Obamacare isn’t what destroyed the insurance market for health insurance.

The damage to the insurance market happened in 1945 with the passage of the McCarran-Ferguson Act.

This is my plan on how to drive health care and health care insurance into the free-market, even for low-income Americans.


Consumers should be able to purchase insurance from every company over the internet.

The problem with the recent act of the House to repeal Obamacare and the Senate bill that failed is that neither bill fixes the health insurance industry. While that’s not Congress’ job, it’s also not its job to screw-up the industry which is exactly what both the 111th Congress and the 79th Congress did.

The job of fixing any industry belongs to the individuals and businesses that make up the industry. They do so by modifying the availability and pricing of their products as recently demonstrated by Aetna. It announced that because it had lost over $700 million it was pulling out of the last two states, Nebraska and Delaware where it had been providing health insurance. “Those losses are the result of marketplace structural issues,” the company said. In essence, the market is all screwed-up.
Aetna’s roots are deep, going back to 1850. It’s a fine company and well respected in the insurance industry by its customers, agents and competitors. Any business person understands that the decision by Aetna’s managers was frustrating and agonizing because they realized that they had failed in their mission.

Congress can learn from Aetna’s decision as it points directly to the 500 pound gorilla in the room, the confusion of the insurance industry that was caused by the 79th Congress when, in the waning years of World War II, 1945 specifically, it passed the McCarran-Ferguson Act and ignored the instructions of our Founding Fathers to “regulate commerce among [between] the Several states” (Commerce Clause) because “Each State would pursue a system of commercial policy … which would beget discontent” (Federalist No 10) and “terminate in serious interruptions of the public tranquility.” (Federalist No 42).

Congress punted its responsibility to provide the most trusted choice of consumer protection – a free-market – to the states and created the cronyism and that manages the insurance industry today.

My plan to “Repeal and Replace” Obamacare is 38 pages long and relies on federal regulation of the insurance industry, the anathema of free-market thinkers like myself. Okay, few people want to read three pages of anything, especially something on the topic of insurance. But, the core problem that we consumers face today is the 56 sets of laws and regulations that make it impossible to buy insurance in a market disciplined by consumer decisions. And, that is exactly what Aetna and other health insurance companies have told us by their actions.


My plan starts with a standardized health insurance policy, morphs into federal or dual regulation of the business of insurance, identifies how health savings accounts can control health care and insurance costs and establishes a single, industry run system and methodology for addressing pre-existing conditions, insolvency protection, etc.

The bills considered do not adequately provide for the market discipline needed for controlling the rising cost of health care or health insurance (i.e. consumer protection), do not fix the problem of buying insurance across state lines, do not address how pre-existing conditions can be insured without bankrupting insurance companies and do not create a plan for driving low income Americans (Medicaid recipients) and other governmentally insured individuals (Medicare and Veterans) into the insurance marketplace.

Both House and Senate bills attempt to tweak all sorts of issues. One of my favorites is how winning the lottery affects an individual’s ability to receive assistance from the government. The bills focus on the intricacies, the minutia of governmental assistance. But, neither bill applies the most proven method of consumer protection, a free-market, for controlling costs and availability of both health care and health insurance.

Under my plan and following the concept of the Weights and Measure Clause of the Constitution, a single health insurance policy would be the only health insurance policy (format, terms, conditions, exclusions, etc.) that would be allowed to be sold in the US. Thus, the insurance buying public … you and me … will finally understand what the heck we’re buying.

Insurers would voluntarily offer other forms of insurance that are related to health insurance such as disability insurance, long-term care, dental coverage, term life insurance and even burial insurance right on their health policy. They could even manage the funds of our Health Savings Accounts and tied to our deductibles and co-pays.

It’s time for us to demand that Congress move health care insurance into the 21st Century and allow us to buy insurance in the same way we shop on eBay, Amazon, use Uber, Airbnb, etc. It is time for a single set of rules.

About the Author

Michael J “Mike” Bowler is a small business consultant who sept over 30 years in the excess and surplus property and casualty insurance industry. Today, Mike sells machinery to the plastic injection molding industry and continues to provide management consulting to a variety of small businesses on projects such as compliance reviews, contract dispute management, marketing and business planning, business turnarounds, etc.