By Susan Rupe
February 26, 2019
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 atSusan.Rupe@innfeedback.com. Follow her
on Twitter @INNsusan.
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