Democrats Gave Americans a Big Boost Buying Health Insurance. It Didn’t Come Cheap. | Kaiser Health News

Democrats Gave Americans a Big Boost Buying Health Insurance. It Didn’t Come Cheap. | Kaiser Health News Comment by Don McCanne This article makes an important point. President Biden and his staff, along with Congress, chose the most expensive method of expanding health care - giving more taxpayer funds to the private insurers. There is a bit of sleight of hand here since it is us - the taxpayers - who are paying these higher prices for a health care financing system heavily dependent on private insurers. Why are costs higher when we use private insurers? The author indicates that private commercial insurers pay more for health care services than government programs, and, by and large, that is correct. But that is a relatively small portion of the higher spending by private insurance, and it does not take into consideration that public programs are more effective at setting appropriate prices - costs plus fair margins - not to mention that they use more efficient financing methods such as global budgeting of hospitals. But what has been ignored in this article is the major reason that private insurers are more expensive, and that is administrative costs. Those extra taxpayer funds going to private insurers include costs such as marketing of their plans, costs of contracting for restrictive provider networks, administering prior authorization requirements, complex systems of processing claims including denial of benefits, simple administrative costs of operating large corporate entities, and distributing generous profits to their executives and passive investors. Which of these administrative services do you want to continue to pay for through increased taxes? So these increased costs that the taxpayers are bearing are not just for more health care, but they are a gift to the most expensive and inefficient financing system on earth. Particularly galling is the fact that the administration is presenting this as if it were a gift from the government to the patients, but that government money is provided by us - the taxpayers. Much of it is hidden from view since a large portion of these taxes we pay are disassociated from health care spending. Keep in mind that funds moved into the health care financing system are not available for other important needs such as food, housing, transportation, education, environment, infrastructure, and so on. A single payer Medicare for All program would fill in our health care financing needs without wasting the hundreds of billions of dollars on these superfluous administrative costs of the private insurers, plus their profits. But they are now talking about making these wasteful expenditures permanent. Maybe they might even add a public option, which would be only one more player in our profoundly inefficient system. As the title of Noam Levey's article indicates, the big boost was in buying health insurance rather than simply health care, and it didn't come cheap. As Paul Starr states, we ended up adding on to an incredibly expensive system. We didn't have to do that. We can still redirect our course toward an efficient, equitable system for all. After all, it's our money, and yet progressive taxation makes health care affordable for all since it is simply based on the ability to pay. That is certainly more efficient than playing games with taxpayer subsidies for premiums and cost sharing for expensive, self-serving private insurers.