Universal HealthcareBy NextBestFit
Phase 1: Enactment & build · Step 1.1

Create the Universal Health Administration

Months 0–18 · HHS Secretary; UHA Administrator (Senate-confirmed, 6-year term, removable only for cause)Discuss this step
politicallikelihood: mediumimpact: medium

Rate-setting captured by providers or politics

Medicare's history shows rates shaped by lobbying (the AMA RUC, SGR overrides).

Early warning signs
  • Overrides of Rates Board
  • Revolving-door appointments
Mitigation
  • Independent board
  • Public data
  • Congressional veto requires both chambers

Implementation risks

RiskMitigation
Agency capture by the providers it pays.Revolving-door bans, public data on every rate decision, and a statutory Inspector General with a dedicated budget.
Under-staffing leads to slow appeals and claims.Administrative funding set as a fixed share of benefit spending, not annually appropriated.