My colleague Dr. Robert Graboyes encourages us to instead think about how to produce better health (not health insurance—not even health care) for more people at a lower cost, year after year. This requires allowing and fostering the kind of revolutionary innovation in the health care industry that we’ve seen in other fields, like information technology. It requires allowing consumers to choose treatments, even high-risk ones. But it also requires innovation in the provision and payment of health care.

For instance, advancements in gene therapy and personalized treatments could one day offer a cure for cancer or disorders currently considered incurable, sometimes with only a single injection. In 2017, the Food and Drug Administration approved its first gene therapy treatment, Kymriah, for acute lymphoblastic leukemia. The FDA expects 10 to 20 cell and gene therapy approvals annually by 2025.