America's health insurers learned an important lesson from the fight for the Affordable Care Act: lay low. They're employing that tactic again, according to a video from a company-wide UnitedHealthcare meeting obtained by The Washington Post.
"One of the things you said: 'We're really quiet' or 'It seems like we're quiet.' Um, we've done a lot more than you would think," chief executive Steve Nelson told an employee, who'd asked about how the company was countering the surge in the Democratic party for a single-payer system. "You want to be kind of thoughtful about how you show up and have these kind of conversations, because the last thing you want to do is become the poster child during the presidential campaign." That means, in the case of UnitedHealth Group, spending $8 million in lobbyists in 2018. Don't worry about their bottom line, though. They made $17 billion last year, so they can afford it.
They were backed up by the industry's trade association, America's Health Insurance Plans, which worked with the pharmaceutical industry to quietly kill the public option proposal the House Democrats had passed in their version of the ACA. AHIP has teamed up with other healthcare industry behemoths to form the Partnership for America's Health Care, which spent $143 million in 2018 lobbying Congress, and is already running attack ads against Medicare-for-all proponents. They're also still fighting a public option in the health insurance exchanges allowing Americans to buy into Medicare.
Having gotten what they wanted out of the ACA (more customers) and having realized that it hasn't destroyed their profits, they want more of it. They're trying to convince Democrats that incremental fixes to Obamacare, "fixing what is broken so that it works better for every American," are the answer. In talking points they've provided on Medicare for all to Nevada Democratic Sen. Jacky Rosen, they argue that it "would be prohibitively expensive" and "reduce the standards of quality and access Americans currently enjoy in their health care."
Americans spent $3.65 trillion on health care in 2018, 4.4 percent more than they spent the year before.
That's far more than any other country and more than $2,000 more per person than the nearest country, Switzerland. For that we've got an increasing maternal mortality rate and for the third year in a row, a dropping life expectancy. That's the longest sustained decline in the U.S. since the years 1915-18, when we had both World War I and the global influenza epidemic.
As much good as the ACA was able to do, it was an incremental fix. All is not well with American health care, and more nibbling around the edges isn't going to solve it. Certainly keeping the profit motive for saving lives at the forefront of the public debate serves no one well. Democrats need to stick to their guns, remember that the American people aren't in love with their health insurers, and they aren't afraid of single payer.