Comment by Don McCanne
We dream of a single payer Medicare for All system in which the highly inefficient, fragmented system of a multitude of private and public health insurers is replaced by a single efficient public payer, which would free up close to half a trillion dollars currently going to administrative waste - funds that could be directed to the health care delivery system that will fill the voids we have in health care today. But what happens to our dream when, right under our noses, the current payers become the health care delivery system?
One-fourth of the members of America's Health Insurance Plans - the health insurance lobby organization - are already integrated delivery systems, and that transformation is accelerating. The insurers are rapidly becoming the health care delivery system. And to further solidify this transformation, they are now adding services to address the social determinants of health such as food and housing, as the insurers are "looking at the need to continue to drive financial profits."
Go ahead and enact a single payer Medicare for All, but then how are you going to shut down the private insurers when they are the health care delivery system? If you try to break them up, what do you think our current Supreme Court would have to say about that?
We think that we're in a battle with the private insurers, but now with the grasp they have of the medical industrial complex, it seems they may have already won. We can't give up, but there is great urgency in doing all we can to save the system by reestablishing the primacy of the patient. Right now that profit thing is working pretty well for the insurers, and the patients are just pawns and the providers are the insurers' tools.