Republicans have been apprehensive about health care since the Obamacare Repeal debacle in 2017. For their part, Democrats will never stop trying to end private health insurance and force everyone into a government-controlled system. If we want to avoid that fate, Republicans cannot cede the issue to Democrats — especially when the public is more favorable to GOP ideas on how to fix the system.

New polling by Public Opinion Strategies on behalf of Americans for Prosperity shows that more than 4-in-10 voters say the healthcare system isn’t working for them. That’s a big deal and should set off alarm bells across Washington. In fact, the 40% threshold has usually preceded big attempts at changing the system, e.g. Obamacare and Hillarycare.

Voters are pretty clear about how they’d like to fix the system — and it’s not by injecting more government into it. Rather, they want more competition and increased personal control over their own healthcare. When asked to choose the better way to lower healthcare costs, for example, 71% prefer “giving Americans more choice and control over their own healthcare” versus just 29% who support “increasing the government's role in regulating and subsidizing healthcare.”

Six-in-ten say Washington should focus on “getting rid of government rules that deny Americans access to more affordable types of healthcare arrangements.” Only 39% believe that Washington should focus on “creating a government-run health insurance plan that is available to all Americans.”

No matter how the question is asked, voters choose competition and personal control over a one-size-fits-all government approach.

If Americans think that healthcare is in rough shape now, things are only going to get worse. Cost pressures are increasing across the system and the issue will soon be back front and center in the political debate whether politicians have the appetite for it or not. Hospitals face labor, drug, and supply pricing pressures, and as these price hikes are factored into the new contracts that determine what consumers and insurance plans pay, costs will skyrocket.

In addition, Americans are putting off care due to cost, which leads to sicker patients who cost more to treat down the road. Nursing strikes for higher pay are becoming routine. There is a doctor shortage that will only get worse. Rampant hospital mergers are leading to higher prices. The average cost for employer health care is projected to increase 6.5% just this year. In some states, individual-purchase insurance is expected to rise by up to 20%.

As we discovered with COVID, big-government enthusiasts will never let a crisis go to waste, but instead will use any emergency to expand central planning. When healthcare costs explode, they will be ready. Will Republicans? Without an alternative, the Democrats’ “free healthcare” will look more appealing to Americans in desperate need of a solution.

Clearly, Democrats are growing ever more committed to a complete government takeover of healthcare. In 2013, Democratic support for a government run healthcare system was 52%; in 2022 it was 72%. In 2020 polls of Democratic primary voters, a majority in every state but South Carolina said they support a single-payer system, which means abolishing all private coverage options and putting Uncle Sam in charge. Democratic candidates for president will feel obliged to support single-payer in 2024 because that is where their base voters are.

Thankfully, though, many rank-and-file Democrats are not quite so ideological. For example, when asked to choose between Medicare for All and the Personal Option plan that gives Americans everything they say they want, voters choose the Personal Option by almost two-to-one (66%-34%). Democrats were essentially split right down the middle, with 51% choosing Medicare for All and 49% choosing the Personal Option. It is hard to find a healthcare plan with as much broad-based support as the Personal Option.

The Personal Option is popular because its core components are popular. For example, Americans want Health Savings Accounts that let them save for medical expenses tax free and shop for value. They want more direct patient care, an exciting new subscription-based model that gives them direct access to their favorite doctors for things such as affordable doctor visits and lab tests with no annoying insurance or government middlemen. They want more competition and an end to the big corporate hospital monopolies. In essence, the Personal Option gives Americans the control, affordability, and peace of mind they crave and deserve.

If Republicans ignore the warning signs and continue to shy away from healthcare, they will end up where they usually do on the issues: playing defense. The Personal Option is their ticket to finally go on offense with a plan that is not only effective but extremely popular.

Dean Clancy is senior health policy fellow at Americans for Prosperity.