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Single Payer and the Revolving Door

Another benefit of a single payer national health insurance system is that it gets rid of the obscenity of the revolving door between the health insurance industry and the government payer.

There is no revolving door because there is no door.

There is no door because the health insurance companies are put out of their misery.

One public payer. Everybody in. Nobody out.

If we had single payer, we wouldn’t be witnessing the obscenity we witnessed this month.

Take the case of Marilyn Tavenner.

She’s the Obama official who was in charge of the rollout of Obamacare.

She stepped down from her job in February and will become president of America’s Health Insurance Plans (AHIP) — the insurance industry lobbying group representing the likes of  Aetna, Anthem, Humana, Kaiser Permanente and many Blue Cross and Blue Shield companies.

Taking her place at the U.S. Centers for Medicare and Medicaid Services is former UnitedHealth executive Andy Slavitt.

Don McCanne of Physicians for a National Health Plan (PNHP) says that Karen Ignagni, AHIP’s previous president and CEO, essentially had carte blanche in the White House as Obamacare was being crafted.

“She also was very influential in obtaining the concessions that protected the excess payments to the Medicare Advantage plans, measures which greatly benefit UnitedHealth Group and others,” McCanne says. “It seems more than a coincidence that UnitedHealth Group dropped out of AHIP shortly after the resignation of Karen Ignagni.”

“Without insider information, it is very difficult to determine the degree of control held by each of the players, but there is no question that HHS/CMS, AHIP, and UnitedHealth and the other insurers are all participating in advancing the privatization of Medicare by enhancing the private Medicare Advantage plans with our taxpayer dollars,” McCanne says. “It is particularly disconcerting that this agenda is supported by Congress and the Obama administration.”

“Imagine what those excess funds could do for our traditional Medicare program, especially in reducing out-of-pocket expenses for premiums, deductibles, coinsurance and catastrophic losses,” McCanne says.

“That would be far better than wasting them on the administrative excesses of the private insurers and on the dishonest activities they engage in to increase their profits by measures such as upcoding or gaming risk adjustment.”

Why is there no public outcry?

“It is simply because the Medicare Advantage plans are able to use about one-third of the extra funds to reduce deductibles and coinsurance, making them appear to be superior products, plus there is no need to purchase supplemental Medigap plans,” McCanne says. “Most of the beneficiaries who are satisfied with their private plans would not be inclined to support increased taxpayer funding of the traditional Medicare program since it doesn’t concern them anymore. And efforts to reduce Medicare Advantage funding to the same levels as traditional Medicare are met with loud protests orchestrated by AHIP. Those in the traditional Medicare program usually have supplemental retiree or Medigap plans with which they are satisfied, and thus they are not advocates for change either.”

“It is really difficult to explain to people that what is a good deal for them is a bad deal for all of us together since it perpetuates high costs and extraordinary administrative waste,” McCanne says. “If their programs seem to be working for them, they don’t want change.”

McCanne says that we need to improve the traditional Medicare program so that it is more comprehensive and provides greater value, and then use it to cover everyone.

“Our task is made much more difficult by the powerful forces that support corporate control of our healthcare system,” he says. “After all, they are the ones with the money. And Tavenner and Slavitt will be there as their agents, working inside and outside of the government. And most people won’t care.”

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Russell Mokhiber is the editor of the Corporate Crime Reporter..

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