Few of us need convincing that the American health insurance system needs reform. But many of the existing proposals focus on expanding one relatively successful piece of the system or building in piecemeal additions. These proposals miss the point.

As the Stanford health economist Liran Einav and the MIT economist and MacArthur Genius Amy Finkelstein argue, our health care system was never deliberately designed, but rather pieced together to deal with issues as they became politically relevant. The result is a sprawling yet arbitrary and inadequate mess. It has left 30 million Americans without formal insurance. Many of the rest live in constant danger of losing their coverage if they lose their job, give birth, get older, get healthier, get richer, or move.

It's time to tear it all down and rebuild, sensibly and deliberately. Marshaling original research, striking insights from American history, and comparative analysis of what works and what doesn’t from systems around the world, Einav and Finkelstein argue for automatic, basic, and free universal coverage for everyone, along with the option to buy additional, supplemental coverage. Their wholly original argument and comprehensive blueprint for an American universal health insurance system will surprise and provoke.

We've Got You Covered: Rebooting American Health Care (Penguin, 2023) is an erudite yet lively and accessible prescription we cannot afford to ignore.

John Emrich has worked for decades years in corporate finance, business valuation and fund management. He has a podcast about the investment space called Kick the Dogma.

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