Grand Bargains Health System Reform: A Proposal for Patient-Centered, Cost-Controlled Universal Coverage

Synopsis of “Grand Bargains”: Fixing Health Care and the Economy (Updated 2025)

Health System Reformation

Grand Bargains health system reform proposes a rapid, fundamental transition to a patient-centered, universal coverage system, government-funded (≥ 67% to 100% of costs), and private funded ≤33% of costs). This plan aims to replace the current fragmented landscape of multiple public and private insurance plans, shifting instead to private, member-owned, self-regulating “Accountable Care Cooperatives” (ACCs). About 2,000 - 5,000 ACCs throughout the U.S. will compete for patients on quality of care and costs to patients.