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Health Care

Take it from me, tweaks won't fix health care. Democrats should focus on Medicare for All.

Go for dramatic reforms. Health insurance companies are interested in profits, not playing fair. I should know. I used to be a vice president at Cigna.

Wendell Potter
Opinion contributor
In Washington, D.C., on Sept. 13, 2017.

Democrats have secured a 40-seat flip of the House of Representatives, based largely on a nationwide call for health care reform. Many Democrats, led by Brian Higgins of New York, are planning to use their newfound control of the House to work on a Medicare buy-in bill.

I spent 20 years as a health insurance executive before leaving my job as a vice president at Cigna. I can tell you firsthand that by focusing on a half-baked measure like a Medicare buy-in, Democrats would hand a huge gift to the private insurance industry while doing less than the bare minimum to help struggling businesses, workers, families and patients.

When the next Congress starts in January, House Democrats should use their new majority introduce, debate and vote on significant legislation that would assure universal coverage, protect taxpayers, and dramatically transform our health care system: Medicare for All.

The Higgins plan to let people aged 50-64 to buy Medicare coverage does nothing to restrict the ability of insurers to profit from our fragmented coverage system. It would allow insurance companies to continue to control prices for almost everyone under 50, while pushing many of their most expensive-to-insure patients out of their risk pool and into Medicare’s — which shifts the cost onto taxpayers. 

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The Higgins bill would also allow insurance companies to continue to weaken traditional Medicare while profiting from Medicare Advantage plans — private-sector alternatives to traditional Medicare that are now a primary driver of insurance-company growth.

Seven in 10 Americans and 85 percent of Democrats are supportive of Medicare for All. Yet Higgins is pushing a bill that not only would fail to reform the broken American health care system, it would almost certainly pad insurance companies’ bottom lines.

It’s time for Democrats to stop proposing health care reform that relies on insurance companies to play fair. After two decades in the for-profit health insurance industry, I can assure you they never will. They have no interest in doing anything that might in any way jeopardize profits. Their only interest is delivering profits to their shareholders. From that perspective, the status quo is very profitable. For everyone else, not so much.

Champion dramatic reforms, not half-measures 

Business owners are struggling to provide health insurance to their employees, workers' take-home pay is shrinking as their premiums go up, patients are literally begging for their lives on fundraising platforms like GoFundMe, doctors and hospitals are drowning in paperwork dealing with insurance claims departments, and more than 80 million people lack adequate health insurance.  That number is increasing every year. Reform is desperately needed.

Democrats have the chance to be the champions of that reform if they don’t waste their energy on half-measures. Instead of thinking about how they can make small tweaks to the health care system, they should start thinking about how to enact dramatic reforms that will assure universal coverage while reducing costs and encouraging economic growth. Voters and taxpayers are asking for Medicare for All. It’s time to listen.

Wendell Potter, a former health insurance executive, is president of the Business Initiative for Health Policy. Follow him on Twitter: @wendellpotter

 

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