A Better Way to Spend $2.3 Trillion: How Citizen Health Cards Could Fix America’s Healthcare Economy
The United States now spends roughly $2.3 trillion a year on healthcare through federal programs and tax breaks. That equals about $6,742 for every American, before counting state and local spending, which pushes the figure closer to $9,000 per person. Yet prices keep climbing, paperwork multiplies, and quality remains inconsistent. Most of that money never touches an individual’s hands. It disappears into a maze of premiums, subsidies, and reimbursements that grow automatically, year after year.
Imagine instead that the same dollars were placed directly on citizen health cards - digital accounts funded each year for every adult and child. The balance, controlled by the consumer, could be used to buy insurance, pay doctors directly, or save for future care. Crucially, the government would credit the accounts, not spend the cash, until a citizen actually used it. Unused balances would simply remain on the card, earning interest and building a personal health reserve.
That single change would turn healthcare from an inflation engine into a deflationary marketplace.
The deflationary effect
When consumers control the money, prices can’t hide. Clinics and hospitals would have to post transparent fees and compete for business. Wasteful intermediaries would vanish, and preventive care would flourish because patients could see what it really costs. Over time, when a citizen accumulates enough in their account (say $25,000) they could spend additional allotments on any needs not exclusively healthcare.
This isn’t austerity. It’s efficiency through choice. Competition and transparency drive prices down while rewarding providers who deliver real value.
The AI inflection point
The timing couldn’t be better. Artificial intelligence is already reading X-rays, analyzing labs, and guiding treatment plans for a fraction of today’s prices. But in our insurance-driven system, those savings will simply widen corporate margins instead of lowering costs. In a citizen-credit model, AI’s deflationary power flows straight to the public. Low-cost diagnostic tools, digital triage, and remote monitoring could finally make quality care affordable to everyone. AI is ready to lower costs but only a system that gives consumers control will let that happen. From health inflation to broad prosperity
As citizens save more and spend less on overpriced care, the unspent billions remain in Treasury accounts until used, reducing government cash outflow. Those idle balances effectively lend back to the public sector and strengthen fiscal stability. Meanwhile, individuals who reach self-insurance levels can redirect new allotments toward wellness, education, or home improvements. Employers, no longer trapped by mandatory insurance costs, can raise wages or expand hiring.
The same federal health dollars that once fueled medical inflation would now boost local economies, savings, and entrepreneurship. Every year, the country would grow healthier and wealthier at the same time.
A controllable future
By shifting existing healthcare funding directly to citizens, America could finally make health costs predictable and sustainable. Government spending would remain roughly the same, but it would circulate through a competitive marketplace that rewards efficiency instead of volume. Combined with AI’s coming wave of diagnostic automation, this approach could achieve what decades of regulation have failed to deliver: a healthcare system that deflates in cost, improves in quality, and strengthens the broader economy.
We already spend enough to give every American excellent care. We just spend it in the wrong direction. It’s time to put the dollars, and the decisions, back into citizens’ hands.