Blog Debate: Final Word on Private Insurance

by Don McCanne · 2009-03-12 18:37:00 UTC
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Editor's Note:  This is the second day of a blog debate about what approach we should take on health care reform in 2009 will be Dr. Don McCanne, a retired family physician now serving as Senior Health Policy Fellow for Physicians for a National Health Program, and Jason Rosenbaum, a writer and activist, and the Deputy Director of Online Campaigns for Health Care for America Now! Dr. McCanne will be presenting the "single-payer" point of view, and Mr. Rosenbaum will be presenting the "public competitor" point of view.  You can read the first day's exchange here.

This is Mr. Rosenbaum's final rebuttal to the question: Is there anything valuable that private insurance brings to the table which, with far more muscular federal regulation, would enhance an American universal health care system?

Read Dr. Don McCanne's original answer to this question.

Read Jason Rosenbaum's response.

Jason Rosenbaum and I do agree that today’s private insurers have failed to cover everyone, have failed to provide affordable comprehensive plans, have wasted too much money on administrative excesses, and have devised innovations to avoid paying for care. We disagree that regulation would be enough to enable level competition between private plans and a public option. If the playing field were truly level, the debate is over, because private plans could never compete, as the Medicare Advantage program has proven.

We agree that public insurance is more stable, more able to control costs, and better at ensuring access for all. The alleged advantages of private plans – greater flexibility in benefit design and payment strategies – are not advantages, but rather disadvantages. Having the flexibility to reduce benefits and shift more costs to the patient is precisely what we need to move away from.

Jason says that this is not the time for idealism, and I agree. Crafting a flawed program merely to satisfy the pro-market ideologues is the wrong approach when what we need is the pragmatic approach of enacting a program that actually works – a single payer national health program.

In his rebuttal to Question 1, Jason said that we should not let the perfect be the enemy of the good, but why on earth would we want to let the mediocre be the enemy of the perfect?

Don McCanne
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