At the recent Democratic debate, Lester Holt asked for a show of hands: Who would end the role of private insurance companies as part of health care reform? Four hands went up – Bernie Sanders, Bill de Blasio, Elizabeth Warren, and Kamala Harris. Other candidates argued for incremental expansions of Medicare within our current heavily private insurance system. John Delaney made a plea to “keep what’s working” – i.e., private insurance that people like. After the debate, Harris muddied the waters a bit, saying she misheard the question, and favored a role for private supplemental insurance.
How do we make sense of all this? In this perspective, I unpack the idea of private insurance – considering benefit design, marketing, financial coverage, and profit status. I examine the potential role of private insurance in Medicare for All (M4A) or single payer health care. Preview: the role is minimal to none.
