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New York University Journal of Law and Liberty




The wealth trapped within American health care is simultaneously a tragedy and a miracle. It is a tragedy because stagnating wages, widening disparities in income, ballooning deficits, and stunted investments in education and social services make such medical profligacy shameful. It is a miracle because it still exists, whereas other U.S. economic resources of similar magnitude have already been dissipated by global market forces without addressing any of the aforementioned failings – indeed, sometimes having contributed to them. It therefore can be released and used.

It is time to “frack the health care system” and innovate the de-medicalization of America. The catchphrase for this effort is assuredly not “Repeal and Replace,” the Republican party’s oversimplified solution to the overblown criticism it continues to level against the Affordable Care Act. A better mantra is “Recover and Repurpose” – releasing the value trapped in our underperforming health care system and directing it toward more individually and socially productive ends.

With careful planning and responsible execution, recovering and repurposing the trillions of dollars being spent on low-value medicine can set an example for an economic transition that offers broad distributive and communal benefits as well as efficiency gains. The current condition of American politics compels such an approach. Cast in its best light, the cleavage revealed by the 2016 election cycle was not between the individual and the collective, or even between choice and coercion, but between re-invention and restoration. Moreover, the restorative forces made it clear that becoming “great again” meant recapturing many of the qualities that health care aberrantly if expensively has retained: jobs, nativism, regional fairness, paternalism, and trust.

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New York University School of Law

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