Hearing Highlights Dysfunction of U.S. Health Care System, Points to Need for 'Medicare for All'

September 16, 2009

Peter Lurie, M.D., M.P.H., Deputy Director, Health Research Group at Public Citizen

Note: The Subcommittee on Domestic Policy of the Committee on Oversight and Government Reform holds a hearing today and Thursday titled, "Between You and Your Doctor: the Bureaucracy of Private Health Insurance."

Today’s hearing before House lawmakers provides a welcome opportunity to reflect upon the dysfunction of the current U.S. health insurance system. Even as some tout the superiority of the U.S. health care system, they seem to forget the last time they or a family member either had to spend hours sorting out unfathomable private health insurance bills or received a massive bill thanks to private companies’ copays, deductibles or exclusions of those with pre-existing conditions. Similarly, health care providers afraid of a "government takeover" seem to have forgotten the inefficiencies of tracking the requirements of dozens of insurance companies or the time they have spent on the phone trying to ensure that some needed medical procedure was covered.

A typical HMO incurs an overhead of 15 to 25 percent; the overhead for the Medicare program is a comparatively lean 3 percent. Private health insurance companies have such high overhead because their prime method for maximizing profits is to deny health care. To deny the service for which the patient or their employer is paying requires an army of insurance company bureaucrats.

There is an elephant in the room. All these problems could be reduced or even eliminated if there was only a "Medicare-for-all" system, also known as single-payer, for health care in this country.