Health care in America should be redesigned Op-ed: We should redesign health care in America. Here's a plan that would help Nebraskans (copy)

In America, you can have health insurance and still not be able to afford the health care you need.

As a nation, we are spending more than $5 trillion a year on health care, yet Americans still struggle to get it in a timely manner. Chronic diseases like heart disease, cancer, and diabetes are major drivers of health care spending and remain among the leading causes of death. Many of these conditions are preventable or can be better managed with earlier detection and treatment.

At the same time, medical costs continue to strain finances. Nebraskan families delay care, skip prescriptions, or avoid the doctor altogether because it's too expensive, too hard to navigate, and requires long drives or stitching together answers from disconnected providers. The problem is not just who pays for health care, it is also how it is delivered.

That is what must change.

I am proposing Whole Health America, a plan to redesign how care is delivered so people can access and use the care they need. It builds on Medicare, Medicaid, employer-based insurance, and Affordable Care Act plans, but makes them work for all Americans by aligning how care is organized, delivered, and paid for.

At its core, Whole Health America makes one straightforward change: primary care becomes the front door to a fully coordinated system. Instead of navigating multiple disconnected providers, patients have one entry point and one care team responsible for their health.

That system brings together medical care, mental health, dental, vision, hearing, and public health as essential services, organized around the patient. Prevention, screenings, and early risk identification become part of everyday care, delivered when they are most effective and least expensive. Care is coordinated across providers, supported by shared information, and guided by clear accountability for outcomes.

Today, a patient with diabetes, anxiety, and a chronic injury might be juggling multiple appointments, bills, and treatment plans that don't connect. Under this model, that same patient has one team responsible for the full picture.

In practice, a patient can walk into one clinic or connect through telehealth and receive a checkup, a mental health screening, and ongoing care through a coordinated team. Their care is connected, follow-up is built in, and they are not left navigating the system alone.

This model expands access by bringing care closer to where people live and work, including rural communities where distance and provider shortages limit access. It strengthens local providers and infrastructure, uses mobile care and telehealth to fill gaps, and supports targeted solutions like a Farmer and Rancher Center of Excellence to address the unique health challenges facing agricultural communities.

Whole Health America lowers costs by fixing what drives them.

First, it moves care earlier. When we catch and manage conditions like diabetes, heart disease, and cancer sooner, we prevent expensive hospitalizations and complications. That is better for patients and significantly less costly over time.

Second, it organizes care around the patient. Today's system is fragmented, with providers working in silos that lead to duplicate tests, conflicting treatment plans, delays, and avoidable complications. Whole Health America integrates essential services into one coordinated system, so patients get the right care, at the right time, without waste.

Third, it cuts administrative burden. Billions of dollars are lost every year to complex billing systems, redundant paperwork, and insurance navigation. By simplifying processes, standardizing payments, and reducing friction between providers and payers, we lower premiums and out-of-pocket costs for families while freeing clinicians to focus on care.

Finally, it aligns incentives with outcomes. Right now, the system pays more when people are sicker and need more services. Whole Health America flips that model. It rewards prevention, early intervention, chronic disease management, and keeping people healthy in their communities.

As a member of Congress, I will act to make this plan reality; launching and scaling coordinated care models through existing authorities, align payment so providers are rewarded for keeping people healthy, and expand access through telehealth, mobile care, and workforce development, especially in rural communities. This approach creates a practical pathway to more affordable and reliable health care by improving how care is delivered. For those currently uninsured, this plan enables health care that is affordable, accessible, and connects them to care earlier.

We have a choice. We can continue to fund a system that reacts to illness after it becomes a crisis, or we can build one that delivers care earlier, connects services, and lowers costs in ways that work for families.

Whole Health America offers a clear path forward, one that moves us toward a system where every American can access affordable, reliable care when they need it. Wellness, not treating sickness, needs to be the goal of health care.

The full detailed plan can be found at kishlaforcongress.com/issues.

Kishla Askins is a retired Naval officer, health care provider and policymaker. She's seeking the Democratic nomination for Nebraska's 2nd Congressional District in the U.S. House of Representatives.