This is the Cato Daily Podcast for Tuesday, January 3rd, 2017.

I'm Caleb Brown.

As Congress debates precisely how and if they'll repeal Obamacare,

there are some actions that state governments can take in the interim to get out from under some of the laws mandates.

Sal Nuzo is vice president of policy at the James Madison Institute.

We spoke in Nashville in October.

I'm not sure exactly where this comes from but there's a phrase you know what good is

money if the store shelves are empty.

Right, so in terms of health care, you draw this distinction between coverage and care.

And the Affordable Care Act focused very much on coverage, not so much on care, and focused

on the promise, which is what coverage is, which is a promise of care, and sometimes that doesn't pan out exactly.

So what are some reforms that states can do that will provide better access to care without regard to coverage.

At the state level there are substantive policy reforms that can move the needle in the direction of providing more market-based

solutions to health care access and health care provision. First and

foremost is the concept of direct primary care.

Direct primary care is truly can be transformative in the health care arena.

And this is where a group of doctors or a practice in an area decide to package a series of services

and what you would typically go to your primary care physician for.

Things like wellness checks, annual visits, blood work, those types of things.

And you essentially pay a monthly fee. It's a very small fee anywhere from

50 to 75 dollars a month and you get all of those services essentially covered

in the context of that subscription fee.

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