I can’t tell if Princeton’s Uwe Reinhardt is purposely being stupid or is doing some Borat-like performance art piece about corruption, when he makes this incredibly bizarre argument against trying to adopt single-payer in the United States. From Wonkblog:
“I have not advocated the single payer model here,” he said, “because our government is too corrupt. Medicare is a large insurance company whose board of directors (Ways and Means and Senate Finance) accept payments from vendors to the company. In the private market, that would get you into trouble.”
The key to a single-payer system is that the government sets prices. Usually, it empowers boards of independent experts who set those prices low. Reinhardt’s argument is that in the United States, health industry interests have so much sway over Congress that the prices would end up being set by health-care interests.
First, as mention in the article, Medicare and Medicaid pay lower rates than private insurance. While they are not perfect they still clearly perform better on the cost front.
More importantly, this ridiculous argument makes no sense based on even Reinhardt’s own logic. If you think corporations have too much influence than adding an extra layer of industry would only make the problem worse. This was the problem with Medicare Advantage.
Under the current system most of the private health insurance is still getting much of its money from the government via exchange subsidies or the special tax treatment for health insurance. So instead of only having to deal with health care providers lobbying Congress for extra money we also have another entirely unnecessary insurance industry lobbying for their cut as well.
If you think American law gives corruptions an unduly large corrupting influence, that is even stronger argument for removing as many private middlemen as you can by going with single-payer. Instead, the Affordable Care Act has two worthless middlemen, exchange operators and private insurance companies.
Maybe the real reasons Reinhardt doesn’t advocate for single-payer is because he is being paid by companies like Wellpoint, so single-payer would hurt him financially. I guess you don’t really understand how bad the corruption is here until you experience it first hand.