Most Americans like private health insurance. Fifty-six percent of voters oppose Medicare for All if it eliminates private coverage.
Many moderate lawmakers are well aware of these polling figures. So they’re calling for an expanded version of Medicare — or the creation of a new government-run plan to compete against private insurers.
All these approaches — Medicare for All, Medicare for All Who Want It, or a public option — would be disastrous. Each would raise taxes, reduce quality of care, and eliminate the private health coverage that most consumers have, like, and expect to keep.
Start with Medicare for All. The general concept — extending government-funded coverage to all Americans — polls well. About half of Americans give it the thumbs-up, according to the Kaiser Family Foundation.
That majority support turns to opposition once people learn Medicare for All would ban private insurance. The plan grants the federal government a monopoly on health insurance — no private insurers or employers would be permitted to pay for health benefits.
People are big fans of private insurance. Seven in ten Americans say they’re satisfied with the coverage they receive through work. That’s a lot — more than 180 million Americans have employer-sponsored insurance.
The “public option” aims to assuage fears by allowing people who have employer-sponsored coverage to keep it and giving those who don’t an alternative.
But like Medicare for All, a public option would lead to the destruction of the private insurance market. It’d just do so more slowly.
Most public option proposals envision reimbursing hospitals and doctors at Medicare’s rates, which are artificially low. In 2017, for every dollar hospitals spent caring for Medicare patients, they received only 87 cents in reimbursement.
Those lower costs allow the public option to charge less than commercial insurers, which don’t have the power to underpay providers.
Many Americans would switch from private insurance to the public option. As they did so, hospitals and doctors would raise prices for the privately insured to compensate. Insurers would be forced to hike premiums in response. That would compel even more individuals to switch.
Employers would surely do the same, dropping benefits programs and encouraging workers to enroll in the public plan. A recent study from KNG Health Consulting found that Medicare for America — a proposal that would transfer everyone who doesn’t receive coverage through an employer to a government-run plan — would cause one in four workers to lose access to employer-sponsored insurance by 2023. More than half of employees at small businesses would lose their employer-sponsored coverage.
Eventually, the public option would be the only option.
As Seema Verma, administrator of the Centers for Medicare & Medicaid Services, put it, “The public option is a Trojan horse” for Medicare for All.
Americans would suffer under government-run health care. Robert Pollin — an economist at the University of Massachusetts Amherst — estimates that 2 million jobs across hospitals, healthcare facilities, and the insurance industry could disappear.
A report from the Congressional Budget Office concluded that Medicare for All could “lead to a shortage of providers, longer wait times, and changes in the quality of care.”
That’s a lot of disruption to a health insurance system that works well for most people.
It’d be far simpler — and more popular — to expand access to coverage through our existing private, employer-driven system than to launch a government takeover of health insurance.
Janet Trautwein is CEO of the National Association of Health Underwriters (www.nahu.org). This piece originally ran in Detroit News.
