Disrupt This: Jettison Medicare and Medicaid.

• Position: MEDICINE AND HEALTH

"Disruptive innovation" is all the buzz. Repealing the Patient Protection and Affordable Care Act is so last year. Well, disrupt this: repeal Medicare and Medicaid and get the government out of the medical care business.

The Federal government appropriately began its involvement in health care in 1798 when Congress established the U.S. Marine Hospital Service. It should have ended with taking care of our soldiers and sailors.

This is America, and the private sector knows what to do. The mid 1800s brought "sickness funds," financed by small wage deductions. In the late 1800s, mining, lumber, and railroad companies created industrial clinic plans that prepaid physicians a fixed monthly fee to provide medical care to employees. Workers were so satisfied with these that they rejected the idea of state-sponsored compulsory insurance.

To guarantee payment in the midst of the Depression, prepaid group plans were established. Hospital and surgical insurance featuring physician choice and fee-for-service payment was introduced. Government policies in the 1940s influenced the growth of employer-sponsored health insurance. Favorable tax treatment and World War ll's wage and price controls led employers to offer health insurance in lieu of higher wages.

The poor were not forgotten. Charity hospitals developed from almshouses that cared for the poor. Public hospitals grew from community efforts to care for those who could not afford to care for themselves.

By 1964, some 80% of Americans were insured privately, with 821 companies offering individual plans. Health insurance was an affordable safety net because most people are healthy most of the time and people took care of their simple medical needs out-of-pocket. The challenge was insuring the poor-risk top five percent of health consumers who spend half of the medical dollars. The government could have--but did not--use the opportunity to encourage the private sector to innovate practical, cost-effective insurance products and launch public education campaigns to invigorate public community hospitals.

However, the 1960s brought us far more than flower power. After an uphill battle fighting images of wizened widows without medical care, the Kerr-Mills Act of 1960--giving Federal funding to the states to help low-income seniors with their medical bills--was passed. This opened the door to a bureaucratic monster that took on a life of its own.

The Great Society's social...