Robert Reich: Single-payer healthcare inevitable
Former Labor Secretary Robert Reich explains why it’s just a matter of time before we have single-payer healthcare.
Click here for reuse options!The best argument for a single-payer health plan is the recent decision by giant health insurer Aetna to bail out next year from 11 of the 15 states where it sells Obamacare plans. Aetna’s decision follows similar moves by UnitedHealth Group, the nation’s largest health insurer, and by Humana, another one of the giants.
All claim they’re not making enough money because too many people with serious health problems are using the Obamacare exchanges, and not enough healthy people are signing up.
The problem isn’t Obamacare per se. It lies in the structure of private markets for health insurance – which creates powerful incentives to avoid sick people and attract healthy ones. Obamacare is just making this structural problem more obvious.
In a nutshell, the more sick people and the fewer healthy people a private for-profit insurer attracts, the less competitive that insurer becomes relative to other insurers that don’t attract as high a percentage of the sick but a higher percentage of the healthy.
Eventually, insurers that take in too many sick and too few healthy people are driven out of business.
…In the short term, Obamacare can be patched up by enlarging government subsidies for purchasing insurance, and ensuring that healthy Americans buy insurance, as the law requires.
But these are band aids. The real choice in the future is either a hugely expensive for-profit oligopoly with the market power to charge high prices even to healthy people and stop insuring sick people.
Or else a government-run single payer system – such as is in place in almost every other advanced economy – dedicated to lower premiums and better care for everyone.
We’re going to have to choose eventually.
Copyright 2016 Liberaland
28 responses to Robert Reich: Single-payer healthcare inevitable
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mea_mark August 24th, 2016 at 15:25
Single payer is coming as well as a basic income. The question I see is, will we nationalize the drug companies so they can’t charge whatever they want for drugs that help people? The fleecing of the people so a few can get rich beyond what is necessary in any way shape or form is going to have to end if we are truly going to become an evolved society. How long do we really want to live as a primitive society?
StoneyCurtisll August 24th, 2016 at 15:26
Great question~!
arc99 August 24th, 2016 at 15:38
I do not see any Constitutional way to nationalize drug companies. Even in Britain with its single payer NHS, the pharmaceutical companies are all privately owned.
Japan has a system where hospitals by law cannot be owned by private corporations. But even that restriction would take decades to phase in here in the United States.
I think our best bet in this country is the “Medicare for All” approach. That would give us a single payer option. Then with millions of people signed up, maybe then there would be greater negotiating leverage with pharmaceutical companies on costs.
mea_mark August 24th, 2016 at 15:47
I bet eminent domain could be somehow used. If the people will it, I think just about anything can happen.
StoneyCurtisll August 24th, 2016 at 15:26
Single Payer is how it should have been all along….
I would be happy to pay a deduction from my paycheck to pay for my healthcare…
Right now I’m paying almost $80 a week from my wages, and then I have to make a co-payment and not everything is covered by my private insurance company…
Gary Parillo August 25th, 2016 at 03:39
Single payer is what it should have been all along,but it has been dominated by mega rich lnsurance companies and utter corruption for decades.It is failing not because of Obama,as the liars on the right try to convince the populace,but because it has been based on greed and profit.I will say the dirty word,a socialized system is what has been and is needed,as functions in every other indusrialized nation on earth.Making obscene profits for the 1% off the misery of the suffering,is evil at its very core.
Mike August 24th, 2016 at 17:57
I’d like to see single payer for no other reason than to put every healthcare insure out of business.
Sadly, this is nothing more than greed and journalism at it’s worst…allowing a corporation to claim poverty when profits are up 7% from 2015 (which was up 17% from 2014)
Here is a link to this years 3rd quarter profits
https://news.aetna.com/news-releases/aetna-reports-second-quarter-2016-results/
And a link to 2015’s profits for the 2nd quarter
http://www.modernhealthcare.com/article/20150428/NEWS/304279979
So can someone please explain how a corporation that made $2.23b (a 7% gain) in profits last year gets to claim hardship…???
Aetna has found a way to once again “pick” their clients rather than abide by the spirit of Obamacare and insure those who might actually need medical care…
Single payer can’t come fast enough
Suzanne McFly August 24th, 2016 at 18:38
Weren’t they going for single payer to start off with but had to modify to attract more conservative democrats?
Mike August 24th, 2016 at 19:11
It was doomed from the start simply because it would of put thousands out of work…it’s also why we pay more than any country in the world for healthcare…PROFIT …
amersham1046 August 24th, 2016 at 20:51
Just starting to cap medical costs-
EpiPen CEO hiked prices on two dozen products and got a 671% pay raise – https://www.theguardian.com/business/2016/aug/24/epipen-ceo-hiked-prices-heather-bresch-mylan
Budda August 25th, 2016 at 09:08
For profit hospitals and for profit insurance companies are not in the health ‘care’ business. Their purpose is to make money not give people health care. So it comes down to; is health care a “right” or is it a for profit business? When it is ever decided that it is a “right” then the government can take over the “business” of health care….for all.
Jimmy Fleck August 25th, 2016 at 09:48
Health care can never be a “right” because it involves someone else providing something for you. What happens when there are too many people that need healthcare and not enough doctors to provide it? Is it your right to demand more people become doctors? Is it your right to insist they work for less money or no money at all? What I predict will happen if we institute a single payer system is soon after the healthcare industry will divide again to where those that can afford private care above the costs of the single payer system will have access to doctors that opt out of the Medicare for all system. There will be no waiting for their services but you will have to pay cash up front. The Medicare for all services for the 95% of the rest of us will have long wait times for basic medical needs.
Budda August 25th, 2016 at 11:34
So all those countries that have single payer have a failing health care system? Don’t think so Skippy.
Jimmy Fleck August 25th, 2016 at 12:16
They are definitely not in the best of shape – http://www.reuters.com/article/us-across-the-world-idUSBRE99S14U20131029
Budda August 25th, 2016 at 14:28
So if the system isn’t cost efficient what should we do? Let people die? If the poor can’t pay for insurance let them die in the streets? Do you have a solution?
Jimmy Fleck August 25th, 2016 at 14:59
I don’t have a solution. I was just stating what I expect to happen if a single payer system is initiated in America. What do you think the tax rates would need to go to to fund Medicare for all? Currently Medicare as designed is running a large deficit and will run out of money somewhere down the road while only providing healthcare to those over 65. And don’t expect that you would only need to tax the “rich” to pay for this either. If you look at the European tax rates to pay for their systems everyone pays at least 20% of their income towards healthcare. Are we going to institute a 20% tax bracket for the poorest people in this country?
Budda August 25th, 2016 at 15:06
Well the system we have right now in America cost at least twice as much as single payer systems and we get a lot less for it. So the way I see it, single payer is more cost efficient, serves all and is the most moral and ethical way to go.
Bunya August 25th, 2016 at 13:33
You bet. America is the BEST place for optimum healthcare – if you can afford it. Unfortunately, that doesn’t include the middle class and poor.
Jimmy Fleck August 25th, 2016 at 14:54
Currently it does include the middle class at least those that were reasonably healthy enough to qualify for insurance. What will happen with a single payer system is the middle class will be forced into the government run system while the ultra wealthy will be able to afford their own private system. Overall middle class people will be paying more for inferior healthcare.
Bunya August 25th, 2016 at 15:36
You’re right. The middle class will be paying more for inferior healthcare, because that would be all they can afford. They’d have no choice because the rich are running the country and calling the shots. It’s not uncommon for a person to spend 2 days in the hospital and walk out with an exorbitant $300,000 bill? Why? Because hospitals are greedy, for profit corporations that can charge whoever they want, whatever they want.
amongoose August 25th, 2016 at 12:06
National Healthcare is going broke in England, how will your system avoid that, the English pay more in taxes than we do, they don’t have the money to pull it off, you think we do?
http://www.telegraph.co.uk/news/health/news/10162848/NHS-is-about-to-run-out-of-cash-top-official-warns.html
Bunya August 25th, 2016 at 13:30
Of course not. All of our tax dollars are tied up in defense spending.
amongoose August 25th, 2016 at 13:37
Which Europe benefits from by not having to spend on defense, they could, and did spend theirs on social causes like “free healthcare”, and still with that they are going broke.
Bunya August 25th, 2016 at 14:12
So what do you suggest? Let people who can’t afford the extortion prices for-profit doctors and hospitals charge (yes, Catholic hospitals are FOR PROFIT) die? The reason healthcare is going broke is because of runaway greed. Pharmaceutical companies are charging over $100/each for a pill that costs .25 to manufacture. They’re basically saying to people who need their medication, “we have the medication you need to save your life – but it’s gonna cost you – a LOT.”
amongoose August 26th, 2016 at 10:33
There’s more than a few villains here. You forgot insurance companies, HMO’s, hospitals, lawyers, and the lobbyist who write bills (like the ACA and the rest).
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As healthcare got better it got more expensive due to research costs and, new equipment among other things.
How do you think the costs could be lowered?
The ACA didn’t work, and price controls seem to have no effect.
Bunya August 26th, 2016 at 10:54
No, healthcare got more expensive due to greed, but they blame it on healthcare costs. The system is broke and there’s no way to lower costs because the fat cats are running the show and the politicians are their actors, being controlled by the dollar signs in their eyes.
amongoose August 26th, 2016 at 11:19
If you can’t lower costs how will it ever be affordable and accessible by all?
Not even a government can afford that.
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When a third party (insurance companies) pay the bill no one pays attention to cost, if it’s perceived as “free” or “someone else is paying”
there is no incentive for cost control on buyer or seller.
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One thing that would help is if insurance companies could sell across state lines, more competition makes the price go down, and there is no real competition in the market now.
A medical savings account (that they could keep tax free if unused) would offer the consumer an incentive to shop around for the best deal.
amongoose August 28th, 2016 at 12:33
Another factor in high drug prices, monopolies, drug companies have no free market competition, the drug approval process makes sure of that and when you have a monopoly you can set any price you want.
http://jama.jamanetwork.com/article.aspx?articleid=2545691