Sen. Ron Wyden (D-Ore.) has introduced legislation, the Healthy Americans Act (HAA), that purports to guarantee “universal, private health insurance for all Americans.” He has garnered support for this legislation from Andy Stern, president of SEIU and founder of the Change to Win Coalition, as well as Ron Pollack of Families USA and Steve Burd, CEO of Safeway.
The HAA is, in fact, one of the most radically destructive proposals ever put forward to address the failings of the American health care system.
It would eliminate the system of employer-based health insurance on which more than 90 percent of the insured depend today and replace it with a system of individually-purchased private insurance overseen by new state-based “health help agencies.” For the first two years after the program went into effect, employers who now provide insurance would be obligated to add those funds to their employees’ wages. After that, this obligation would end, though all employers would be required to pay “shared responsibility payments” to the federal government to help subsidize premium payments for low-income individuals. All of us would be required to purchase private insurance, with subsidies scaled to our income level.
No regulation of the private health insurance industry is proposed. Instead, according to literature from Wyden’s office, “the Healthy Americans Act relies on competition to drive down costs and promote quality.” Nothing in the plan would make competition among the private insurers work any better than it has in the past. In fact, the standardization of plans envisioned in the HAA might well lead to even further concentration in an already highly concentrated industry where two corporations, United Health and Wellpoint, dominate the market across the country.
Why should those millions of Americans who now receive insurance from their employers, including the members of labor unions which fought for decades for those benefits, be willing to give up this coverage for the uncertainties and inequities of the private for-profit insurance market? In the face of continuing increases in the cost of health care exceeding general inflation as well as the growth in average wages, why should workers want to take over responsibility for paying for their health care?
Andy Stern, one of the supporters of this plan, has asserted that the employer-based insurance system is “collapsing,” but he has identified the wrong culprit. It is not the employer base that is collapsing, it is the entire system of private insurance which is becoming increasingly unaffordable as it reveals itself incapable of stemming the rising cost of health care or assuring access for everyone. Not only can the complex, fragmented, wasteful and unreliable health insurance industry not control the cost of care; numerous studies have shown that it adds 30 percent or more to the cost of care through unnecessary and duplicative billing, marketing and administrative costs.
Instead of moving backwards to a time before there was employer-based insurance, when everyone was on their own to get health care, we should be moving forward to recognize health care as a necessary public good that should be a public responsibility. We should be expanding and improving the Medicare program, which we know provides reliable, cost-effective coverage for millions of Americans today and has been doing so for more than 40 years. Publicly administered Medicare for All, not private for-profit insurance, is the only path forward if we want a system that will truly create healthy Americans.
Len Rodberg is research director, N.Y. Metro Chapter of Physicians for a National Health Program.