By Dr. Sanjeev K. Sriram
Common Dreams, June 12, 2019
When I talk to friends, family, and colleagues about Medicare for All, sometimes someone asks, “but don’t people like their insurance?” It’s not hard to see where they got that idea. America’s Health Insurance Plans (AHIP), the leading lobbyist for the for-profit insurance industry, says 71 percent of Americans “like” their private health insurance. It’s important to scrutinize the messenger and the message here. If McDonald’s told us that 71 percent of their customers said their food was healthy and nutritious, we’d be reasonably skeptical at the very least.
When independently surveyed, only 16 percent of Americans trust the health insurance industry to put patients before profits. The only group we trust less is Big Pharma (only 9 percent believe these corporations prioritize patients). So how do we make sense of all this? Do people really “like” health insurance plans sold by such untrusted corporations?
As a physician who regularly haggles with insurance companies, I have many four-letter words for that industry. “Like” is not one of them. Similar to millions of Americans with private health insurance, I have paid absurd co-pays, premiums, and deductibles to different insurance companies over the course of my career. I am certain I have never “liked” private health insurance the way I like comic books or the way my wife likes spin classes. I begrudgingly tolerate private health insurance (for now). The same goes for my patients, colleagues, friends, and family. Out of fear of financial ruin, we have allowed ever-increasing portions of our paychecks to go to health insurance companies.
Four in ten Americans with employer-sponsored health insurance say their family is struggling to pay premiums, medical bills, or out-of-pocket medical costs. Half of us have a family member who is avoiding necessary medical care or prescriptions because of cost.
Of Americans reporting problems paying medical bills, 73 percent are cutting back on food, clothing, and other basic necessities. Over six in ten of these everyday Americans have already depleted what little savings they had. One in three GoFundMe crowdfunding pages is directed toward paying for health care. For millions of patients and families, private health insurance is a source of, not a savior from, financial hardship.
As a physician and public health policy adviser, I used to believe the insurance industry would become better partners in our health care through the very reasonable guidelines and expectations set by the Affordable Care Act. Over the last several years, I have lost faith and accepted the insurance corporations for what they are: machines of unappeasable greed, accountable only to shareholders, never my patients or other families. In 2018, as millions of Americans borrowed $88 billion to pay for health care, 62 CEOs of health care companies made a combined total of $1.1 billion in compensation. When it comes to our current health care system’s priorities, patients are no match for profits.
We do not have to live like this. Thousands of physicians, medical students, nurses, and our colleagues across health care (but sadly, not the American Medical Association) are joining the Medicare for All movement because we want our work to be about protecting people’s health, not destroying their wealth.
Dr. Sriram completed his medical degree and his pediatrics residency at UCLA, where he served as Chief Resident at the Department of Pediatrics. In June 2009, he earned his Master’s in Public Health after completing the Commonwealth Fund Mongan Fellowship in Minority Health Policy at the Harvard School of Public Health. He currently practices general pediatrics in southeast Washington, D.C.
Sanders on Medicare for All: ‘People don’t like insurance companies, they like their doctors’
By Zack Budryk
The Hill, June 16, 2019
Sen. Bernie Sanders (I-Vt.), a 2020 presidential candidate, defended one of his signature policy proposals, Medicare for All, on “Fox News Sunday.”
“Medicare itself is far, far more popular than our private insurance,” Sanders told Fox’s Chris Wallace. “People don’t like insurance companies, they like their doctors and they like their hospitals.”
Public Opinion on Single-Payer, National Health Plans, and Expanding Access to Medicare Coverage
Kaiser Family Foundation, April 24, 2019
Would you favor or oppose a national Medicare-for-all plan if you heard that it would do each of the following?
- 58% – Eliminate private insurance companies
- 27% – Guarantee health insurance as a right for all Americans
How important is it that a national plan….?
Percent stating very or somewhat important
- 98% – Covers all Americans
- 97% – Simplifies the health care system
- 89% – Eliminates monthly premiums
- 88% – Eliminates out-of-pocket costs like co-pays and deductibles
- 83% – Shifts what people pay for health care to taxes
- 67% – Eliminates private health insurance companies
By Don McCanne, M.D.
One of the most common reasons given for rejecting single payer Medicare for All is that individuals would lose their choice of continuing with the health plan they receive through their work. In fact, without supporting evidence, it is frequently claimed that people want to keep the plans they have rather than being forced into a one-size-fits-all program in which government bureaucrats dictate your care. Of course, the one size that is all inclusive is the size that most of us would prefer, and Medicare bureaucrats do not intervene in the physician-patient relationship.
Some polling has suggested that support for Medicare for All diminishes when told that private insurance would be eliminated. The KFF poll cited indicates that 58 percent would be opposed to elimination of private plans. The problem is that not enough information has been provided. When asked about a series of features of a national plan, two-thirds believe that it is important that the national plan would eliminate private health insurance companies. Other features strongly supported include universality, simplification of the system, eliminating monthly premiums, eliminating copays and deductibles, and shifting the financing to the tax system. When individuals know more about the details of single payer Medicare for All, they become even more supportive.
The point is that people do want to have their choice of physicians and hospitals, as they would under Medicare for all, but those choices are limited by the provider networks established by private insurers. They do like their doctors and hospitals that they have personally chosen, but they don’t “like” their insurers to which they are often assigned by default, especially when the insurers fail to protect them against financial hardship.
So do not let opponents of single payer infer that individuals like private plans better than Medicare for All when they haven’t been given the facts. The list in the KFF poll of what people think is important is a good place to start when describing what people really do like in health care financing.
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