This came up in last night’s debate. It’s being discussed in the pre-debate programming. It will come up in tonight’s debate. So maybe somebody can explain why a majority of the Democratic presidential candidates are going out of the way to say we should still have private health insurance. I guess I can understand the political argument that people are afraid of change. But from a policy perspective is there a legitimate preference for private insurance?
Here is what I would say if I asked why we should get rid of private health insurance.
Who wouldn’t want public health insurance?
First, let’s talk about patient choice. Public insurance would create a single provider network. That means you would have access to any participating doctor, specialist, hospital or clinic in the country. That is true freedom of choice for patients.
Second, let’s talk about the cost of expanding coverage. I believe every American is entitled to high-quality, affordable health care. With that as our goal, how do you create the lowest cost-per-person? By having the largest possible risk pool. There is no larger risk pool than public health insurance. Maintaining private insurance along with public health insurance would only serve to fragment the population into separate risk pools. Unless we want to go back to the days where private insurers are allowed to deny access to their risk pool based on preexisting conditions and other health risk factors (I certainly don’t want that, do you?) public health insurance will result in the lowest possible cost while providing the most possible coverage.
Third, let’s talk about the costs of health care services provided. Who would you rather have negotiating prices with providers and Big Pharma on your behalf? A private insurance representative with the leverage of 10 million people behind them OR a government rep representing 300 million people?
Fourth, let’s talk about what for-profit health insurance companies are doing in exchange for the roughly 20% of our premium dollars that they get? Private health insurers used to keep an even higher percentage before the Affordable Care Act set limits. Medicare can process and pay claims using only 3 to 5%. So what are private insurers doing with the other 15 to 17 cents out of every premium dollar they receive? They are paying their executives a heck of a lot of money. They are going on corporate retreats in exotic locales. And they are sharing the remaining profits with their wealthy shareholder.
So, who wants to keep private health insurance? Not me.