Public Health System No Cure For Ailing U.S., NAHU CEO Says

By Susan Rupe

Single-payer. Medicare For All. Public option.

Those names are thrown around to describe alternatives to the current health insurance system.

National Association of Health Underwriters CEO Janet Trautwein has spent the past few years studying single-payer systems in nations around the world. She shared her insights in light of the current political discussion on single-payer during the NAHU Capitol Conference.

Most European countries that have some form of single-payer vary greatly from the U.S., Trautwein said. For one thing, consumers covered under single-payer plans frequently experience long wait times to access care. In addition, the governments of most single-payer countries are heavily involved in setting the price of care, especially prescription drugs.

Doctors in single-payer countries agree to be paid a lower amount than doctors in the U.S., she said. Medical education is subsidized by the government and there are limits on medical lawsuits, which also contributes to lower costs.

But consumers in single-payer countries often buy health coverage that enables them to access care more quickly.

One proposal floated around in the U.S. is a Medicaid buy-in and public option.

"But a commercial plan can't compete against a plan that uses government-set pricing," Trautwein said. "It would destabilize the individual and small-employer markets and destroy the hospital system.

"The public option does not play on a level playing field. A commercial carrier can't negotiate the same rate as a government plan. It would lead to a death spiral."

A Medicare buy-in also would result in long wait times for care and increased costs, Trautwein said. "Medicare was designed to support a senior population, not everyone," she said.

"Ultimately, we have to let the free market and public programs work together."

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at[email protected]. Follow her on Twitter @INNsusan.