Executive Summary: Achieving a Healthier America

September 28, 2021


In the United States, the healthcare system exposes serial and chronic policy failure like almost no other area of governance. This is largely because its incentives are all wrong. Rather than improving health and health outcomes for Americans, the healthcare system is directed toward the benefit of well-connected firms, special interests, and big government. With rising consumer costs and diminished consumer control over the past half century, healthcare reform consistently tops the list of the greatest public policy concerns of Americans. Despite having the world’s best medical innovation, specialty care, and scientific discovery, our fractured healthcare system does not serve Americans to its fullest potential. The America First Policy Institute’s (AFPI) Center for a Healthy America seeks to realign incentives to achieve a healthier America that values individuals, choices, and liberty.


The high cost, limited choices, and variable quality of healthcare in the U.S. are significant concerns for the personal health and economic well-being of Americans.

Patients and doctors—not politicians or bureaucrats—should decide what, how, and where care occurs, and individuals should be empowered with full financial control of dollars spent on healthcare.

Because the health of Americans is essential for a thriving and prosperous country, AFPI will create healthcare policies and educate stakeholders to put the patient and doctor in control, dignify life, promote better health and health outcomes, improve access, and lower costs for Americans.


Policy Priorities: The 18 primary policy goals are broken into three categories of better care, more choice, and lower costs, and are explained in more detail in the Center overview paper.


  • Protect people with pre-existing conditions
  • Drive patient control over medical records
  • Promote innovations in treatment for complex and common medical conditions
  • Enhance access to trusted doctors and appropriate care when and where they are needed
  • Enhance pandemic preparedness


  • Educate stakeholders on affordable health plans and alternative forms of coverage
  • Promote individual control of healthcare
  • Expand telehealth for millions
  • Support Exchange flexibilities
  • Increase value-based care


  • Lower prescription drug prices
  • Promote transparent, upfront pricing
  • End surprise billing
  • Align market incentives
  • Understand the impact of consolidation on the practice of medicine and explore solutions
  • Evaluate government policies that impede competition and promote free-market solutions
  • Cut waste, fraud, and abuse
  • Enhance preventive care

Implementation: Through education and research, the Center for a Healthy America will work to return healthcare back into the hands of the American people through:

  • Bold, evidence-based solutions to well-known problems that have been ignored for too long.
  • Implementation of transparency in the costs of care and insurance to avoid unexpected medical bills.
  • Individual agency and full control of how personal healthcare dollars are spent.
  • Improved and actionable healthcare quality measurement, reporting, and transparency.
  • Impactful partnerships with stakeholders to study and inform model policies based on research.
  • Innovation hubs to facilitate private sector resource development based on free-market principles and on free-market regulations implemented over the past four years, such as linking medical records and pricing tools in apps.

Applying a Treatment Plan for Americans: The country’s decades-long debate on healthcare has too frequently maintained the status quo rather than promoting policies that put Americans first. As a result, specific populations and sectors have seen their agency and control stripped away and replaced with onerous mandates and regulations. With this in mind, the Center for a Healthy America has applied a customized assessment and treatment plan, much like the tools used by physicians during an office visit, to four key groups— patients, doctors, employers, and states—in order to facilitate targeted interventions.


The Center for a Healthy America is invested in improving the health of Americans now and for generations to come. We believe this is best achieved by putting healthcare back into the hands of the American people and working every day to deliver better care, more choice, and lower costs. In the long-term, this will empower all Americans—no matter their background, income level, race, or ethnicity—to live healthy lives in order to fully realize their potential and achieve their dreams.