Why mixing Medicare with commercial insurance is not the health reform we need

At a gathering last weekend in Burlington, Vermont, convened by the Sanders Institute, with support from National Nurses United, I spoke about the perils of giving people the choice between Medicare and commercial insurance. We need improved Medicare for all, one single federally administered health plan that meets everyone’s needs.

To maximize profits, commercial health insurers, including Medicare Advantage plans have to steer clear of delivering good affordable care to people who most need care, people with complex or disabling conditions. They don’t compete to deliver better care at lower cost for people with costly needs and never will. It’s not in their financial interest.

Think about it. When was the last time you heard Aetna, or UnitedHealth boast about its great cancer or stroke care or say “Join us if you have heart disease?”

Commercial health insurers too often design their networks so that they don’t include the top cancer center or other centers of excellence in a community. They want to keep people with cancer and other costly conditions from signing up with them. Have you ever heard of a health plan that says if you need costly care, you can use top doctors and hospitals with low costs? That’s the one we all want. That’s Medicare for all. You can’t get that from a commercial health plan.

Here’s why. If a group of people got together to offer the best commercial health insurance, with a robust network of the best hospitals and doctors, they would be out of business before they opened their doors. Everyone needing costly care would join. They couldn’t spread costs across healthy and sick. And, they couldn’t afford to deliver needed care. And, that, in a nutshell is why commercial health insurers will never meet our needs.

There is no way to create a level playing field between commercial insurers and Medicare. Commercial health insurers will always game the system if there is a public option and people have the choice of traditional Medicare. Only if there is a single payer, as with improved Medicare for all, can you pool and broadly distribute costs, rein in spending, and guarantee everyone good coverage.

Commercial health insurers force people to gamble with their health and their savings. If you’ve ever wondered why you have little or no clue what you’ll pay for your care with your health insurance, it’s not your fault. They do not tell you.

Commercial health plans are designed specifically to not meet everyone’s needs. Their narrow networks, arbitrary delays and denials of care and high out-of-pocket costs penalize people who need costly care and keep people from getting needed care.

We need to end systemic bureaucratic waste and profiteering in our health care system. Commercial insurers drive up administrative costs and pocket profits for their shareholders rather than investing in their members’ needs, let alone the public health. They don’t look out for the long-term collective health of Americans.

We need a transparent single-payer health care system so we understand what’s working and what’s not working and the government can drive systemic improvements. Commercial insurers hide their data, claiming it’s proprietary. Their financial incentives are not aligned with the public good.

If you support Medicare for All, please sign this petition to Congress.

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