single-payer Health Care
Executive Summary The adoption of a single-payer health care system is often framed as a one-time, revolutionary event, but there is reason to suspect that the real path to single payer is the incremental displacement of the private sector. From…
Insight
Single-payer Systems Rely on Reductive Criteria for Care Decisions
Executive Summary Health technology assessments (HTAs) are evaluations used by health care payers to determine the value of various health technologies and interventions such as treatment protocols, pharmaceuticals, and medical devices. These assessments are reductive determinations of whether a patient’s…
Insight
The Negative Implications of a One-size-fits-all Approach to Health Care
Executive Summary Single-payer health care systems impose a one-size-fits-all policy approach to the necessarily personal issue of accessing health care, intended as a recipe for equity but, in reality, is a ticking time bomb for system failure. This one-size-fits-all structure…
Insight
Medicare Advantage, Fee-for-Service, and the Value of Competition
Executive Summary Rising premiums are a reminder that the most efficient Medicare model is one that blends access and affordability with market discipline – Medicare Advantage. The structure of Medicare Advantage mirrors many of the strengths of the employer-sponsored insurance…
Insight
Shutdowns Show Why Government-run Health Care Is Risky
Executive Summary Since October 1, 2025, when federal discretionary appropriations lapsed and the government entered a shutdown, the federal health care system began operating on autopilot: While Medicare and Medicaid programs are financially operating, necessary health care administration processes such…
Insight
The Dangers of Price-Setting Endeavors
Executive Summary While most pharmaceutical pricing debates have been focused on most-favored-nation price-setting and direct-to-consumer pharmaceutical purchasing channels, the larger and more significant issue of Inflation Reduction Act (IRA) Medicare price-setting has been unfolding in the background. The IRA drug negotiations are only one piece of the price-setting puzzle,…
Insight
US/UK Economic Prosperity Deal: An Inadvertent Case Study Into the Dangers of Single-payer Health Care
Executive Summary The recently announced “agreement on pharmaceutical pricing” between the United States and the United Kingdom (U.K.) resolves an outstanding policy item of 2025; in exchange for tariff relief from the United States, the U.K. will work to address…
