I am very distressed that our elected legislators seem to be headed towards placating their contributors, rather than what they were elected to bring us, accessible and affordable healthcare for all.
Since they seem obsessed by bringing us a not well thought out mess - something like Romney brought Massachusetts, mostly to eliminate the free riders, as the economy crashes sending more and more people into destitution, but they refuse to give up on the model that has most insurance provided by employers, I have been doing some reading on "The Massachusetts Miracle" - I think that its safe to say that the Massachusetts Miracle" has been a disaster for many of the state's residents.
According to the Boston Globe, this all could have been avoided if the legislators had picked a different healthcare model, but instead, they decided to embrace the commercial insurance market. According to a series they wrote in 2008, especially this story, "A handshake that made healthcare history" they could not have made a worse mistake.
"P******* HealthCare was born in 1993, but its powerhouse potential didn't fully hit home until 2000. That's when the emerging giant cut a quiet deal with B******** to ratchet up insurance costs across the state. Nothing in Massachusetts healthcare has been the same since."
Like what happened with Enron and California, any economist can tell you, that any captive market pays extra. Insurance companies are buying up and partnering through "gentlemans agreements" with hospitals throughout the USA. They are doing this in anticipation of increases in government regulation, hoping to monopolize markets like was done in Massachusetts. The price increase situation in Massachusetts will be replicated across the nation if we endorse the private insurance model by mandating the purchase of private OR public "insurance". The insurers will move to buy up and control the provider networks. The only way to avoid these increases in prices is single payer or the nationalization of health care (which might be impractical, but it WOULD control prices. To meet the demand, with access to a national health plan's resources, unlike with single payer, we could increase immigration quotas for physicians from other nations-and institute telemedicine-leveraging the entire world's medical talent to lower prices here in the US!)
That would be the one supplier model.
It might make sense. We really only have the two alternatives single payer, and single supplier. Why? To prevent adverse selection, we need to prevent cherry picking. To prevent adverse selection, we need to "insure" everybody. To prevent an insurance death spiral, we can't let premium costs rise too high, or the healthy and those who can't afford the premiums will choose to pay the fine and become uninsured, while the sick who cost a lot will remain insured, causing huge losses. Whenever you increase demand, there is a risk of price increases. Single payer nations seem to be able to control prices for things such as drugs far more effectively.
Nations that have single payer (i.e. "private option") systems in which people have a right to good quality healthcare and pay extra for options preserve the private insurers but they tend to pay far less than the United States, which already pays the most in the world for everything.
Claims by the US government and US pharma industry that the single payer (they call them "free rider nations") are exploiting the United States's generosity to have us pay for drug research for the entire world while they "free ride" with their low controlled prices are unfounded- See papers proving this here and here
The lack of government oversight has resulted in huge increases in prices paid by consumers. The insurance industry is not about to give up their stranglehold on America's pocketbooks easily or willingly. Empowering them by prolonging their monopolies would be a huge mistake.